Cultural competence literature and training aim to equip healthcare workers to better understand patients of different cultures and value systems, in an effort to ensure effective and equitable healthcare services for diverse patient populations. However, without nuanced awareness and contextual knowledge, the values embedded within cultural competence practice may cripple rather than empower the very people they mean to respect. A narrow cultural view can lessen cultural understanding rather than grow it. In its first part, this paper argues that a hasty, unrestrained, and uneducated willingness to accept something as a cultural good, despite being well intentioned, can still cause significant harms-particularly when based on false, misinformed, and stereotypical conceptions-including the minimization of issues, the reinforcement of stereotypes, and the impediment of cultural change. The second part of this paper examines medical autonomy within the context of Saudi Arabian women. It pushes back on the common perception that Saudi women, by virtue of culture and religion, view dependency on and deference to male relatives as a cultural good. Through a historical examination and a presentation of the current women's movement in Saudi Arabia, it is argued that the continued assumption that personal agency is a value external to Saudi women is false, misguided, and ethically problematic. Lastly, this paper considers some approaches to help providers navigate the narrow grounds between paternalism and patronization when caring for patients.

Background The purpose of this study is to make a philosophical argument against the phenomenological critique of standardization in clinical ethics. We used the context of clinical ethics in Saudi Arabia to demonstrate the importance of credentialing clinical ethicists. Methods Philosophical methods of argumentation and conceptual analysis were used. Results We found the phenomenological critique of standardization to be flawed because it relies on a series of false dichotomies. Conclusions We concluded that the phenomenological framing of the credentialing debate relies upon two extreme views to be navigated between, not chosen among, in the credentialing of clinical ethicists.