ABSTRACT
Davis (1999) earlier highlighted the importance of awareness of our nursing values and ethics, particularly contrasting those from individualistic cultures predominant in North America and Europe with collectivist cultures found throughout Africa, Asia, and South America. In collectivist cultures, constituting 70% of all cultures, loyalties of the
individual to the group can outweigh individual rights. In individualistic cultures the rights of the individual are central, and must be balanced against the common good. Although this draws a simplistic dichotomy, these dierences in cultural values inform many of the perceived ethical conicts faced by nurses working across culturesinformed consent, end-of-life decision making, rights of human subjects in research, health-care rationing. ese dierences in cultural values also inform the relationships with patients that are at the very center of the nursing process. Crigger (2008) reected on the development of global nursing ethics based on a methodology of inclusive decision making, balance between the rights of the community and the individual, the use of reexivity (i.e., the ability to reect critically), openness to new approaches to human rights and freedoms, and a realistic view of business and technology. Globalization is described as “a process by which the world is interdependently organized and understood . . . the process is discursive and holistic, and will in turn aect people economically, psychologically, spiritually, politically, and culturally” (Crigger 2008: 19). Like Allan and Ogilvie (2004), Crigger argues that nursing is uniquely placed to address health disparities that are oen rooted in social and economic disparities. A theory of mutuality (based on Galtung 1975; Hayhoe 1989; Xu, Xu, Sun, & Zhang 2001) provides a framework for approaching collaboration with sensitivity to the context of diering cultures and value systems. Galtung (1975) suggested that the principles of equity, autonomy, solidarity, and participation could oset the exploitation and dominance characterizing imperialism in international relations. Hayhoe (1989) and Xu et al. (2001) expanded on these ideas, applying them to activities such as knowledge transfer and partnerships to promote education. In partnerships framed by mutuality, processes of agreement on goals and structure are equitable, with interactions symmetrical and horizontal rather than vertical and imbalanced. e principle of autonomy is demonstrated by mutual respect. Solidarity is dened as the networks of interactions that allow participants to critically use and disseminate the results of the partnership. Finally, the theory of mutuality assumes the possibility of full participation of all partners from the beginning. is framework can be used to suggest structures and processes to guard against dominance of one partner and identify strategies for encouraging the partnership’s success.
