Medically sanctioned ‘cultural safety’ pedestal elevates Indigenous activism above child safety
Why are professional groups aiding Indigenous activism as part of medical school training?
Last week a British court decided that woman means woman. Here was the high-water mark of common sense, a court deciding that biological sex is real and that women are women.
The hijacking of the word woman by sections of the trans movement was the nadir of radical ideology. A small minority was intent on using the word woman to secure power and control.
It is a familiar tactic. A group laying claim to a word, weaponising it, often by distorting its meaning, to make all kinds of unreasonable demands – even ones that cause damage and distress to others.
A similar phenomenon is under way in Australia. The word safety – especially in company with the word culture – has been appropriated and manipulated in ways that trivialise genuine safety.
The hijacking of this important word safety reached a low point when, as Christine Middap reported last weekend, the stable family life provided by devoted non-Indigenous foster parents to two small Indigenous children was thrown into disarray because it was alleged, unfairly as it happened, they were not providing a culturally safe environment for the children.
As Middap reported, two Indigenous baby siblings, Anna* and Robbie*, were removed from their parents due to neglect, and when extended family members were not able to care for them the babies, both under the age of two, were placed with the foster parents – Sue* and Pete*. The two children remained happily with Sue and Pete for some years.
After the NSW government contracted an Aboriginal agency to manage foster care arrangements, the agency raised concerns that the children’s cultural safety was in jeopardy.
Sue and Pete “were to soon learn that the children’s ‘cultural safety’ was put on the same pedestal as physical safety, and the couple, aged in their 40s, were never clear how they could make their home any more culturally secure”, wrote Middap.
“The children have always been very proud of their background and where they’re from and we’ve always encouraged that,” Sue told Middap
Sue and Pete were forced to go to court for common sense to prevail. Anna and Robbie remain living with them.
But this phrase, cultural safety, continues to be warped and weaponised in misguided ways to embolden an ideological agenda that believes non-Indigenous people should not care for Indigenous children.
This blinkered adult-centric agenda trivialises the most pressing needs of children who have experienced neglect and dysfunction. It allows race and culture to trump a caring, safe and stable home.
The use of the word safety is a deliberately loaded choice. One could use a different word. For example, we could speak of cultural understanding to ensure that Indigenous children fostered by non-Indigenous people have a connection with their culture.
“Understanding” is a more neutral and objective word. What efforts have been made to teach children about their culture? What cultural education has been given them, what cultural events have they been taken to, what opportunities to spend time with Indigenous people have they been given?
Why is it that Indigenous activists have chosen the more emotive term of cultural safety over cultural understanding? And that an industry has rapidly emerged to provide “cultural safety” training?
Could it be because cultural safety has far more power as a phrase? The opposite of understanding is a misunderstanding. Whereas the opposite of safe is unsafe.
When something becomes culturally unsafe, it becomes easier for misguided bureaucrats and activists to demand bigger actions and more serious consequences than simply to encourage greater cultural understanding.
It is confusing enough that “culture” is a vague term, but add in the word safety and the phrase can be easily exploited as a blank cheque for ideologically driven outcomes.
That Sue and Pete had to fight for common sense to prevail is a travesty. That two small children could have been removed from a loving and stable home would have been tragedy.
But the travesty and tragedy will surely be repeated many times over if we allow words such as cultural safety to be weaponised.
Do the multitude of well-meaning people who promote “cultural safety” in various workplaces in Australia understand how this phrase is being co-opted for ideological purposes?
The Australian Medical Council, various medical schools, specialty colleges and medical regulators have, in recent times, introduced mandatory “cultural safety” training and assessments for all doctors.
By putting cultural safety on a medically sanctioned pedestal, the medical profession risks being complicit in enabling activists and bureaucrats to use “cultural safety” as a big stick against foster parents in the first instance. Ultimately that means children most in need of a loving and stable home will suffer.
James* is a senior radiologist in Brisbane. He plans to take part in the national rollout that will start in July of targeted lung cancer screening for people most at risk of the disease.
The screening will involve many other radiologists who will screen at-risk groups to find lung cancer early and to reduce deaths from the disease.
James told Inquirer about the accreditation for the screening program that he has almost completed. It involves five webinars. The first three include an introduction, material about nodules and information about AI being used in their work.
The fourth webinar was roughly 75 minutes of “cultural safety” training.
The final webinar in the accreditation process involved information of other things that a radiologist might see on the scans.
