Transcultural Context for Transcultural Nursing
CHAPTER 4
Transcultural Context for Transcultural Nursing
We are all connected. We are entangled; if you want to call it quantum entanglement, fine. But we are entangled. And there is no real separation between us, so that what we do to another, we do to an aspect of our self. None of us are [is] innocent in that regard. There’s something out there we don’t like; we can’t really turn our backs on it because we are all co-creators somehow or another. And we have to do the right things to try to get the future that is best for all of us. That’s our responsibility as co-creators….
William Tiller, What the Bleep Do We Know!? (2005, p. 226)
Chapter Objectives
1. To appreciate the changing image of cultural reality at the global crossroad.
2. To identify social structural characteristics, which symbolize categories of social information of the person in communal, social, virtual, organizational, and global contexts.
3. To examine the person in the transcultural context.
4. To appreciate the concept of transculturality (interculturality).
5. To present the meaning of transcultural nursing/caring.
6. To appreciate the call and meaning of transcultural communicative spiritual-ethical caring.
7. To present and promote thought and discussion on a transcultural caring experience: Mary.
KEY WORDS
Culture • transcultural context • social structural characteristics • rituals • symbols • multiculturalism • identity • panidentity •e-dentity/virtual • race • diversity • ethnicity • panethnicity • caring • personal-mutual community • transculturality (interculturality) • social organizations • transcultural nursing • transcultural caring • transcultural communicative spiritual-ethical caring
The theorist, Harman (1998) stated that we are living through one of the most phenomenal times in history. Scientific and technological changes are occurring at a rapid rate. And resource development, competition, conflict/war, and cooperation are changing the global political and economic landscapes. Cultures are integrating and emerging in new and dynamic ways, and at the same time, cultures are tearing apart. These changes bring into question the meaning of identity and the position and responsibility of the person in the family, community, organization, society, culture, the virtual culture, and world—the transcultural context (see Fig. 4-1 ). The Universal Declaration on Cultural Diversity (UDCD) by the United Nations’ Educational, Scientific, and Cultural Organization (UNESCO) declared that culture is the common heritage of humanity and is expressed locally and distinctly by diverse groups (Chernela, 2006). While the composition of culture is changing at such a rapid rate, the desire to maintain connection to specific cultural/ethnic identity and traditions remains strong. Cultures survive because of genetic heritage, loyalty to traditions, reciprocal cooperation, and willingness of people to care and make social sacrifices for each other (Dunbar, Knight, & Power, 1999). The transcultural context is a reflection of these phenomena—a mutual human-environment process that is historical and relational—continually evolving and emerging.
Figure 4-1: Dimension of the model: Transcultural Context Dimension.
Within the transcultural context, ethnic or cultural traditions and social organization are represented symbolically through social categories or structures, such as kinship (i.e., genetic/family heritage/lineage), language/linguistic, religion/spirituality, political, economic, legal, technological (including the virtual community), educational, ecological/environment, agricultural, and health care to explain, understand, or deal with the society and world. Embedded within the structures of social organization (i.e., social, cultural, psychological, and spiritual) are stories about people in community and culture throughout history around the globe. Culture as community or community as culture refers to a philosophy, a family, a family of choice, a group, a locality, a place, or virtual space where people give and receive love and caring, and find meaning (Cohen, 1985; Day, 2006; Delanty, 2003; Kirkpatrick, 1986; Leininger & McFarland, 2006; McFarland & Wehbe-Alamah, 2015; Lipson & Dibble, 2005; Ray, 2001a, 2001b, 2010a, 2010b, 2010c; Rheingold, 2002; Smith & Liehr, 2014; Wolf, 2014). The social organizational structures of community interface with each other and illuminate the social reality. For instance, kinship structure relates to heritage, family, relatives, and close relationships within societies, and religion structure relates to systems of belief. Encounters within and among different ethnic groups/cultures have generated both conflict and good will with respect to the diversity of beliefs, symbols, and meanings of these various social structures. These encounters and decisions made according to these encounters have determined the course of history.
