The Cultural Diversity Policy of the Montreal Heart Institute (MHI) is based on the tenets of the Charter of human rights and freedoms, the Canadian Charter of Rights and Freedoms, the Charter of the French Language, and An Act respecting health services and social services. The policy sets out management mechanisms that aim to ensure that cultural diversity is respected in all of the MHI's activity areas.
This policy applies to patients and their families, employees, physicians, volunteers and trainees at the MHI. The goal of the policy is to promote care and service quality and accessibility for patients from diverse cultures, promote access to care and services in different languages for people from different cultural communities in Quebec, and facilitate employment access and integration of employees from diverse cultures.
Definitions
Culture and cultural diversity
“Culture should be regarded as the set of distinctive spiritual, material, intellectual and emotional features of society or a social group. It encompasses, in addition to art and literature, lifestyles, ways of living together, value systems, traditions and beliefs. This diversity is embodied in the uniqueness and plurality of the identities of the groups and societies making up humankind.”
(UNESCO Universal Declaration on Cultural Diversity, 2001)
Discrimination
Every person has a right to full and equal recognition and exercise of his human rights and freedoms, without distinction, exclusion or preference based on race, colour, sex, pregnancy, sexual orientation, civil status, age except as provided by law, religion, political convictions, language, ethnic or national origin, social condition, a handicap or the use of any means to palliate a handicap.
Discrimination exists where such a distinction, exclusion or preference has the effect of nullifying or impairing such right.
(Charter of human rights and freedoms, R.S.Q., chapter C-12, section 10)
Accommodation
An adaptation of a norm or general practice, dictated by the right to equality, in order to grant different treatment to a person who would otherwise be adversely affected by the application of that norm or practice constitutes an accommodation. Accommodation is a legal concept that aims to correct any discriminatory impact and that only applies to exceptional cases. An accommodation may only be made if it is reasonable, that is, if it does not impose on the department, body or institution any undue hardship with regard to, among other considerations, related costs or the impact on the proper operation of the department, body or institution or on the rights of others.
(Bill No. 94: An Act to establish guidelines governing accommodation requests within the Administration and certain institutions)
In the context of cultural diversity, we generally adapt workplaces and personalize daily care and services based on an individual's health condition, history, needs and beliefs.
See Appendix 1 for examples of adaptation and personalization
Applications
- The Management Committee is responsible for adopting this policy and ensuring that it is communicated to managers, employees, physicians, volunteers, trainees, patients and families.
- In the annual management report, the Executive Director reiterates the MHI's commitment to non-discrimination and cultural diversity and describes the measures taken and outcomes achieved in relation to this policy's objectives.
- The MHI's administration provides a silent space for prayer, meditation or any other form of personal renewal for patients, families and staff members, no matter what their religious beliefs and out of respect for differences.
- The Pastoral Service provides support and assistance to hospitalized patients and their loved ones while respecting their values, beliefs and culture.
- The MHI's administration is responsible for implementing a procedure on the services of interpreters, who help staff members when they have to work with patients who do not sufficiently master French or English.
- The MHI's administration ensures that employees and physicians have access to clinical ethics consultations to help them manage complex situations arising from cultural diversity and requests for the personalization of patient care.
- The Human Resources Department respects the principle of non-discrimination in relation to hiring, training, the probation period, professional development, promotions, transfers, commuting, layoffs, suspensions, dismissals, and the working conditions of all individuals as well as in relation to the creation of employment classifications or categories.
- Managers encourage teams to reflect on and discuss these issues to find reasonable solutions to meet requests for adapting the workplace for a staff member or personalizing care or services by considering the following four criteria:
1. The request does not run counter to clinical judgment, best practices, the code of conduct, or a clinical urgency to act.
2. The request is in keeping with infection prevention and safety rules.
3. The request does not lead to undue costs or costs that exceed the organization's human, material or financial resources.
4. The request respects the rights and freedoms of other patients and staff members.
- All managers must promote this policy among their staff and ensure that it is respected in their departments and services.
- Each staff member, physician, trainee or volunteer must read and adhere to this policy.
- Each staff member, physician, trainee or volunteer must show respect for cultural diversity and the rights and freedoms of patients, families and co-workers.
APPENDIX 1
Examples of adapted or personalized practices
Adaptations for staff:
- A day off for a religious holiday (for example, through the vacation bank).
- Prolonged leave (to visit family in the person's country of origin).
- Adaptation of dress code (essentially for veils or head scarves).
- Space set up to allow people to pray at work.
Personalization of care and services:
- Accommodations for religious rites: prayer, fasting, end-of-life rites.
- Special dietary requests: kosher food, food brought in by the family.
- Adaptations related to the gender of care staff or the gender of people sharing the same room.
- Agreeing to turn the bed of a Muslim patient towards Mecca in the final moments of life.
- Using an interpreter to better explain the scope or details of a procedure or treatment to obtain informed consent.
Reference:
CSSS de Laval (2007). Cadre de référence relatif à l’intervention en contexte interculturel : la personnalisation des soins et des services et les accommodements à l’égard des usagers et des intervenants. Submission to the Bouchard-Taylor Commission.