It is relative. In a world of increasing cultural diversity, it can seem that everything is indeed relative. But should we concede that there is such thing as right or wrong, and no objective truth? In this paper, I will examine the relevance of relativism in nursing practice especially in the care of new immigrants. By using cultural relativism and its implication on cultural competent care as the focal point, I will capture the most important insights to the nursing profession in the context of relativism. As a recent Canadian immigrant with deep roots in cultural belief and spirituality, I was often challenged by novel ideas, and I experienced conflicts of social, cultural, moral and ethics outlooks. In response, I continually sought negotiation of these conflicts and, most importantly, began to appreciate the meaning of diversity and the significance of balancing the cultures of the two societies I have lived in. As I started learning about different worldviews and why we behave the way we do, I began to think about the idea of absolutism and rigidity to one’s way of life, and my perspective has been significantly transformed. I now strongly believe that viewing the world through the lens of relativism not only encourages tolerance, it also improves the nursing profession by enhancing the ways in which we deliver care to new immigrants-especially people with deep cultural and moral values, which might not be applicable to the society they are immigrating to.
As a result of increased migration to North America, the concept of relativism has occupied a prominent place in the health care. In fact, it is quickly becoming a persistent theme in undergraduate nursing both in theory and in practice. The constant recurrence of relativism singularly indicates its relevance in the nursing field, and thus it is important to have a general understanding of what it is. The idea of relativism arises out of an acknowledgement of the existence of differences in attitudes and beliefs, and at its most basic, relativism is the view that cognitive, moral or aesthetic norms and values depend on the social or conceptual systems that emphasize them, and therefore it is impossible to maintain a neutral standpoint in evaluating them. Despite varying philosophical positions on relativism, it is a dominant concept in many other disciplines including Nursing where relativism guides care giving attitudes and beliefs. Before we can fully understand relativism in nursing, it is crucial to examine its history and to further dig deeper into its concept.
History of Relativism
Protagoras was quoted by Plato as saying, “The way things appear to me, in that way they exist for me; and the way things appears to you, in that way they exist for you.” This statement was the first mention of the idea of relativism as documented. The statement encapsulates the whole idea of relativism in that it implies that there is no one single truth applicable to everyone; instead, there are personal or individual truths. We all see the world from different perspectives and our realities differ, therefore there are things that are true for some people but are not for others. In this light, Protagoras implies that nothing is false. Despite the recognition of Protagoras as the pioneer of the relativistic thought, indications of relativism have been present before him. Due to contact between the Greeks and other civilization such as Babylonians, Egyptians, Scythians, Thracians and Indians through trades and war, they observed differences in customs and arrangement social and political institutions and realized that societies operated in a different way from theirs. For example, Egyptians practiced familial intra-marriage-usually between brothers and sisters-however the Greeks considered this an abomination. In addition to the influence of other cultures on the Greek culture, the emergence of the concept of relativism in Greek thought is also as a result of the intellectual waves predominant in Greek as the time. Furthermore, conflicting schools of thoughts within the intellectual sphere led many to think that there is no just one truth, thus breeding thoughts and idea of relativism. Other earlier philosophers that contributed to relativistic thinking included Xenophanes and Heraclitus. Xenophanes made a clear distinction between what is relative-human knowledge- and what is absolute-divine knowledge. Heraclitus, on the other hand, advocated the doctrine of the unity of opposites, and his beliefs are summed up in one of his aphorisms, “The road up and the road down are the same thing.” Other early philosophers also contributed to relativism, but Protagoras is attributed as pioneer of the concept and leader of subsequent philosophers who contributed generously to the definitions and varieties of relativism in modern days.
What is Relativism?
According to the Wordnet by the Princeton University, the term relativism as a worldview in philosophy is the philosophical doctrine that all criteria of judgment are relative to the individual involved. The Webster online dictionary defines it as a theory that knowledge is relative to the limited nature of the mind and the conditions of knowing. Relativism holds only when more than one term or position are involved. That is, it is impossible to a position to be relativist if it is the only position-where there is relativity, there is at least a two-term relation. In addition, a relativist position cannot be assumed when considering absolute properties. For example, properties such as gravity and dimensions in space are absolute and entirely dependent on the subject. On the other hand, relative properties are dependent on additional background factors. Interestingly, it is position for something to have absolute properties but still be relative. For example, if someone is five feet tall, such a person is, in terms of pure metric measurement, five feet tall-there is no relativity in that property. However, that person can be regarded as tall in certain places or cultures and can be regarded has extremely tall in some places or cultures. Thus, If I say that something has a property in relative fashion, I might mean my attribution of that property to be understood in a comparative manner. Rorty defines “relativism” as the view that every belief on certain topics is as good as every other. Each culture and person does things and belief things based on their experiences in life. Every decision, statement, actions we take in life is related to one thing or the other. It is often related to thoughts we have processed before those decisions or actions, but these thoughts cannot be isolated from some factors.