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Examples of social realities include:
• Language or linguistic structure identifies how people communicate;
• Iconographic art relates to cultural signs and symbols;
• Technological structure, including the virtual structure, relates to what humans create for survival and progress;
• Economic structure speaks of exchange of goods, services, money, or their equivalents;
• Legal structure determines rules and laws;
• Political structure determines how people govern to live together;
• Education structure determines how people informally and formally teach, learn, grow, and develop; and
• Health-care structure relates to cultural beliefs and systems of health, illness, healing, care or caring, dying, and death.
Change binding us on a global scale has revealed the connectedness of all cultures and the search for a deeper meaning to living together (i.e., transculturality or interculturality) (Leininger & McFarland, 2006; McFarland & Wehbe-Alamah, 2015; Postero, 2007). Because history has revealed that ethnic groups engage in conflict and peaceful resolution in the evolution of culture, anthropologists ask, “[t]o what degree are humans innately or primarily aggressive and violent or, conversely, pacific and cooperative…?” (Bonta, 2007, p. 13). What are the social, cultural, and psychological structures that foster conflict and nonviolence that make the restoration of harmony in communities possible (Bonta, 2007; Chinn, 2013; Davidheiser, 2007)?
Despite aggression and conflict and competition for resources, for the most part, people in diverse cultures recognize that cooperation among groups is necessary for survival. Now, recognition of our common humanity, along with appreciation of multiple traditions, has sparked a movement toward more consideration of what is valuable and what should be valued in local and global cultures (Werner & Bell, 2004). The public eye now is turned toward social equity, human rights, peace and justice, economic viability of all people, and ecological protection and safety. Despite what seem to be irresolvable crises in so many parts of the world, there is a quest for building public trust in world communities (Ray, 2010c). This chapter will highlight our current transcultural context—the person in family and community—within the perspective of the changing image of reality, including identity, culture, multiculturalism, race, ethnicity and panethnicity, and the virtual community. The chapter also will present transcultural nursing ideas and transcultural communicative spiritual-ethical caring ideals. These factors will help nurses in grappling with, participating in, and understanding local and global nursing and health-care issues, changing forms of cultural knowledge in the world, and the need for transcultural nursing and communicative spiritual-ethical caring.
Transcultural Context
The transcultural context illuminates the interrelationship between the person and the other. For example, it illuminates the interrelationship between person and environment, person and nature, person and society, and person and the cosmos. Persons hence are intimately related to and are one with their environment—the mutual human-environment process (Davidson, Ray, & Turkel, 2011). There is a personal-mutual meaning to relationships, communities, and cultures. “On the one hand, we look outward and attempt to see the world for what it is, and on the other hand we look inward to grow in understanding of ourselves” (Thoma, 2003, p. 15). The new sciences of complexity, including the social sciences, technology, and spirituality, reveal a changing vision of reality—we are all connected; we are part of an unbroken circle of the oneness of the universe; we are all linked together coherently but each doing different things at different paces (Ho, 2003). Rather than a focus on individuals as independent particles or bits of information as independent, there is a focus on the inseparable web of relationships (Bar-Yam, 2004; Newman, Smith, Dexheimer-Pharris, & Jones, 2008; Ray & Turkel, 2014; Smith, 1996). “The properties of the parts can be understood only by the dynamics of the whole” (Capra, Steindl-Rast, with Matus, 1991, p. xii). The whole, while difficult to describe, is more than the sum of its parts. It is dynamic, and always open to possibilities, emerging and unfolding (Bar-Yam, 2004). Energy as cosmic mystery, force, or oneness is a significant component of the new science and is always emerging. Energy within the network of relationships can be created at each local point and can be transferred or spread over entire systems, or the universe itself. In the arena of human and spiritual relationships, energy is viewed as the oneness of God, as love, and as caring (Dalai Lama, 1999; Merton, 1985; Newman et al, 2008; Ray, 1994a, 1997; Teilhard de Chardin, 1957, 1959, 1965; The New American Bible, 1970; Watson, 2005). Energy relates to belongingness and is concerned with “…a reality greater than myself, whether it is a love relationship, a community, a religion, or the whole universe” (Capra et al, 1991, p. 14). Thus, humanity, science, and spirit are no longer separated. “It isn’t a question of science bringing spirituality in. Wolf (2005) states that “it’s more a question of expanding the circle within which both science and spirituality lie, so that the kind of question we can ask can be looked at from the different points of view that both science and spirituality bring to the table” (Wolf in Arntz, Chasse, & Vicente, 2005, p. 210). “To make known the unknown is the rallying cry of science [including the social world and spirituality]” (Arntz et al, 2005, p. 210).
