Zita Weber

40 Journal of Practice Teaching 5(3) 2004, pp.40-54 © 2004. Whiting and Birch

Working towards culturally
sensitive ethical practice in a
multicultural society

Zita Weber1

Summary: In the last two decades there has been a lot of theorising about mul-
ticulturalism and professional practice. Many practitioners are challenged by
cultural diversity daily. Practising from a culturally sensitive ethical perspective
in a multicultural society is essential for good practice. Postmodern infl uences
and critical questioning are seen to inform culturally sensitive ethical practice
in their encouragement of practitioners’ adoption of multiple belief systems
and multiple perspectives and the need to pose questions challenging practice
regarding awareness of cultural encapsulation and cultural sensitivity. The
development of culturally sensitive ethical practice guidelines within the context
of a multicultural society is proposed, fi rstly, by assessing the cultural sensitivity
of the ethics codes and secondly, by balancing culture and ethical codes.

Key words: professional practice, cultural competence, ethics, cultural diversity,
multiple perspectives, respect

1. Lecturer in Social Work Practice

Address for Correspondence: School of Social Work and Policy Studies,
The University of Sydney, Education Building, Sydney, NSW 2006, Australia.
[email protected]

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Working towards culturally sensitive ethical practice in a multicultural society

41 Journal of Practice Teaching 5(3) 2004, pp.40-54 © 2004. Whiting and Birch

In the last two decades, there has been a lot written about multicultural-
ism and professional practice (Diaz-Lazaro and Cohen, 2001; Dominelli,
1988; Ivey, 1987; Ivey, Ivey and Simek-Morgan, 1997; Johnson, 1989;
Ivey, Pedersen and Ivey, 2001; Nguyen and Bowles, 1998; Pedersen,
2000; Sue and Sue, 1977; Sue and Sue, 2003; Thompson, 1997;
Wohl, 1989). Many of us are challenged by cultural diversity daily.
Of late, some literature has explored the heightened awareness of the
importance of cultural considerations in practice and the realisation that
culturally competent practice and ethical decision-making need close
refl ection (Goldberg, 2000; Ivey, Pedersen and Ivey, 2001; Pack-Brown,
Whittington-Clark and Parker, 1998; Pack-Brown and Williams, 2000;
Pack-Brown and Williams, 2003).

My own thinking has become sharper over time. Because I’d been a
migrant child, I always believed I had some real understanding and a
deep level of empathy for cultural differences and sensibilities. However,
over the years, I’ve discovered how much I had to learn about the realities
of working with cultural diversity.

Teaching social work students at both undergraduate and graduate
levels in Australia, a country recognised as comprising many different
languages, cultural traditions and ethnic origins, I’m confronted by
cultural sensitivity and competence issues and the ever-present ethical
issues and dilemmas.

Post modern infl uences

Working towards culturally sensitive ethical practice presupposes a
post modern stance (Christopher, 1996; Sue et al., 1996), and a move
away from epistemological assumptions that are not necessarily shared
across cultures. Such a stance entertains the existence of multiple belief
systems and multiple perspectives (Gonzalez, 1997; Highlen, 1996; Sue
et al, 1996). For instance, culturally sensitive practice would accept
the existence of multiple worldviews and reinforce the notion that
such worldviews are neither ‘good or bad’ nor ‘right or wrong’. The
refutation of this ‘either or’ view endorses the validity of each worldview
and reinforces cultural relativism by recognising that each culture and
attendant worldview is unique and can only be understood in itself
and not by reference to any other culture and attendant worldview.

Zita Weber

42 Journal of Practice Teaching 5(3) 2004, pp.40-54 © 2004. Whiting and Birch

Socio-politically, this stance is important as it inherently recognises the
unfairness of one group imposing its standards on another.

Postmodernism also would inform the practitioner working towards
culturally sensitive ethical practice that language does not equal
‘perception of reality’. Adopting a relational view of language allows
the practitioner to look beyond the truths and realities of the dominant
culture as enshrined in language, both oral and written. Language and
conceptual constructions vary tremendously between cultures. The
importance of sensitivity to language and the way in which it is used
may be illustrated in the encounter where the practitioner is using
language and formulating questions from their cultural perspective
regarding mental health concerns and the client is viewing the concerns
from their different worldview. Such a situation is exemplifi ed by Tsui
and Schultz (1985) who write,

The therapist must explicitly educate the client about the purpose of
questions regarding clinical history, previous treatment information,
family background and psychosocial stressors. The linkage of these issues
to their current symptoms is not clear to many Asian clients. Many Asian
clients conceive of mental distress as the result of physiological disorder
or character fl aws. This issue must be dealt with sensitively before any
sensible therapeutic work can be effected. (pp.567-568)

Similarly, it is important to take into consideration cultural nuances
of nonverbal cues as different cultural groups ascribe varied meaning
to certain nonverbal behaviour. Eye contact, for instance, is expected
among persons communicating in mainstream English-speaking cultures
(Australia, Britain, USA, Canada). Certain stereotypes have developed
regarding evasiveness and untrustworthiness of those people who avoid
direct gazing. However, it is now well known that in some cultures,
direct eye contact is regarded as disrespectful and an invasion of privacy.
I experienced this cultural nuance when teaching in Texas where some
Mexican-American students employed minimal eye contact with me.
When I enquired about this, it was explained that as a older person in
position of authority, it would be disrespectful to look me directly in
the eye.

Failing to understand the signifi cance of nonverbal behaviour may
pose barriers to effective communication. Again, I experienced a cultural
nuance in expectation when working with an Asian family. Whilst they

Working towards culturally sensitive ethical practice in a multicultural society

43 Journal of Practice Teaching 5(3) 2004, pp.40-54 © 2004. Whiting and Birch

expected me to provide advice as the ‘authority’ in the matter, I expected
them to be more talkative and active in exploring options in the care of
a member of the family who had been diagnosed with a major mental
illness. Respect for authority may result in passivity and silence and as
Tsui and Schultz (1985) note, ‘Long gaps of silence may occur as the
client waits patiently for the therapist to structure the interview, take
charge and thus provide the solution’ (p.565). Erroneously concluding
that the client has fl at affect or is unmotivated are potential hazards if
the practitioner fails to correctly interpret the often smallest cultural
nuance in nonverbal cues.

Although a post modern stance provides philosophical underpinnings
that embrace the phenomena of cultural diversity and cultural sensitivity,
translating concepts into dynamic, evolving practice poses some critical
questions. Differences and nuances create challenges to our balancing
of professional obligation with expectation of service delivery and
determinations regarding the distinction between client behaviour that
is culturally appropriate and behaviour that is problematic.

Some critical questions

How can we ensure that we develop and maintain cultural sensitivity?
What of the danger of cultural encapsulation? Can we develop culturally
sensitive ethical guidelines and bring culturally appropriate interpreta-
tions to our work? How do we go about teaching about values and ethics
in a multicultural context? These are some questions that both students
and practitioners ask at teaching and learning forums.

In one sense, the only way to address such questions is to pose
further questions that challenge our ways of thinking. To avoid cultural
encapsulation and a practice that is infused with Western assumptions
and values we need to use all our critical refl ective abilities to deconstruct
the sometimes narrowly prescribed ways of working. We need to pose
questions that challenge known practice around (i) not giving advice
and suggestions because it may foster dependency (ii) not taking a
teaching role (iii) not accepting gifts from clients and (iii) not entering
into dual or multiple relationships because establishing boundaries is
important (Sue et al, 1998).