Relativised properties often only implicitly involve a reference to background factors (such as social or cultural background); however, we cannot determine whether the property in question is present or not if these non-explicit background factors are not specified. Relativism should be distinguished from pluralism. Pluralism is the claim that for many questions in the domains of metaphysics, aesthetics, ethics, and even science, there could be more than one appropriate answer. The pluralist, like the relativist, rejects absolutism and monism but does not accept the relativists’ claim that issues of truth, right and wrong, etc., can be arbitrated only relative to and in the context of their cultural or conceptual background. For the pluralists, in many domains and situations, there can be more than one correct context-independent evaluation and description. Relativisms come in two broad flavors- the skeptical and the permissive. Sceptism, which means no point of view is privileged, no description is true, and no assessment of value is valid. Where permissiveness means that all points of view are equally privileged, all descriptions are true and all assessments of value are equally valid. Both skepticism and permissiveness stand in opposition to absolutism, which means there is an objective truth. As mentioned earlier, different forms of relativism exist, and these shall be revisited after the examination of how the worldview of ‘relativism” will aid in our understanding of immigration.
Relativism and Immigration
In every society, there are certain important life events that are predictable and normative therein and that demand some major and lasting personal change from the individual. These events are often-but not always-connected with a biological change of life such as puberty, maturity, and parenthood. In contrast to these transitional events, there also exist other critical life events, which are less prevalent and less predictable, and which place extreme demands on the individual for personal change and adaptation. These extraordinary experiences include intercultural transitions, particularly those associated with international migration. A multifaceted, complex and consequential event, intercultural migration poses special challenges as a subject of scientific inquiry. At the same time, it provides a unique window for viewing processes of change and adaptation. In this section, I will be discussing the issue of migration and the importance of a relativistic worldview in evaluating and comprehending differing positions. Relativism as a worldview gives the host country and caregivers a better understanding of how to relate and communicate with migrants. Migrants might think that they could move freely from one context, epoch, culture, language or personal point of view to another taking their beliefs, customs and moral principles with them, unchanged. On the other hand, people from the host country might think that they could bring themselves to bear upon the beliefs, customs and moral principles of the inhabitants of other cultures. In addition, migrants might think that they could, with just a bit of an effort, understand the beliefs of others in their new environment without ambiguity, adopting the customs of other cultures and living their lives to the full extent. However, the possibility of such cultural transplantings and excursions makes sense only if certain fundamental conditions on the means of establishing a sufficiently reliable translatability between languages, or, what amounts to the same thing, one universal language into which the statements couched in any language can be made by anyone in any possible circumstances.
With all these problems of transferability and adopting of others culture or upholding to one’s own culture, Relativism serves as a means of relating to another way of life without denigrating or causing harm to the overall person. A vivid example of this is the migration of a woman from a part of Africa where female genital mutilation is still being practiced to the United States where this practice is viewed as highly barbaric. The migrant woman retains the belief that female genital mutilation (FGM) is a respectable tradition that makes women faithful to their spouses or partners, and she might attempt to continue the practice because of its value; however, the law will thwart her attempts because FGM is a criminal act in the western society. Therefore, should migrants be allowed to uphold their beliefs and practices even though these acts might have realistic consequences in the host country? Personally, I don’t believe in FGM, and I think it is a barbaric act that should be put to an end; however, I ask myself, how do I know that FGM is a barbaric act? Why should I criticize people holding such beliefs? In Kant’s words, our knowledge of this world comes from the environment where we are most socialized. Hence, the practice of FGM might actually be good, but because I was socialized in an environment or culture that shows disapproval to FGM, I might believe otherwise. It is very important to try to understand where people are coming from by seeing through their perspective of life because there is no absolute truth, and our views about life, beliefs, and practices are true for us only-not for everyone else. Immigrating from different places results in cultural interactions, which brings a lot of social issues to think about especially in health care. For example, most of the health care personnel in Canada are educated in there and, of course, will judge things based on the knowledge of things they have acquired through education and personal experiences in that culture. When they encounter immigrant patients, they might face situations whereby they are exposed to another culture, and that is why a relativistic worldview should guide our thinking because it will help us interpret life events from the perspective of others. Looking from the relativism lens might not have a high degree of significance for people that are exposed to similar cultures such as the Western culture; however, it is very important when considering migrants from developing parts of the world where certain values and beliefs are still held as scared. Most migrants are usually healthy, but for them to continue to be healthy and patronize the health institutions, health care givers must have the understanding that what is true for these people is not necessarily true for them, and therefore they must not be judgmental in their caregiving. Even a little thing as taking migrant patient’s advice, sometimes, pays off and enhances the understanding of diagnoses. For example, a malaria patient who had just come from Africa might have information, based on experience, which can help with diagnosis of the disease. However, since malaria is not prevalent in Canada, a Canadian physician might find it hard to diagnose. If the physicians takes little information like “I think I have a malaria” from the patient, there is prospect for faster disgnosis. It is unfortunate, however, that caregivers do not usually listen to the migrant patient, and this affects the relationship between the new migrant and the health care personnel when it is eventually found out that malaria was the problem.
