Background: Shared decision-making (SDM) is often considered the ideal for decision-making in oncology. Views of specific groups such as ethnic minorities have seldom been considered in its development. Aim: In this study we seek to assess in oncology if there is a need for adaptation of the current SDM model to ethnic minorities and to formulate possible adjustments. Design: This study is embedded in empirical bioethics, an interdisciplinary approach integrating empirical data with ethical reasoning to formulate normative conclusions regarding a practice. For the empirical social scientific part, a cross-sectional qualitative study will be conducted; for the ethical reflection the Reflective Equilibrium will be used to develop a coherent view on the application of SDM among ethnic minorities in oncology. Method: Semi-structured interviews combined with visual methods (timelines and relational maps) will be held with healthcare professionals (HCPs), ethnic minority patients, and their relatives to identify values steering the behavior of these actors in SDM. In addition, focus groups (FGs) will be held with ethnic minority community members to identify value structures at the group level. Respondents will be recruited through organizations with access to ethnic minorities and collaborating hospitals. Data will be analyzed using a reflexive thematic analysis through the lens of Schwartz’s value theory. The results of the empirical phase will be included in the RE to formulate possible adjustments of the SDM model, if needed. Discussion: The integration of empirical data with ethical reflection is an innovative method in decision-making. This method enables a systematic and profound assessment of the need for adaptation of SDM and the formulation of theoretically and empirically based suggestions for adaptations of the model. Findings of this study may enrich the SDM model.
Within a short period of time, the Netherlands transformed itself from a relatively tolerant country to a nation that called for cultural assimilation, tough measures and neo-patriotism. The discursive genre of 'new realism' played a crucial role in this retreat from multiculturalism, and that had a dual effect for immigrant women. Whereas formerly they were virtually ignored by both the integration and the emancipation policy, since the triumph of new realism they are in the centre of both policy lines and there is now more policy attention for their needs and interests. Yet in the public debate the culture card is drawn frequently and immigrant women are portrayed as either victims or accomplices of their oppressive cultures. Policy makers and practitioners in the field, however, succeeded in avoiding cultural stereotyping by developing cultural-sensitive measures, while naming them in culture-blind terms.
This article traces the emergence of one particular genre of discourse, the genre of "new realism" in the Dutch public debates on multicultural society from the early 1990s till Spring 2002. The focus upon different "genres" implies an interest in the performative power of discourse, i.e. the way in which any discourse, in or by its descriptions of reality, (co)produces that reality. Four distinctive characteristics of "new realism" are detected in three subsequent public debates, culminating in the genre of "hyper-realism", of which the immensely successful and recently murdered politician Pim Fortuyn proved to be the consummate champion. Cet article explique le développement d'un genre particulier de discours, le "nouveau réalisme", au sein du débat public sur la société multiculturelle aux Pays Bas. La période étudidée s'étale du début des années 1990 jusqu'au printemps 2002. L'importance attribuée aux différents "genres" reflète un intérêt pour le pouvoir performatif du discours, notamment la facon dont le discours (co)produit la réalité qu'il décrit. On décèle quatre traits distinctifs du "nouveau réalisme" dans trois débats publics qui débouchent sur le "hyper-réalisme" genre dont Pim Fortuyn, homme politique ayant connu un grand succès et victime récente d'un meurtre,s'était fait le champion attitré.