James was left perplexed by the fourth webinar. The cultural safety trainer, AJ Williams-Tchen, talked of many things including white anxiety, unconscious bias, racism, colonisation, along with a history lesson about the 1967 referendum, the Stolen Generations, the 2008 apology by Kevin Rudd. He said: “Closing the Gap areas are very Western, they’re very individualistic. And Aboriginal people are not individualistic, they’re very collective.” His told his own story, a journey from living on the streets of Sydney to nursing to being a cultural awareness trainer. He spoke at length about what he admitted was a nebulous concept called cultural safety. “There’s no one specific definition,” he said.
Parts of his address were touching. But why is the medical profession putting compulsory cultural safety training on a pedestal alongside actual medical training?
“I might not be very good at my job,” James says sardonically, “because I can’t tell by looking at a CAT scan whether someone’s from Bolivia or whether they’re from the local Indigenous tribe,”
James, a highly respected, highly experienced radiologist, is perplexed about the lack of relevance between the session and analysing a CAT scan for cancer nodules.
Medical professional bodies – including the Royal Australian and New Zealand College of Radiologists, the Australian Medical Council and the Medical Board of Australia – have adopted a carpet-bombing campaign to cultural safety, imposing on every doctor cultural safety sessions that are high on ideology and low on relevance to medical training.
In August 2023 the Australian Medical Council released a joint statement along with other medical groups including the Australian Indigenous Doctors’ Association, Medical Deans Australia and New Zealand and the Medical Board of the Australian Health Practitioner Regulation Agency announcing a significant change to the medical school standards to include “a strong focus on cultural safety in all aspects of medical education”.
“The medical school standards are built on the principles of self-determination and respect for Aboriginal and/or Torres Strait and Maori peoples,” the statement said.
“Cultural safety is a foundational requirement, not a nice-to-have,” announced Shaun Ewen, chair of the AMC Aboriginal and/or Torres Strait Islander and Maori Committee in May 2024.
James questions why respect for Indigenous people is being treated separately from professional obligations of doctors to every patient.
“We get everybody in our practice,” James says. “Whether they’re Croatians or Chinese or Indigenous, you just treat people the same. You talk to them respectfully. You call them sir, until they say, ‘Call me Brian.’ ”
Cathy is a medical specialist who works in a major training hospital in Adelaide. She recently assessed a junior doctor using the mandated criteria set down by the AMC. She noticed paragraph 3.5: “Understanding the impacts of colonisation and racism: Demonstrate knowledge of the ongoing impact of colonisation, intergeneration trauma and racism on the health and wellbeing of Australian and Torres Strait Islander peoples”.
“I’ve not seen that in the assessments previously for any junior doctors,” Cathy told Inquirer. “What does that mean, that you’ve understood colonisation and racism? How should I test a doctor on that?”
Cathy says it was a pointless box-ticking exercise. “It’s really difficult to genuinely assess this because this is assessing someone’s politics” and that, she says, has no relevance to assessing medical expertise.
“When I am working with a doctor, I’m thinking the main priorities and concerns are how they interact with patients, are they professional, are they team players, do they demonstrate good clinical knowledge, can I give the doctor a task and will they follow through on it? Do they prescribe medication safely? All these things are important obviously when you’re seeing patients.
“But if I don’t tick that box (in paragraph 3.5), then I have to explain how they’ve not met that criteria and I jeopardise their career.”
The Medical Board of Australia controls continuing professional development requirements for all doctors to remain registered in Australia. Its policy on cultural safety education says its definition of cultural safety is informed by “provision of a rights-based approach to healthcare supported by the United Nations Declaration on the Rights of Indigenous Peoples”.
Given that every Australian has the same right to high-quality healthcare, it’s not obvious why the medical board is referencing a UN declaration that Australia refused to sign for good reason.
The UN declaration demands separatism and co-sovereignty. Article three says “Indigenous peoples have the right to self-determination” and by “virtue of that right they freely determine their political status”. Article four gives Indigenous peoples “in exercising their right to self-determination” the “right to autonomy or self-government in matters relating to their internal and local affairs” – as well as the “ways and means for financing their autonomous functions”. Article 14 gives Indigenous peoples the “right to establish and control their education systems and institutions”.
Why is the medical board foisting on doctors a political project that would, on the evidence of the voice result, also be resoundingly rejected by Australians?
It’s one thing to play feel-good politics by citing radical UN declarations and inserting cultural re-education camps into the accreditation and ongoing registration of Australian doctors.
But even this tokenistic embrace of cultural safety by medical professional bodies will embolden activists to keep treating cultural safety as a weapon to achieve ideologically driven ends.
When ideology clashes with the best interests of children in need of a loving and stable home, and the former wins out, we enter truly dangerous territory.
*All names have been changed.
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