Ethical Standards for Transnational Mental Health and Psychosocial Support (MHPSS)

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Do No Harm, Preventing Cross-Cultural Errors and Inviting Pushback


By Dr. Siddharth Ashvin Shah, CEO and Founder, Greenleaf Integrative

Shah, S.A. Clin Soc Work J (2012) 40: 438.
© Springer Science+Business Media, LLC 2011



Important components of bioethics are routinely underappreciated in cross-cultural and transnational mental health and psychosocial support (MHPSS) efforts. This article provides case examples of cultural errors and/or harm by outsiders delivering MHPSS on different continents. The errors illustrate violations of informed consent (principle of autonomy) and avoiding harm (nonmaleficence). Ethical cultural adaptation standards are presented in order to avert such errors. Given the real risk of outsiders applying culturally erroneous and/or harmful practices in the process of delivering aid, the ability to discern pushback (resistance and redirection by intended beneficiaries) can yield ethically significant data. Actively inviting pushback is proposed as an additional methodology for ethical cultural adaptation with the purpose of at least gaining informed consent and, at best, shaping the most beneficent MHPSS.


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