CHANGING VIEWS OF THE TRANSCULTURAL CONTEXT FROM THE PHILOSOPHY OF SCIENCE
Changing views of the philosophy of science facilitate deeper understanding of the changing image of reality as transcultural, technological, dynamic, and emerging. What do we mean by the transcultural context? We know that it encompasses the personal and mutual or the idea of connectedness of person, family, community, society, and the world. To answer this question more specifically in the modern world, we will turn to metaphysics, a branch of philosophy that deals with reality. What is the metaphysical reality (matter and energy/force)? What is the nature of being or person (ontology), how do we know (epistemology), and what is “reality” that lies beyond the physical (the transcendent)? Answers demonstrate that the paradigm shifts over time. Harman (1998) declared that three metaphysical principles of reality underlie science. “Each age had its own characteristic worldview, its characteristic paradigm, and one ultimately leads to another” (Arntz, et al, 2005, p. 29).
Nursing Reflection
Transcultural Context
Persons are intimately related to and are one with their environment—the mutual human-environment process. There is a personal-mutual meaning to relationships, communities, and cultures. “On the one hand, we look outward and attempt to see the world for what it is, and on the other hand we look inward to grow in understanding of ourselves” (Thoma, 2003, p. 15). Our image of reality is always dynamic, emerging, and open to possibilities as we engage in transcultural human relationships.
• In earlier centuries, the first metaphysical perspective—matter and energy, capacity of a force—dealt with matter or material giving rise to mind. At the same time, there was an appreciation of the “oneness” of all (Halper, 2005).
• In the middle ages, the second metaphysical perspective acknowledged the dualistic nature of matter and mind. Mind was considered divided from body (mind-body split) or humanity was divided from nature.
• In the new and third metaphysical perspective, the mind gives rise to matter (Harman, 1998, pp. 29–30); “mind and matter are one and the same” (Arntz et al, 2005, p. 241). “Every sense experience, thought, action and interaction plays out on the field of consciousness” (Arntz et al, 2005, p. 77). Patterns emerge in consciousness from the cellular, to networks of interaction, to collective memory. Human beings, the world, and everything in it are highly complex (Bar-Yam, 2004; Newman et al, 2008). For example, look at the human body: consciousness is not now considered to be located only in the brain but the brain is a reservoir for awareness, understanding, and choice (intentional consciousness). “Quantum computations in our brains connect our consciousness to the funda -mental [sic] universe” (Arntz et al, 2005, p. 138), the human-environment integral relationship. The brain is designed to magnify these quantum effects (interactions of the cortex and proteins that control behavioral action of everything) and project them upward to larger and larger processing elements; the brain is like a computer, an information processing system (Arntz et al, 2005; Smith, 1996). In nursing, Margaret Newman claimed that health was expanding consciousness. Unfolding consciousness is a process that will occur regardless of what actions nurses perform; however, nurses assist clients in getting in touch with what is going on in their lives and in what way they can facilitate the process through caring, pattern recognition, and being open to possibilities (Newman, in Brown & Alligood, 2014).