What if the encounter with a client from a different culture demands

Zita Weber

44 Journal of Practice Teaching 5(3) 2004, pp.40-54 © 2004. Whiting and Birch

that you exhibit the expertise and authority that otherwise would be
discouraged as qualities that magnify power differentials between you
and your client? What if the client’s view about mental illness, for
instance, is based on beliefs regarding magic and witchcraft, however,
they ask that you educate them on terminology and the biomedical point
of view, so that they might understand what is being communicated to
them? What if the client proffers a small gift and presses you to accept
at your last session together? What if …. There are endless ‘what if…’
questions we might pose to challenge our ways of thinking and ensure
greater cultural sensitivity.

Essentially, these crucial questions point to the logic of returning to
the fundamentals.

Whenever I pick up the Australian Association of Social Work (AASW)
Code of Ethics (2000), I’m struck by two competing thoughts:

1. it is an essential resource – a valuable document;
2. it is a prescriptive document that has little interpretive value and if

followed to the letter, one would be unable to practice.

There is the ambivalence of feeling contented that I have a reference
book and the frustration that I’m told so little when it comes to sticky
situations.

This Code, along with the British, U.S. and Canadian codes, is neces-
sarily a broad-based document which can offer guidance, but cannot
and should not be relied upon to solve ethical dilemmas involving
cultural issues.

These codes contain concepts and ideas that are well-known among
helping professionals. Nevertheless, when considering culturally
sensitive and ethical practice, one crucial question arises: How can
abstractions within codes be interpreted? Subsequent key questions
could be: What questions should we be critically refl ecting upon to
become aware of the power of cultural variables? Most importantly,
how can we translate this awareness into behaviour leading to effective
intervention?

I intend to work towards developing culturally sensitive ethical
practice guidelines within the context of a multicultural society by
fi rstly, assessing the cultural sensitivity of the ethics codes and secondly,
balancing culture and ethical codes.

Working towards culturally sensitive ethical practice in a multicultural society

45 Journal of Practice Teaching 5(3) 2004, pp.40-54 © 2004. Whiting and Birch

Assessing cultural sensitivity of the ethics code

Professionals are expected to know and adhere to their ethics code.
However, practitioners also need to demonstrate knowledge about their
codes’ sensitivity to diverse cultures. While codes have embedded within
them requirements for cultural competence, for instance, in the Australian
Association of Social Workers’ Code of Ethics (2000) Section 4.2.4 is titled
Cultural Awareness – how do some other principles fi t with this?

For example, how do some cultural assumptions and expectations
of our clients fi t with ethics codes’ statements regarding ‘professional
integrity’?

In the AASW Code of Ethics, Section 4.1.4 titled ‘Professional
Integrity’ under (e) states: ‘Social workers will ensure that professional
relationships are not exploited to gain personal, material or fi nancial
advantage’. This sounds perfectly reasonable. But how does the practice
of gift-giving to show appreciation to a practitioner fi t with the principle
of professional integrity as stated? There have been numerous occasions
in my practice as a social worker when ethnic families have brought gifts
to the fi nal session. Does acceptance of such gifts, offered in the spirit of
genuine appreciation, constitute some exploitative material gain? One
supervisor had cautioned me about never accepting any gifts, taking an
unqualifi ed position. Another equally experienced supervisor had taken
a much more relational position. Accepting the offered gift, in his view,
turned on the ‘it depends’ argument. Cultural considerations might well
be a dependent variable. Does accepting the gift suggest greater cultural
sensitivity but less ethical practice or does rejecting the gift signify less
sensitivity and greater adherence to ethical practice? Does a simplistic
position of following the code to the letter make for good practice
– culturally or otherwise? Perhaps the supervisor who recommended
a ‘it depends’ position was suggesting a more balanced and measured
approach, whereby cultural sensitivity was balanced with the spirit of,
rather than the bald words, within a code of ethics.

Section 4.1.4 ‘Professional Integrity’ includes under (g) cautions about
dual relationships. Similar provisions appear in the BASW Code p. 7
under 3.4 ‘Integrity’ 3.4.2 e ‘To set and enforce explicit and appropriate
professional boundaries to minimize the risk of confl ict, exploitation or
harm in all relationships with current or former service users, research
participants, students, supervisees or colleagues.’