Relativism and Nursing
This section will examine the importance of relativism in the nursing profession. Nursing profession since its inception has frequently been confronted with challenges of one form of transition or the other. For example, nurses have been sent to different countries through missionary and war. Increased interaction with other cultures poses great problems if not approach with relativism. The lens of relativism provides a good worldview to help the profession face the overwhelming challenge of immigration, which is a form of transition. Nurses are to be advocates for people undergoing transitions, and we must understand that people come from different background, speak different languages, and view life very differently than we do. We must also have the understanding that there are no absolute truths and that people have knowledge based on their environment. This perspective, if adopted, will help in caring not only for migrants but also for the various clients nurses encounter each day. Although some believe that other people have different ideas and realities, they also believe that theirs is better. It is important for nursing professionals to know that their beliefs, culture or thinking are not superior to their patients’. Moreover, it is important to pay attention to the overall well being of the patient as new immigrant are sometimes not able to express themselves because of their experiences in life such as having a refugee status. In a study conducted with Muslim mothers in Newfoundland, the mothers all said caregivers don’t understand what they are going through and don’t even seem to care to do that because they feel that their religion are better off than theirs. This shows that caregivers sometimes have a stereotype mindset about some group of people and, sometimes, they act as if they are superior. The nursing profession should be a caring profession that upholds equality in care-no matter the patient’s belief. Seeing patient’s truth, culture and way of life as equal to that of the caregivers; not oppressing people that one thinks are of inferior beliefs compared to such caregiver will go a long way to help this noble profession. The health care system philosophy of unitarianism might seem to contradict the underpinning of relativism because one of the thesis of this worldview is that there is no absolute truth, which does not agree with the thesis of utilitarianism, which is that we have to do things for the good of the majority. The majority, most of the time, are people who are born in Canada or have been most socialized in a western society. This puts the immigrant population at risk because the philosophy of the society does not support their own truth because they are the minority. In reference to the aforementioned example of FGM, there are evidence to believe that the practice is not healthy and therefore not supported in this society, but we are not to condemn immigrants who wants to practice this because they also believe that this particular practice is good and beneficial to their children. Therefore, using a relativism lens, we are not to denounce their practices because it is not truth to us.
Kinds of Relativism
Relativism comes in many varieties. That is, there are different kinds of things about which we can be relativists. We can be relativists about morality, about knowledge, arts, culture, language and so on. Although, every form of relativism is slightly associated with each other, it is important to distinguish between different forms we can encounter in our daily lives. The most common forms are cultural, moral and epistemological relativism. I shall examine the meaning of various forms of relativism; however, this paper will focus more on cultural relativism and what the attitude of nurses should be towards a person undergoing multiple transitions-different forms of transitions including immigration and childbirth.
According to the Stanfordâ€¦â€¦â€¦.. Moral relativism is the philosophical position that morality is relative and that people ought to aim to be good, however just by following his or her personal consciences. There exist diverse local conceptions of what are morally good and different systems of laws in which at least some of these conceptions are entrenched. Ethnic groups have differing opinions over matters such as punishment for murder, aborting fetuses, stem cell transplant. Moral relativists will hold the opinion that many of these are irresolvable in moral terms. They believe that there are no universal moral standards to which all ethnic moralities and legal systems must be subjected. This is because morality is not about what is true and false in an empirical sense, but rather about what we hold as good and what is less so. David Hume holds the view that judgement on moral issues is not about the search for truth; it is about the search for the good. Moral relativists have argued if it has any role to play in the nursing profession, and the consensus is a resounding yes. Moral relativism is connected with a normative position about how we as health care providers ought to think or act towards those with whom we morally disagree. This view purports on the contrary that we should tolerate instead of being judgmental of client who disagree with what we feel is morally right. Moral relativism will help in understanding that there are deep and widespread disagreement between cultures and how people view life. I will argue that health care providers should understand that truth or justification of moral judgments is not absolute, but relative to some group of persons.
