Intercultural dementia care in culturally diverse settings: An ethical analysis informed by a qualitative study with the Turkish immigrant community in Germany

• Applicant: Dr. Zümrüt Alpinar Segawa, Ph.D.
• Subject Area: Practical Philosophy
• Term: since 2023
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 513287228

The inclusion of culturally diverse individuals in healthcare settings will be inevitable as people’s mobility increases. Culture-specific demands can raise conflicts between the dominant culture’s medical system and individuals from minority cultures. This is relevant for dementia care ethics, because it is rife with culturally loaded ideas of personhood, responsibility and good life. Some studies show that persons with migration background do not have fair access to dementia-related healthcare services and that the needs of those people are not addressed in dementia-related services or ethical guidelines for dementia care. Therefore, I will use dementia-related healthcare as a specific context (a) to reflect on culture’s role in decision-making processes, (b) to empirically explore the needs and challenges linked to having a migration background, and (c) to develop culture-sensitive, responsive recommendations for guiding healthcare professionals. The project combines different methodologies for an empirical bioethics approach. Its theoretical focus is on investigating culture’s role in decision-making within dementia care and on developing an approach to solve moral conflicts in culturally diverse settings while avoiding moral relativism and stereotyping. Its empirical focus is on affected individuals with a Turkish migrant background living in Germany and professional healthcare workers in the field. The project touches upon a pressing issue, since the first-generation Turkish immigrant community is now reaching an age where they are at risk of developing dementia. Further, there is a lack of empirical ethics studies focusing on the influence of ethnic and cultural differences in family members and affected persons’ attitudes in the context of dementia-related healthcare. This is at least partly due to lack of sufficient language skills and relevant cultural background knowledge among German scholars, which I can fulfill. The project will also provide an empirical basis for developing culture-sensitive guidelines for dementia-related care. The project engages this topic on an ethical-philosophical and on an empirical level. To this end, theoretical considerations around the provision of healthcare in a culturally diverse context will be combined with a qualitative study. I will reflect on the ethical standards used for decision-making in dementia care, investigate empirically the extent to which these standards diverge from ethical standards that are more common to members of a minority culture, and in conclusion recommend paths to avoiding and reconciling conflicts in ethical standards.

• DFG Programme: Research Grants