To explain the idea of consciousness, we will examine this third perspective more fully. The third perspective has been coined as the new sciences of complexity but its roots return to early Greek and Biblical thought (Briggs & Peat, 1989; Halper, 2006). Complexity sciences include various theories, such as the quantum, chaos, holography, and string theories, and concepts, such as consciousness, expanding consciousness (Newman, 1994), belongingness, interconnectedness, uncertainty, dynamism, patterns of relationship, self-organization, and emergence (Bar-Yam, 2004). This change in perspective—the ascent to consciousness—yields a personal-mutual or personal-environmental-global connection including a spiritual connection. “The world as part of our minds is no longer considered lifeless matter…but arises from a field that looks more like information, intelligence or consciousness than like matter” (Arntz et al, 2005, p. 19). In this ascent to consciousness, personalization of the mind is thus, relational. The person as a central being is brought into association with other minds. Because the universe as part of our minds, is no longer considered lifeless matter but arises from a field that is even more subtle than energy, we belong; it is information, intelligence, consciousness, and even love (Arntz et al, 2005; Newman et al, 2008; Ray, 1981a, 1989a, 1997; Smith, 1999; Watson, 2005). The personalized energy of the mind is in communion and communication with the other, persons and nature—the global mind (Capra et al, 1991; Harman, 1998; Goodwin, 2003). Teilhard de Chardin (1959) stated that “[t]o be fully ourselves…we must advance—towards the ‘other’” (p. 263). We belong to the other, the plants, animals, the environment, and the universe. “We all belong together in this great cosmic unity” (Capra et al, 1991, p. 15).
Persons who advance toward the other in the mutual human-environment (transcultural) process have developed structures of cultural knowledge that form our identity, ethnic or cultural or multicultural traditions, and transcultural relationships, which can unite or divide. As living history and tradition, culture and transculturalism provide guidance on how we should live when we share a common humanity with similar and disparate values (Ray, 1989a, 1994b, 2010a, 2010b, 2010c). As such, culture cannot be found in particular cultures nor in specific interactions but in an emergent process—sets of possibilities that are cocreated when people engage in personal responsibility and moral accountability through mutual dialogue and questioning. (See the essence of the theory of “Transcultural caring dynamics in nursing and health care” and its interacting dimensions, where everything is emerging by means of awareness, understanding, and choice— Chapters 1 – 6 .) Teilhard de Chardin (1965) concluded, “[t]he peoples of the earth, the ‘natural units of humanity’ must achieve earthly Harmony through the very variety of their racial [and ethnic] characteristics—characteristics which reciprocally enrich one another” (p. 13).
To build the earth, world culture is faced with “…putting man [human beings] back into the center of the picture (p. 186)…. to transfigure the agonizing immensity of the world into a center of loving energy” (Merton, 1985, p. 191). Human persons must address the meaning of personal and collective identities, the meaning of caring and sacrifice that holds people together, to comprehend the making of modern identity. Teilhard de Chardin claimed that this energy is love; it is not just the ascent to consciousness in the modern sense but the ascent to a superconsciousness, where “the laws of love are directed not merely to the fulfillment of his own will but rather to the transcendent and mysterious purposes of the Spirit, i.e., the good of all men [human beings and animals]” (Merton, 1985, p. 193). Spiritual and ethical superconscious demands that people begin a new life because “the burden of the old has now become an unbearable accumulation of fatigue, mistakes, betrayals, evasions, disappointments” (Merton, 1985, p. 195), as well as “…violence, hatred and revenge” (p. 213). There is the need in individual and world culture to recover humility, authenticity and forgiveness, “to be renewed, transformed and liberated from selfishness and grow in transcultural caring: love (compassion) and justice” (Ray, 1989a, 2010a, 2010c). To illustrate this idea, Merton (1985) stated the following:
… men [and women], nations, and societies are [must be] willing to make the enormous sacrifices required if they are to communicate intelligibly with one another, understand one another, cooperate with one another in feeding the hungry millions [literally and figuratively] and in building a world of peace (p. 219).
