The WEIRD Trio: The Cultural Gap between Physicians, Learners, and Patients in Pluralistic Societies

Physicians are shaped by sociological and philosophical factors that often differ from those of their patients. This is of particular concern in pluralistic societies when navigating ethical disagreements because physicians often misunderstand or even dismiss patient perspectives as being irrational. This paper examines these factors and why many physicians approach ethics as they do while elucidating various patient perspectives and demonstrating how they make sense when considered from a different cultural worldview. Many physicians are trained in contexts that are WEIRD: Western, educated, industrialized, rich, and democratic. These sociological characteristics tend to go hand in hand with the trio of individualism, secularism, and existentialism. These then shape an approach to ethics that focuses on the individual patient, makes no reference to the divine, and focuses on a patient's personal desires. This contrasts significantly with many patients who are collectivistic or religious, and then make rational decisions based on other values. The social fact of pluralism implores physicians to temper confidence in their own cultures while considering others to promote mutual understanding and improved care. This paper concludes with a discussion of how bridges can be built across cultures without sliding into relativism, beginning with recognizing and communicating our shared moral intuitions.