Zita Weber

46 Journal of Practice Teaching 5(3) 2004, pp.40-54 © 2004. Whiting and Birch

Both these codes of ethics add a qualifi cation to this statement which, in
effect, softens the statement. This qualifi cation relates to minimising the ‘risk
of confl ict, exploitation or harm’. In the BASW Code p. 7 under 3.4.2.f states
‘To avoid any behaviour which may violate professional boundaries, result in
unintentional harm or damage the professional relationship.’

This qualifi cation is important and in order to understand what
professional integrity might look like in relation to cultural sensitivity,
it is worthwhile considering a relatively familiar scenario for many
practitioners.

Let’s take as an illustration the example of an invitation extended
to you by a client to attend a social event. This invitation may come
unexpectedly from a client or family you have been seeing for some time.
The client may be from an ethnic background which has a collectivistic
culture and she thinks of you, as her social worker, as ‘family’. She asks
that you attend her granddaughter’s christening celebration. She would
be ‘honoured’ if you did so.

This invitation poses a dilemma for you as you consider a response
that, on the one hand, conforms to ethical sanctions against dual rela-
tionships and, on the other, respects the client’s genuine valuing of you
within the context of her culture. In previous sessions, she has explained
that her cultural context embraces multiplicity in relationship roles and
that she has had her priest and her doctor to dinner. For this client, the
notion of strict professional boundaries is not part of her culture.

The questions that might crowd your mind could be:

• Is there a real risk of harm or exploitation if I attend the social
event?

• Do I risk harming the client/s if I attend?
• What decision, attending or not attending, would best respect the

client’s dignity?
• How can I respond in a way that refl ects the client’s worth as an

individual ?
(questions adapted from Pack-Brown and Williams, 2003)

Also crowding your mind might be ethical decision-making
frameworks to assist in working through dilemmas. One such model,
forwarded by Welfel (1998) proposes an ethical decision-making model
that consists of nine steps:

Working towards culturally sensitive ethical practice in a multicultural society

47 Journal of Practice Teaching 5(3) 2004, pp.40-54 © 2004. Whiting and Birch

1. develop ethical sensitivity
2. defi ne dilemma and options
3. refer to professional standards
4. search out ethics scholarship
5. apply ethical principles to the situation
6. consult with supervisor or respected colleagues
7. deliberate and decide
8. inform supervisor, implement and document actions
9. refl ect on the experience

Such a model encourages the sort of critical questioning and refl ection
that offers the comfort of systemic analysis yet pushes the practitioner
to consider the dilemma from several different perspectives (codes,
scholarship and colleagues’ views). Searching out ethics scholarship in
this instance, would necessitate attention to diversity and difference and
presuppose cultural sensitivity.

This framework implies balancing ethical considerations and for me,
effective practice must have a balance.

Balancing culture and ethical codes

In this case of the invitation to a social event, an infant’s christening,
several responses are possible, not all of which are sensitive to both the
client’s culture and ethical principles. What are some of the options?
What are their strengths and drawbacks?

Response 1

Explain to the client that your professional ethics code does not permit
your participation in her social event. This is an example of a response
emanating from a procedural perspective without consideration of
the client’s cultural context and practices. It would be fair to say that
this response is not a culturally sensitive one. In fact, the client might
be within her rights to beg the question, Who is protected here? The
practitioner? The client? Both?

Response 2

Engage the client in discussion around the importance to her for you to

Zita Weber

48 Journal of Practice Teaching 5(3) 2004, pp.40-54 © 2004. Whiting and Birch

attend. It might be argued that this response is more culturally sensitive
than the fi rst, however, it inherently questions the client’s motives,
suggesting to her that her request needs examination.

Response 3

Discuss with the client how she would feel if you did or did not attend.
This response is similar to Response 2, suggesting that her request
must be analysed. In addition, exploring her reactions to your options
is premature and likely to confuse the client.