THE ONE AND THE MANY
The scientific and theological paradigm shifts are extending to the social sciences and are affecting all cultures (Byrne & Callaghan, 2014; Lemkow, 1990; O’Murchu, 1997). The universe and the people in it as interconnected living beings are part of the emergence of the new conceptions of reality. People are at the heart of the choice to change, to transform. “The key is new knowledge” (Arntz et al, 2005, p. 49) and understanding. The Buddha reminded us that “[w]hat we think we become” (p. 85). What has been so dominant in the past was the Cartesian notion of mind-body dualism—separateness of mind from matter, the observer from what is observed, science from religion, and so forth (Harman, 1998). Now scholars are recognizing that humans are integrally involved in a mutual human-environment process (Rogers, 1970). The human as a microcosm reflects the macrocosm of the “other” as a whole and vice versa (other humans or the universe). There is a similarity of patterns and archetypes that connect. We are intimately connected with what we encounter or observe. The physicist, Capra revealed, “the human is an image of the totally created reality” (1991, p. 115). Personhood or the identity of person now is defined through relationships, self-awareness, or consciousness of the other as related to oneself (Capra et al, 1991). Axelrod (1984) remarked that as we go forward together in the world we must enlarge the specter of the future. Our future can be understood within a caring perspective within the transcultural context. Our future as a transcultural reality, a participatory process, is cocreated through mutual respect and cooperation. Mutual respect in a transcultural context comes by way of transcultural caring (i.e., love, compassion, and justice) if we believe that the future is sufficiently important relative to the present. Because of the new reality of belongingness and interconnectedness in the global world of today, there is an ethical demand (transcultural spiritual-ethical caring communication) for increasing awareness, dialogue, and understanding to facilitate choices that will help heal and transform persons in their environments and cultures—the center of the theoretical model articulated in this book.
Nursing’s Contribution to Understanding the Changing Image of Reality
In nursing, Rogers (1970, 1994; Smith, 1999, 2011) was a leader in science and highlighted the irreducibility of humans and the environment, human-environment integrality in her theory of nursing, the science of unitary human beings (SUHB). This unitive theory gave nursing an understanding that the mutual human-environment process is relational, pandimensional, open-ended (unfolding and emerging), and pattern seeing. It is more than seeing the person as a part, rather as a whole, more than the sum of the parts (Phillips, 1994). Other theorists and scholars followed in Rogers’ footsteps, such as Newman (1986; Newman et al, 2008; Pharris, 2005), who developed the theory of health as expanded consciousness; Parse, who advanced the theory of human becoming (Parse, 1998, 2005); and Davidson (Davidson & Ray, 1991; Davidson, Ray, & Turkel, 2011), who integrated complexity sciences and the SUHB.
In her theory of nursing: Culture Care Diversity and Universality: A Worldwide Theory of Nursing, Leininger (1978, 1991, 1997a, 1997b; Leininger & McFarland, 2006; McFarland & Wehbe-Alamah, 2015) identified the united nature of persons and their cultural context, human community, or environment. The person is a cultural/multicultural being and is connected to the context through transcultural interactions. We share a common humanity, and transcultural care, as Leininger stated, is the universal that connects. To be is to care. The existential philosopher Heidegger (1962) stated that “[t]he totality of Being-in-the-world as a structural whole has revealed itself as care” (p. 231). Care and caring are necessary for human survival, and culture care values and beliefs are embedded in religious, kinship, political, cultural, economic, technological, and historical dimensions. While care is a universal reality for cultural survival, patterns, forms, expressions, and processes of care vary among all cultures of the world. Leininger’s theory helped nursing to recognize that caring is the essence of nursing and that when caring for people, nurses need to understand how people are intimately connected with their cultural context, their ethnic and religious traditions, the changing global community, and the environment. Nurses also must be aware of how human beings have constructed categories or structures of cultural knowledge to make sense out of or construct meaning of the world in which they/we live.
Nursing Reflection
Personhood or the identity of person now is defined through relationships, self-awareness, or consciousness of the other as related to oneself (Capra et al, 1991). In nursing, Boykin and Schoenhofer (2001) illuminate personhood as a process of living grounded in caring; persons are whole and complete in the moment; and personhood is enhanced through participating in nurturing relationships with caring others. Transcultural caring is the universal reality that connects one with the other (Coffman, 2006, 2014; Leininger, 1991; Leininger & McFarland, 2006; McFarland & Wehbe-Alamah, 2015; Ray, 1989a, 1989b, 2005, 2010a, 2010b, 2010c; Ray & Turkel, 2014).