Epistemic relativism is a claim about epistemic justication. Epistemic justification
is contrasted with pragmatic justication. The intuitive idea is that the epistemic
justication for a belief is constituted by evidence for the truth of that belief. It
is a consideration that counts in favor of that belief being true. Epistemic relativism, also called cognitive relativism, is the one of the hardest to grasp; it is simply understood as relativism about knowledge, and it is derived from the Greek word, Knowledge. The claims of epistemic relativism are very similar, structurally, to those made by a moral relativist. Thus, an epistemic relativist claims that: All knowledge claims are true (or false) only relative to some standard, and this standard cannot itself be known to be true. Thus, epistemic relativists believe that our morality is no better than other tribes’, but also our science is merely one local system of knowledge among others. Epistemic relativists are usually cultural relativists; hence, they hold that every belief system reflects the way of life or the culture of a particular people and none can be said to be better than any of the others. As mentioned earlier, all forms of relativism are linked to each other, thus generally speaking, epistemic relativists are also moral relativists. If we cannot have absolute knowledge about the subject matter, then we cannot have absolute knowledge about morality.
After careful discussion of previous section, we can conclude that relativism is based on the thesis that refutes any form of absolutisms or the position that there could and should be universal agreement on matters of truth, goodness. So a relativist may accept that in any given culture or society, there can be no more than one correct view on any topic but deny that one single correct norm or belief can apply cross-culturally.
Cultural relativism is the view that all beliefs, customs, and ethics are relative to the individual within his own social context. In other words, “right” and “wrong” are culture-specific; what is considered moral in one society may be considered immoral in another, and, since no universal standard of morality exists, no one has the right to judge another society’s customs. Cultural relativism is widely accepted in modern anthropology. Cultural relativists believe that all cultures are worthy in their own right and are of equal value. Diversity of cultures, even those with conflicting moral beliefs, is not to be considered in terms of right and wrong or good and bad. Today’s anthropologists consider all cultures to be equally legitimate expressions of human existence and to be studied from a purely neutral perspective. The argument goes that although we may prefer the aspects and values of one culture to another, and give reasons for doing so, we cannot say with any degree of certainty that any culture is better than the others. In this context, culture is a big word and includes things like religion, political system, economic system, educational system, gender relations, dietary habits and preferences. One example surrounding childbirth is that some cultures don’t believe in giving their babies name before the seventh day of birth. These cultures have this belief because in the olden days, according to the forefathers, mortality was high, and since there was no guarantee for survival, babies are not given names until the seventh day of birth in order to reduce the sadness that might accompany the loss. This type of culture is related to the health care situation, which can be, in turn, related to the economic system of a country. Another example from my culture is that women are not expected to be seen in public till the 40th day after delivery; therefore, before they can move freely about, they have to come to church to bless this child. This belief can be traced into Christian religion where Jesus was seen in public only after the 40th day of birth. These examples affirm how culture can be traced to some function of the society. There are other factors tied to the culture of the environment in which nurses work. These factors are very important in understanding how a culture of an environment can affect how people view the health care providers. These include cultural, technology, knowledge, language and communication, postpartum factors.
