Introduction

When thinking about cultural differences and the care of children, it is tempting to view a child's culture rather than the child herself as the appropriate recipient of diagnosis and treatment. That is because we have come to value cultural heritage as a defining feature of our identities. Of course, one's heritage has little meaning unless it is respected, perhaps affirmed, by others and by public culture at large. As Charles Taylor puts the point, today's concern for culture and respect is premised on the idea “that our identity is partly shaped by recognition or its absence, often by the misrecognition of others, and so a person or group … can suffer real damage, real distortion, if the people around them mirror back to them a confining or demeaning or contemptible picture of themselves.” Our “sense of self” depends on internalizing the views that others have of us, and the lack of recognition “can inflict harm, can be a form of oppression,” imprisoning us “in a false, distorted, and reduced mode of being” (Taylor 1992: 25).

That said, in healthcare settings, especially pediatric settings, respect for culture and identity might crowd out other important values. In an age that urges us to recognize and perhaps affirm particular cultural and personal backgrounds, there is the danger that respecting a patient's heritage might compromise care for that patient's bodily needs. In healthcare settings informed by identity politics, a child's true particularity, or particular claims to care, can get lost.