The Meaning of Seeking Understanding of Global Culture and Community
How do people come to identify themselves as belonging to a particular culture, a community, and to the global community that is ever changing? Many people actually feel disengaged from communities that matter, such as at home and work and national and international communities that affect their lives. In the United States especially, individualism is considered a very important value; in the East, communalism is a more important value. In more recent analyses of community and an understanding of consciousness as the “global mind,” there is acknowledgment that human beings relate both individually and communally, that is, relationally—the person is always situated in community, a transcultural context (Cohen, 1985; Day, 2006; Delanty, 2003; Kirkpatrick, 1986; Leininger, 1991; Rogers, 1970, 1994).
What does it mean to be a member of a culture, a community, a transcultural context? How do human beings feel accepted, loved, and cared for? How do others influence them? What facilitates growth and change in a dynamic and complex world of diversity of values in human society as a whole? As science, theology, and other disciplines are accepting the notion of consciousness and experience into their philosophies and research, how will the “global mind” (consciousness) direct the new reality of the meaning of culture as whole, caring, dynamic, and emergent? “No phenomenon in science is more complex, spans a wider range of possible states, or is harder to predict than human social behavior,” stated Vallacher and Nowak (1994, p. xv). “The way we think about people is often complicated, sometimes confusing and never static” (Vallacher & Nowak, 1994, p. 269). Consciousness and the transcultural context are living history.
PROCESSES WITHIN THE DYNAMIC TRANSCULTURAL CONTEXT
“Social and cultural practices, involving work, ideas, projects, beliefs, duties, choices, regrets, fears, both derive from and produce the situation that currently happens to envelop us” (Davies, 2006, p. 9). When culture, which is always dynamic, is developed, cocreated, and enhanced by human beings in relationship, it becomes transcultural. Cultural manifestations address how meaning is cocreated transculturally among people of diverse cultures. How the structures and processes of cultural knowledge can be more understood to determine what is valuable and what should be valued are expressed in ordinary life (Werner & Bell, 2004). Cultural manifestations, such as customs, rituals, words or stories, myths, images or art, food or culinary art, and musical compositions, are illuminated as signs or symbols to convey the meaning of something and communicate information in a culture (Womack, 2005).
Cultural Practices: Customs, Rituals, Signs, Symbols
Cultural practices illuminate customs, signs, rituals, and symbols. Often these practices are characterized as folk, indigenous, or traditional. Customs are “cultural group behavioral patterns or observances that may be established by tradition, social habits, and religious precepts and they are differentiated from specific legal mandates” (Winick, 1970, pp. 148-149). They are enforced by ethical, religious, or social disapproval if there are violations to customary practices. “Both symbols and signs [and rituals] communicate information through images, words, and behaviors” (Womack, 2005, p. 3). Signs convey meaning but have a more fixed meaning or one possible meaning in specific contexts. Signs give direction, such as religious signs that signify the action an individual would take to God’s will in specific contexts (Womack, 2005). Rituals are the prescribed order of customary cultural practices and observances. Rituals are generated over time, provide stability, indicate change, and impart security to people in diverse cultures, for example, birth, marriage, and death rituals observed in all cultures (Womack, 2005, p. 4). “ Symbols [italics added] are above all a means of communication” (Womack, 2005, p. 1). Symbols are indefinite expressions or manifestations of cultural behavior and knowledge and have multiple levels of meaning. As such, “[sy]mbols are the language of religion, magic, and expressive culture, including art, literature, theater, music, festivals, and sporting events” (p. 1). Symbols that express diverse meanings produce action, such as in nursing, the symbol of the stethoscope around the neck replacing the nurses’ cap as a symbol of status and authority. Through collective memory of its rituals, signs, and symbols, culture becomes history and tradition (Wolf, 2014). Bee (1974) stated that all cultures are in a process of sociocultural change. Culture thus encapsulates the past in the present meaning, a “sense” of history by gathering knowledge from humans in the social and cultural practices (i.e., rituals, symbols, and signs) of the world (Davies, 2006).
