Cultural safety means that care is judged safe by the person receiving it, not by the doctor's good intentions. It involves reflecting on your own culture, assumptions and power as a doctor, and on how racism affects care. It is part of the Medical Board's code of conduct.
For Aboriginal and Torres Strait Islander patients:
- Understand the history: colonisation, dispossession of land, the Stolen Generations (children forcibly removed from families), and ongoing racism. This explains mistrust of health services.
- Family and kinship matter; decisions are often made collectively. Ask who the patient would like involved.
- Offer involvement of an Aboriginal Health Worker or Liaison Officer.
- Some topics may be men's business or women's business; offer a same-gender clinician where possible.
- Sorry Business (mourning) can mean missed appointments; do not label patients non-compliant.
- Avoid jargon, allow silence, and check understanding.
Cultural safety applies to all patients, including migrants and refugees. It is not a checklist of cultural facts; it is an attitude of respect and self-awareness.