Response 4

Immediately accept the client’s invitation to attend because you
believe not doing so would offend the client and risk the professional
relationship, which has been a long and positive one. This response,
of immediate acceptance, might suggest that the practitioner has not
carefully weighed the costs and benefi ts of agreeing to attend.

Response 5

Explain your dilemma to the client and tell her you wish to consult with
colleagues, including someone from her ethnic background before you
make a decision. In doing so, the practitioner positions the dilemma
as one related to ethical constraints rather than to the client’s request.
This response considers the process of weighing cultural factors against
ethical constraints. Nevertheless, by suggesting a consultation with
an ‘ethnic expert’, the practitioner inherently questions the client’s
knowledge and understanding of what is appropriate.

Response 6

Share with the client that you feel honoured to be asked to such an
important event in her life, but that her invitation presents a dilemma
for you. This might be seen as a culturally sensitive statement because
it positions the problem squarely in the practitioner’s hands and shares
the dilemma with the client, without demonstrating disrespect for the
client’s wisdom. This response might be followed by Response 3.

In my practice, I have known professionals from many varied back-
grounds to take very different positions on invitations to social events,
particularly when the request has come from a client from a different cul-
tural background. I have never seen any of them take the decision lightly

Working towards culturally sensitive ethical practice in a multicultural society

49 Journal of Practice Teaching 5(3) 2004, pp.40-54 © 2004. Whiting and Birch

and certainly, when I decided to not attend my client’s granddaughter’s
christening, I deliberated carefully, sought my supervisor’s opinion and
spoke with colleagues before deciding that although there was very
little risk of real harm to the client in my attending the event, doing
so would extend boundaries beyond their professional perimeters. My
discussion with the client acknowledged the importance culturally for
her inclusion of me in such an event and my respect for her cultural
position. However, our discussion also covered respect for different
positions and the need for us to continue in roles that clearly indicated
that our relationship was professional rather than friendly. Nevertheless,
I have known other practitioners who have attended social events and
argued that their need to be culturally sensitive was greater than their
need to maintain clear professional role identity.

There are many other examples of the need to balance culture and
ethical codes. Notions related to client welfare is one.

In the AASW code, Section 3.1 Value: Human Dignity and Worth
states that the social work profession holds that ‘each person has a right
to well-being, self-fulfi lment and self-determination, consistent with
the rights of others’. The NASW (U.S.) contains an ethical principle
valuing the ‘inherent dignity and worth of the person.’ Consistent with
this value, social workers are required to ‘treat each person in a caring
and respectful fashion, (being) mindful of individual differences and
cultural and ethnic diversity.’ There is a similar provision in the BASW
3.1.2b p.4

Certainly, the overarching principle contained in these sections of
various codes is protection of the welfare, or best interest, of the client.
Nevertheless, these statements are broad and they leave room for
interpretation and possibly, misinterpretation.

These codes, based as they are on principles of self-determination,
individualism and clear relational boundaries, may well advocate a
stance which is at odds with more interdependent, self-in-relation pat-
terns of some ethnic and cultural ways of being. These contradictions
may place practitioners in a bind – doing what is in the best interest
of the client may confl ict with various ethical codes. For instance, an
Aboriginal woman with terminal cervical cancer rejected all forms of
Western treatment in a large Sydney hospital and although not consid-
ered to be in her ‘best interests’ she insisted on discharging herself and
going ‘home’ to her country community to be cared for by her extended
family. For this Aboriginal woman, her self-determination could be

Zita Weber

50 Journal of Practice Teaching 5(3) 2004, pp.40-54 © 2004. Whiting and Birch

seen to run counter to her best interests. However, she felt alienated in
a big city hospital away from her family and her wish of ‘going home’
to be ‘with family’ was granted. In this case, the social worker and the
team balanced ethical codes with culture and believed that the client
would fare better in what she considered her own caring environment.
The abstraction of ‘best interests’ needs careful consideration in such a
case and self-determination regarding continuation or not of treatment
viewed from different perspectives. Client welfare is not an obvious
matter. Paradoxically, what appears to not be in the ‘best interests’ of
the client, might in reality, be her ‘best interests’.