Every other factors that will be discussed is related to culture. Culture, apart from being unique, also means different things to people. While a person in a group can hold their culture as being sacred, some people feel it is not significant. People may ask questions like “why did you live your country if you feel you have to uphold your cultural values”? But using relativism lens, there must be understanding surrounding that not only are cultural norms not the same but people are also different even within cultures based on their educational level and exposure. An immigrant coming as a refugee is different from one coming to study. Education, as study shows, have effect on how a person behaves, thinks and live. An example is that giving birth in a foreign country implies going through a life event with little or no access to your own traditions. Therefore, healthcare providers should not only provide cultural sensitive care but also have an understanding that there is nothing like “the best culture” and that someone is fortunate because they are having a baby in the country where they were most socialized. Having this kind of attitude guides caregiving and also improves culturally sensitive care. In Somalia, for example, there are different roles for each gender during childbearing. A study looking at the difficulties experienced by Somali women in Sweden raised the issue of roles for each gender surrounding childbirth. According to Somalian culture, men do not take any active part throughout pregnancy and are not expected to be present during delivery, but when they got to Sweden, they go through something unique and unfamiliar. They had become pioneers in finding adequate role divisions in a new gender structure, going beyond their traditional limits for expected gender behavior. The men were first to enter a field, which had earlier been both hidden and forbidden, to them. The majority of the men were first -time visitors to the antenatal clinic and delivery unit, and it was definitely the first time they had watch their wife give birth. Not only are some of the men sad at this change in role, the women themselves felt it wasn’t part of the role of the men to see “disgusting things” like blood and helplessness as the women are bedridden for the duration of the childbirth. Nurses should be aware of these differences in traditions, and policies that emphasize the presence of the partner during childbirth should not be enforced to everyone giving birth. Men who are comfortable with this role change and are willing to take part should be assisted with their new role, while men who still feel strongly about their traditions should be left alone and alternatives should be given to help the women through childbirth. Health care providers should not judge or enforce what seems right to them; instead, they should support the family through their own traditions and cultural beliefs. This is one of the reasons cultural relativism is appropriate for patients with different cultural beliefs than the one they are presented with.
Knowledge, which is defined as the facts, feelings or experiences known by a person or a group of person or a state of knowing, is mostly related to where one is most socialized, and it is invariably related to the culture. People come to know this world and to know what is right or wrong by what they have learnt. Therefore moving out of one’s society where one’s culture is predominant to another where one’s culture is only slightly regarded could be painful depending on the circumstances. During the period of transition, migrants encounter things, which may contradict what they had thought was true and right to them. How they come to terms with this clashing worldviews will affect whether they would have successful or unsuccessful transitions. An example is that in a country like Nigeria where epidural is used by 4% of the population. Even midwives are not taught in school about them because of the widespread belief that epidural will affect the love women have for their babies. During childbirth, shouting and screaming is very common in the intrapartum ward, therefore an immigrant coming from Nigeria who has had previous knowledge about epidural myths will be reluctant to have it. In addition, such a person will not be happy if the nurses are inpatient with her and give her choices of epidural when she feels that she is exhibiting the norms of childbirth in the society where she came from. It is important to note, though, that there are personal differences and sometimes, educated people might be more open to try options available. Caregivers must try and support people undergoing this form of transitions associated with culture and should be open to them. They must not disregard their cultures because of bias or believe that their way of doing things are superior to those of migrants undergoing these transitions. Another example would be lack of knowledge about migrant religion and cultural practices, in a study byâ€¦â€¦.. Muslim women in Newfoundland expressed several needs related to religion. One way to address this need using relativism insight is to have health care providers develop knowledge and skills in cultural competency by respecting their modesty during physical examination. Such expectations are especially important to many Muslim women throughout their maternity care. Since Muslim women are not a homogenous group, it is more honest, respectful and appropriate to inquire about an individual woman’s needs and expectations directly from them. However, a diversity responsive setting would ensure that procedures that respect all women’s modesty needs are implemented and enforced.
Language/ communication factor
Some people argue that not only do we have cultural relativism but also language relativism, which is not often talked about. Language is an essential component of cultural relativism. Language across culture is different and what is right for A might not be right for B. In fact, language and ways of communicating across cultural groups are not new, and there are many ways in which a knowledgeable group communicates. An example is the use of eye contact as a means of communication. Some cultures will argue that lack of eye contact means lack of confidence, while others will argue that it is disrespectful to maintain eye contact with elderly persons. Using a relativism standpoint, both groups are right because there is no absolute truth and one language is not superior to another. The truth about communication depends on what each groups think is the norm for them. Therefore as health care providers, how can cultural relativism help in giving a centered care for migrant? We should develop a mindset that one culture should not interfere or intervene in another culture from a supposed position of superiority. Instead, care should be given in a culturally sensitive manner and patients should be encouraged to communicate in the way they feel most comfortable and not be looked down upon if the caregiver perceives any form of communication barriers.
Cultural values ties to the technology available for a group of people or where the migrants are coming from. For example, a migrant coming from London or the United State might not have a lot of cultural taboos compared to one coming from Sudan. This might be because the technology accessible to migrants in their home countries or societies is tied to the economy of that country. Therefore, the culture also can be said to be associated with the technology that the people can access in a particular nation. Countries that have many cultural values attached to processes usually lack technology, and this can be a source of various forms of traditional beliefs. As technology