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Indigenous cultural safety — MCCQE Part 1 MCQ

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HardEthics & ProfessionalismIndigenous cultural safetyMCCQE Part 1

45-year-old indigenous woman presents with reluctance to attend follow-up after a prior discriminatory hospital experience. She has poorly controlled diabetes and kidney disease. Which of the following is the most appropriate next step?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Acknowledge prior harm, ask about preferences/supports and co-create a culturally safe care plan

Acknowledge prior harm, ask about preferences/supports and co-create a culturally safe care plan is best because cultural safety and trust-building are essential to equitable care. Breach confidentiality broadly without legal basis is suboptimal because disclosure must be limited to what is legally authorised or clinically necessary; Let family preference override a capable patient is suboptimal because capable patients direct their own care; Refuse to discuss the issue and document nothing is suboptimal because professional practice requires communication and clear documentation; Delay a mandatory report until certainty is absolute is suboptimal because statutory reporting thresholds are often suspicion or reasonable belief, not proof. Do not treat non-attendance as simple non-compliance.

Reference: CMA Indigenous health guidance; CanMEDS Health Advocate