Procedures that are performed throughout healthcare practice may be limited in different situations when a patient’s culture or religious beliefs do not permit this procedure from taking place and other alternatives must be pursued. In other situations, the head of household, typically, the male, is the only individual who is permitted to make healthcare decisions on behalf of the patient. Under these circumstances, it may be difficult for healthcare providers to obtain a decision that is in the patient’s best interests if the patient is female or the decision-maker does not understand the patient’s health status.
In these cases, any patient who is not the head of the household is not permitted to participate in any decision-making regarding his or her health status, which is likely to be confusing, frustrating, and even perplexing from the perspective of the healthcare provider. It is the responsibility of providers, however, to make decisions that are in the best interests of their patients, taking familial decision-making into account during this process. Nonetheless, these circumstances may lead to serious dilemmas at the practice level when the two sides are not on the same page in regards to a patient’s current condition and related health needs.
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It is important to identify the specific characteristics that impact decision-making when the male head of household is responsible for making healthcare decisions for other members. In some faiths, such as the Muslim faith, many women are not in favor of males making their primary healthcare decisions and would prefer to be involved in these decisions; furthermore, they may desire female healthcare providers whenever possible (Walton, Akram, & Hossain, 2014). It is necessary for individual patients to recognize that they should be involved in making decisions in regards to their own health and must demonstrate their understanding of the key factors which impact decision-making at a high level (Walton et al., 2014). These efforts may have a positive and meaningful impact on decision-making, particularly for females, as they may face difficult challenges in their efforts to make decisions regarding their own health and wellbeing that could have lasting effects on patient care.
The concept of shared decision-making regarding healthcare is important because it provides the patient with a greater opportunity to have a say in his or her own healthcare moving forward (Legare et al., 2014). This practice, however, is less than ideal in cultures where males serve as the head of the household and the primary decision-maker for all decisions, including healthcare. It is important for healthcare providers to acknowledge the differences among cultures that contribute to limited decision-making regarding healthcare needs for patients and which may take patients out of this equation under some conditions. In these instances, it is important for healthcare providers to consider other alternatives to propose to patients and their families, including shared decision-making approaches that may effectively support decisions that will positively impact patients under a variety of conditions (Legare et al., 2014). These efforts require an understanding of the key variables which impact decision-making and how patients might become more involved in this process, regardless of their culture.
When the male makes the primary healthcare decisions for the entire family, this is contradictory to the beliefs involving shared decision-making and equality (Mahmoodi et al., 2015). From this perspective, it may be argued that perceptions regarding shared decision-making are not created equal and that other parameters must be considered that impact how decisions are made at the patient care level (Mahmoodi et al., 2015). These factors also demonstrate the importance of developing an environment in which patient needs are addressed in an equal manner and in which there are opportunities for patients to have a greater say in their own healthcare decision-making (Mahmoodi et al., 2015). However, these circumstances are not always feasible and require healthcare providers to better understand when this option is not feasible due to cultural beliefs.
One of the key issues to consider is the role of cultural competence in the practice setting to establish boundaries and recognize where differences in cultures may have an impact on healthcare decision-making. These examples support the need for improved cultural competence in healthcare to ensure that patients have the tools and resources that are required to make careful decisions, and if the male is the decision-maker, this is well understood by the healthcare team. It is imperative that cultural competence is optimal for healthcare providers so that they understand the non-traditional and culturally defined barriers that may exist throughout healthcare practice (Betancourt, Corbett, & Bondaryk, 2014). Furthermore, these issues must be addressed in an environment that is patient-centered, regardless of who is making the decision regarding any future plans of care (Renzaho, Romios, Crock, & Sonderland, 2013). These conditions are essential to understand why decisions are made in different ways and how to best manage these decisions with the patient’s best interests in mind.
A successful approach to cultural competence is required within the healthcare industry to ensure that any decisions regarding patient care are appropriate and timely. However, this requires an understanding of cultural differences which may impact who makes these decisions and how to treat patients moving forward. It is expected that these issues require healthcare providers to examine how different cultural needs, expectations, and barriers may limit traditional healthcare practice decision-making and how to best accommodate patient care needs safely and effectively as best as possible.
