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April 2010, Volume 40 Number 4 , p 18 - 19


  • Susan A. Salladay PhD, RN


I'm caring for an 86-year-old Tibetan woman who speaks very little English, according to her son. When I talk with her, she always nods in response to my questions and statements as if she's agreeing. When I enter her room, she greets me by clapping as though she's glad to see me, but she never smiles or speaks directly to me. Her son voices all her treatment decisions, so I'm not sure whether he's expressing her wishes or his own. No Tibetan translators are available in our small town. How can I be sure my patient's truly giving informed consent for her treatment?—F.C., BRITISH COLUMBIAUnder these circumstances, it's unlikely that this patient is truly giving informed consent. But that doesn't mean that she isn't able to give informed consent. She needs your help as her advocate.Ethically, nurses are obligated to provide culturally competent nursing care. The outstanding work of Madeleine Leininger, founder of the transcultural nursing movement,

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