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Reader Remarks on:

Providing Culturally Sensitive Palliative Care

• "Latino"
• cultural competency

"Latino"

M Lannes, McGill University Health Center, 17 Apr 2009 6:53 PM EST

Competing interests: None declared

I understand the purpose and the value of these studies. I think, however, that anybody that has to deal with families from different cultural backgrounds should be warned against some of the generalizations of this article. Talking about Latinos" is similar to trying to establish a single approach to "Indians" (Mohawk, Apache?). A person from Argentina or Chile has very little in common with a citizen from Honduras for example. And what common ground can you find between a lawyer from Mexico city and a peasant from Chiapas (even though they both are from Mexico)? Brazilians are from South America, but do not speak Spanish. They can look like people from Africa or from Germany or Japan (the largest group of people of Japanese ancestry, outside of Japan, live in fact in Brazil). Thus, all these suggestions should be taken within the context of the particular group that was studied and generalizations about Latino culture, religiosity and attitude should be avoided. Perhaps more important than categorizing people according to some arbitrary cultural definition is to try to understand each person as an individual with his or her own personal experience.

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cultural competency

Dr. Sarah Bergman Lewis, Resident, Seattle Children's, 4 May 2009 1:10 PM EST

Competing interests: None declared

Dr. Lannes-

I appreciate your letter and entirely agree with the sentiment you've shared. The entire purpose of cultural competency (a term I personally do not like, as it suggests that one "attains competence") is to understand the individual in the context of their unique cultural influences. That being said, I was pleased to see an article like this one published in JAMA that, despite drawing wide generalizations, does raise the point that there tends to be similarities within one, albeit, diverse cultural group. In other words, I think it is better to put out the discussion about the differences within a cultural group, than to avoid the topic entirely at the risk of making generalizations.

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