The King County Medical Examiner’s Office at Harborview Medical Center (HMC) in Seattle, WA has hosted a series of meetings to improve cross-cultural communication and competency in their work with members of local refugee and immigrant communities. The series of meetings is a forum for medical examiners, pathologists and investigators to learn about the cultural and religious norms associated with death and dying among some of the area’s new and diverse populations.
The encounters present the opportunity to develop specific guidelines and resources to assist the medical examiners and other professionals in relating with families and communities about death in a context of cultural, religious and often linguistic diversity. The legal roles and responsibilities of the medical examiner and the traditional roles and responsibilities of family and community that occur during times of death are discussed.
The Medical Examiner’s Office initiates the exchange of information with prepared questions. The Nurse Coordinator of Harborview’s Community House Calls program facilitates the meeting. Information about death in a community is provided by the Community House Calls program’s Caseworker Cultural Mediator (CCM), who is both an HMC employee and a member of the community. Staffs of the medical examiner’s office and the medical center, religious advisors to the community, and members of the larger Seattle community also participate in these encounters. To date, meetings have happened with members of the Ethiopian Orthodox Christian, Somali and Vietnamese Buddhist communities.
Methods of Documentation
Following are summaries of topics related to specific communities as they were discussed in meetings at the Medical Examiner’s Office. The author audio tape-recorded each encounter, summarized the recordings in note form and drafted a first document which was reviewed by the appropriate Caseworker Cultural Mediator (CCM) for conceptual accuracy. Suggested changes were made and a subsequent draft was reviewed by the CCM, the Community House Calls program supervisor and appropriate religious advisors. The information being presented here reflects this review process. The information is intended to be used only as a general guide and is not meant to be used in place of individual assessment of the needs and concerns of a family and community of the deceased.
Note On Assessing Culture
It is important to remember that simply because a person is identified as a member of a particular ethnic group or religion does not necessarily mean that the person or the person’s family has the set of beliefs that may be associated with the ethnicity or religion. For every case, an assessment must be made of how acculturated a person and their family are, their language skills, and whether an interpreter is needed. This assessment is key.
Representatives of the following communities have met with personnel from the Medical Examiner’s office and summaries are available: