Race Culture and Ethnicity

Race, as defined by Merriam-Webster's Collegiate Dictionary, 10th edition, is a ''class or kind of people unified by community of interests, habits, or inherited physical characteristics'' (p. 959). The term culture has a broad meaning;it refers to the unifying beliefs of any group of people of similar religion, values, attitudes, ritual practices, family structure, language, or mode of social organization. Culture provides values that are shared by members of a specific society or a social group within a society. Culture socializes its members on how to perceive the world, how to behave in the world, and how to experience the world emotionally. Elements that represent cultural values and notions include language, social or familial roles, and beliefs about the universe, the nature of good and evil, appropriate dress, eating and hygienic habits, manners, and food. Culture pervades lives and shapes human identity. All personal experiences and norms are perceived through the culture from which they emerge. It shapes human perception of reality and influences societal forms of conduct. Different cultures reinforce different behaviors; what is acceptable in one culture may be considered deviant in another.

Cultural values determine, in part, how a patient should behave. This includes the types of acceptable treatment, type of follow-up permitted, and who will make the decisions. From the medical point of view prevalent in the United States, the clinician and the patient make the decisions, but when a patient's family exerts great influence, the situation can be very different. In some traditional cultures, the family takes over this role for the patient.

*''Limited English proficiency" is a term used by the U.S. Department of Health and Human Services to define the portion of the population that is non—English speaking or limited-English speaking.

Authority figures such as parents or grandparents often predominate. For example, in the case of Romany (''Gypsy'') patients, the primary decision-maker may not even be a relative. Among Orthodox Jewish patients, a medical decision may be made only after consultation with a rabbi. Among the Amish, the entire community may play a role in the decision-making.

Ethnicity is a cultural group's sense of identification associated with the group's common social and cultural heritage. The Harvard Encyclopedia of American Ethnic Groups defines ethnicity as ''a common geographical origin, language, religious faith, and cultural ties (e.g., shared traditions, values, symbols, literature, music, and food preferences).''

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