Emergence and Sociocultural Behavior
Social behavior is always emerging in transcultural contexts. People facilitate understanding by teaching and learning how information is generated and how to use it. In the past, information was transmitted on a much smaller scale, thus cultures were bound and insular. The electronic age of information and communication, however, has revealed the rapidity with which information can be disseminated. Information can be volatile and stable at the same time in global relationships depending on how it is received and what choices are made. Thus, how we process information is paradoxical—on the one hand, information can create conflict to some and stability to others. Either one can become an adaptive state depending on the choices that are made. For example, terrorists adapt to the information that can disrupt stable social behavior. Stimulation from information in this case is agitating. On the other hand, transcultural communicative caring information that supports and reassures a social group can be calming and cocreate unity or a sense of trust and wholeness, even harmony. In the dynamics of information sharing in local and global cultural change, how does one decipher the truth? Philosophers, theologians, and scientists claim that collectively, we have to be open to new ideas, analyze them, reflect on the past, and ethically do the right things to cocreate a future that will be best for all of us (Arntz et al, 2005). Information can be used for good or bad. “Justice [fairness] is the great transformer of earlier misused power that culminated into unresolvable, interpersonal conflicts” (Appleton, 2005, p. 138).
Doing the right thing begins by seeking understanding of how information is clustered and how people network. To cocreate “right” futures calls for aspiring to “a culture of participatory civility where people learn to listen, contribute to, and respond on the merits [of dialogue, public policies] in an atmosphere of mutual respect” (Fishkin, 1992, p. 190). As Rawls (1971; Ray, 1989a; Ray & Turkel, 2014) stated, justice must be distributive so that equal liberty is open to all citizens (locally and globally), and subsequently all citizens have the same basic rights that apply to everyone equally. That component of justice is highlighted in the meaning of transcultural caring as compassion and love and justice as fairness and right action within culturally dynamic communities (Ray, 1989a, 2010a).
A leading social philosopher, Habermas, claimed that people mature through socialization and communication. His theory of communicative action, of shared understanding using reason and knowledge related to social, political, and economic conditions, addressed moral consciousness, the necessity of the claim to truth (doing good), the claim to truthfulness (seeking goodness), and the claim to rightness of how people mutually relate and interact (Habermas, 1995; Ray, 1992, 1999a; Sumner, 2006, 2008). When there is consideration for what it means to be human, and there is negotiated discourse, the discourse is moral (communicative ethics). “Through communicative reason, we strive for mutual understanding and learn to assume the standpoint of the other [compassion and empathy]” (Habermas 2006; Wolin, 2006, p. B16). Problems or misunderstanding often emerge when, in the course of communication, the many languages and interpretations within and among cultures interrupt reasoned discourse. Integration of cultures at such a rapid rate in many parts of the world, especially the West and especially with immigration, opens up the need for continual dialogue about the meaning of communicative interactions within the complexity of the lifeworld.
Transcultural Context as Dynamic
Everything is transcultural. As we know, the transcultural context highlights the person in family, community, and society including technology, organizations, and culture. The transcultural context is complex, dynamic, and emergent. The call to communicative action and the need for transcultural communicative caring ethics reflects a deepening of consciousness in humanity and the world; it is an integration of compassion and justice; it is reinforcement of the meaning of the personal and the mutual; it is a plea to serve the good of all people. As the personal and the mutual become more understood as one and the same, we recognize that what happens to any one of us happens to everyone. We are responsible for self and others and the whole universe.