Consider another situation. Clients from collectivist cultures for
whom self-identity is inseparable from kinship systems may wish to
bring family members with them to group therapy sessions. This may
pose a problem for the professional in terms of the importance of
maintaining the confi dentiality of group members, yet the professional
might understand that it is within the ‘best interests’ of the client to
have the support they want. In this case, the professional must balance
the rights of others and confi dentiality with the expectation of different
cultural groups and aim to negotiate a culturally sensitive decision. This
notion of collectivity and support from family is raised by Pedersen
(2000) who considers the concept of dependency as a potential source
of confl ict between ethical codes and culture.

In many diverse cultures, dependency on others is a way of life. Over
time, cultural expectations regarding strong networks of interdependence
have developed. Sometimes, socio-economic reasons have dictated that
such interdependence is critical to the survival of many immigrants as
well as indigenous people. Again a point of tension arises in that the
ethics codes advise against relationships in which clients feel dependent
on the professional. Perhaps several questions need to be asked to
tease out the elements of the dilemma. Is it possible that a dependent
relationship might be in the client’s ‘best interest’ at least temporarily?
Is it conceivable that a strong relationship with a professional might
provide a sense of security and help the client, who feels they have little
personal power, to build greater self-suffi ciency? Again, paradoxically,
the culturally sensitive practitioner might well be seen to be ‘encourag-
ing’ dependency in order to help the client become more empowered
eventually. Such tensions between individualism and collectivism and
empowerment and dependency are common in work with people
from diverse cultures and the ethical dilemmas they raise need careful

Working towards culturally sensitive ethical practice in a multicultural society

51 Journal of Practice Teaching 5(3) 2004, pp.40-54 © 2004. Whiting and Birch

refl ection and logical consideration. A mere wish by the professional
to be ‘politically correct’ is not enough, indeed, it runs counter to true
professionalism, which requires that the professional be in a position to
state clearly their dilemma and the reasons for their decision.

A cautionary note

There may be occasions when responding in a culturally sensitive
manner may mean taking an historical view and working with its
implications for clients in the contemporary context. For instance,
an important consequence of oppression of indigenous and minority
groups is the development of an intergenerational healthy cultural para-
noia phenomenon (Ho, 1992; Paniagua, 1994; Smith, 1981). Amongst
Australian Aboriginal people, for example, there is strong suspicion of
professionals in offi cial roles, particularly in relation to child welfare.
Historically, welfare authorities routinely removed children from parents,
a practice that has led to what is now known as ‘the lost generations’.
It makes perfect sense then, that Aboriginal people today might be
distrustful of professionals who offer help, but are also in a position to
recommend removal of children from families. Similarly, in the United
States, this healthy paranoia phenomenon is evident amongst some
African-American people who fi nd it diffi cult to trust professionals who
have disempowered them in the past (Smith, 1981).

However, the question might have to be asked: How do I determine
the difference between client behaviour that is culturally appropriate
and behaviour that is problematic? For instance, when does the healthy
cultural paranoia exhibited by some oppressed cultural groups become
problematic for them? Making that determination from a culturally
sensitive stance is the challenge.

Zita Weber

52 Journal of Practice Teaching 5(3) 2004, pp.40-54 © 2004. Whiting and Birch

Some concluding thoughts

Neither cultural encapsulation where the professional is trapped in one
way of thinking and believing that theirs is the universal way, nor a keen
sense of political correctness makes for culturally sensitive practice. The
professional who wishes to be culturally sensitive and competent and have
confi dence in making culturally sensitive ethical decisions, needs to live
with uncertainty and acknowledge the power of the postmodernist stance
regarding the existence, and legitimacy of, multiple worldviews. At all times,
such a practitioner is performing a delicate balancing act. They must be
guided by and bring together into a coherent whole, ethical decision-making
frameworks, what the ethics codes state, what the client says and believes …

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