Understanding structures of experience within patterns of diverse cultures illuminates the interconnectedness of all, and the social systems that are emerging. Structures of social experience form social structures or categories of experience and become institutionalized as norms that can guide and serve the overall good of a society, individual and collective cultures, nation-states, and the global community. The social structure unfolds to reveal the person within family and community not only as social, cultural, ethical, educational, and spiritual entities but also as political, economic, legal, technological, educational, and environmental entities within changing cultural systems. Understanding these structures of experience can come through deep reflection, appreciation, and knowledge of world societies and the need for human caring and justice. Social interaction is cocreated and shaped by history, traditions including religions, political power, laws, cultural energy, and ethical responses to the meaning of the “good” society. Within each society, there is a quest for illumination, recognition, and understanding of diverse values within diverse cultures and races.
As the dynamics of relationship are changing through the dynamics of different forms of cultural and or multicultural learning, destructive patterns of relational energy can create negative energy that ignores the transcultural meanings of what makes a good society or world culture. We can think of the terror created after the experience of September 11, 2001, in the United States where people of many cultures, religions, and countries were affected (Berman, 2004). The event challenged personal understanding and collective consciousness and views of good and evil. It transformed American cultural politics; it caused fear and isolation and retaliation in the form of war, but also opened up room for a national examination of where the American culture is now and where it is going (Sherman & Nardin, 2006). Did the evaluation lead to greater understanding? Knowledge of transcultural energy for good or bad can infuse communities with understanding of the inseparable relationship between the individual and the world. All cultures have a face and a heart. Actions can be manifested by reactions leading to prolonged conflict, violence, and potentially warlike responses or to a deeper understanding of what happens within networks of relationships. The resolution of conflict comes only when all parties finally come to awareness and understanding of our inseparable natures and begin to acknowledge the face and heart of the other. Although difficult, taking the standpoint of the other with compassion, empathy, and justice is crucial for any conflict resolution. The social philosopher, Taylor, reported that in the modern world, the religious notion of agape, which is love that is altruistic, unconditional, and unlimited (Templeton, 1999) will strengthen the idea of serving the good in society to cocreate a better world despite the uncertainty and complexity of all our worlds (1989, p. 516). Furthermore, Habermas (2006; Wolin, 2006) recognized that a new postsecular (postmaterial) moral, political, and economic world is emerging. However, now that ethical, religious, and spiritual views are visibly considered in the realms of the political and economic, they must always be examined within a context of openness and suspension of anyone’s particular religious or spiritual conviction as the path to truth. The intrinsic worth of each person and the diversity of meaning of all views need to be respected and honored. Habermas stated that it is necessary that this extraordinary type of understanding be supported and sustained. As an example, conflict emerged during and after the election in 2007 in Turkey when there was the potential to bring Islamic-inspired rule back to Turkey, which was under a democratic secular rule of law. On July 30, 2008, the court ruled on the constitutionality of the country’s ruling government elected in 2007 declaring it not a threat to Turkish democracy. At the same time, the court restrained the potential for steering the country in a too religious direction (Tavernise in New York Times, Europe Online, July 31, 2008). Thus, cultural or multicultural recognition is supported within cultural and political affiliations and must be sustained through transcultural communicative spiritual-ethical caring (Ray, 1989a, 1994a, 2010a, 2010b, 2010c; Taylor, 1994).
Transcultural Caring as Communicative Spiritual-Ethical Caring
Transcultural nurses support the ideal of communicative spiritual-ethical caring with its focus on compassion and justice within a position of cultural dynamics. Transcultural caring is at the essence of nursing (Ray, 1989a, 1999b, 2010a, 2010b, 2010c; Ray & Turkel, 2014). Transcultural caring as the ideal acknowledges the face and heart of the other as the norm. It is the ground of transcultural communicative spiritual-ethical caring, a spiritual and ethical way of being. For example, professional transcultural nurses engage with patients, the community, and the world community; they seek and serve the good as trusted members of the human community. As a human “face and heart” in a suffering world, nurses reveal compassion and act justly, conveying unconditional love and truth. Transcultural caring nurses speak to understanding humans in need of physical, emotional, and spiritual care given with profound respect and competence for healing, health, well-being, or a peaceful death. Thus, transcultural communicative spiritual-ethical caring is all encompassing.
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