Cultural assumptions

The incident

“The woman arrived at the clinic where I worked as a cultural mediator. She was invited to a brief interview with me, so that I could complete a personal file, before proceeding with the gynaecological examination requested. During the interview, I immediately sensed that she was uneasy and preoccupied. She told me that her two worries were that she did not have a resident’s permit and that she was pregnant.

It was not clear to me whether she wanted to carry on with the pregnancy or not. As a usual procedure, a pregnant patient would be presented with two options. Firstly, she could be offered the possibility to pursue a voluntary interruption of pregnancy (after a consultation with the doctors at the hospital). The other possibility would be that she could carry on safely with the pregnancy and be safeguarded by a particular resident’s permit.

The very perplexed and unsure behaviour of the girl combined with her statement during the interview that she was a Muslim – led me to conclude that she wanted to carry on with the pregnancy. Therefore, I tried to give her as much information as possible regarding the safeguards provided for her by the Italian state in this situation – and regarding the possible assistance she could have received. I hardly pointed to the possibility of a voluntary interruption of pregnancy. It was only shortly after – during the gynaecological examination – that the woman expressed her will to interrupt the pregnancy. I felt lost for a second, as I realised that I had acted on my preconceptions about Muslim women, jumping to conclusions by misinterpreting her behaviour and speech. We then continued the interview after the examination, and I explained the methods and periods of the voluntary interruption of pregnancy.”

1. Identities of the actors in the situation

The situation involves 2 women:

The narrator is an Italian woman working as an intercultural mediator and facilitator in a health facility clinic for foreigners within an Italian hospital. One of the narrator´s tasks is to provide personal files for foreigners, who are going to visit Italian hospitals. She is a 25 years old woman. The narrator can be described as religious with a Catholic background. She is open-minded by attitude and training.

The person, who caused the shock, is a Muslim woman, 28 years old. The woman is a refugee from Maghreb, Northwest Africa. The woman has only been in Italy for a short period of time and she does not speak Italian. She is very Westernised in terms of her appearance.

2. Context of the situation

The two women sat down to complete the patient´s file. This interview took place in a room adjacent to the doctors´ examination room which would be used as part of patient’s review and as a means of completing the patient’s file. They were alone, the door was closed. The mediator tried to offer concrete help but misunderstood the patient’s needs.

Their encounter is about a professional interview, where the mediator is going to open a file on the female refugee as a procedure prior to a gynaecological examination in an Italian hospital. Thanks to the presence of the intercultural mediator, this Italian hospital caters for increasing numbers of refugees/migrants.

The meeting between the two women in this case, from two different social groups, led to a misunderstanding probably also due to the multiplicity of cases arising from the uncontrollable migration flows.

3. Emotional reaction

She had a feeling of despair; she was embarrassed, because she did not understand the needs of this woman. She felt lost for a second, as she realised that she made assumptions, jumping to conclusions by misinterpreting the patients’ behaviour and speech. The role of an intercultural mediator, her role, focuses on overcoming communication barriers, but she was caught up in one because she only heard what she wanted to hear and did not ask the right questions.

4. Representations, values, norms, ideas, prejudice: The frame of references of the person who experienced the shock.

Professional Identity

The narrator has a strong vocation toward helping those who are in need. As a mediator she wanted to present all of the possible options for the patient to choose which suits her best. She offered the whole package of potential solutions in order to keep the pregnancy going (as this was her interpretation of the situation).

Culturalisation, prejudice and self-shock

The patient openly states that she is a Muslim, thus leading the mediator to make assumptions about her will to continue or discontinue her pregnancy. However, as the decision for the interruption suggests, we can make the hypothesis that the patient values her freedom of choice over the precepts of her religion.

As the narrator says herself “I realised that I had acted on my preconceptions about Muslim women, jumping to conclusions by misinterpreting her behaviour and speech.”

Interestingly, conceptions and attitudes that will lead to a negative bias towards other people, do not require any bad intention to form, instead they are consequences of automatic triggers in our perception and thinking processes, and of the basic social motives of belonging and self-enhancement. As the patient presents herself as a Muslim, by culturalisation the narrator does not think that she might want to interrupt the pregnancy because of her religious beliefs.

5. What image emerges from the analysis of point 4 for the other group (neutral slightly negative, very negative, "stigmatized", positive, very positive, real, unreal) etc?

The narrator was regretful for being unable to understand the needs of the women. The image that emerges is a negative image of herself, rather than a negative image of the other. The image of the other woman was rather neutral.

6. Representations, values, norms, prejudice: The frame of references of the person or group that is causing the shock / that caused the shock in the narrator.

1.  Freedom of choice and personal interpretation of the Religion

We could think that the patient might have a wide interpretation of the religion or even describe herself as a Muslim without being an orthodox practicing of her faith. As in many other religions, it could be a cultural heritage for the person but the extent of their engagement can differ from one to another. For example, some Catholics can decide to celebrate Christmas without going to the church for confession.

Allowing precedence to freedom of choice in this situation may also be linked to the context of migration, which has taken her away from her usual family and religion-based context and surrounding, and freeing her from gender-related norms of behaviour.

2. Critical thinking / Rationality

The patient might have also taken into account her new context where she do not have any support system to help her during the pregnancy and raising a child in the new country.

3. Individual safety in a migration situation

Being in a situation of migration, the patient had to take into consideration her own safety and the consequences of a pregnancy on her own life. We can therefore make the hypothesis that she took into consideration the consequences of the pregnancy and the impact of having to care for a child on her current situation. In this sense, we cannot be 100% sure that making the decision to interrupt the pregnancy was an act of freedom of choice, but rather that she felt compelled to make that decision considering her situation.

7. Does the situation highlight any problem concerning the professional practice, or in general about the respect of cultural differences in intercultural situations?

In terms of professional practice, there is a self-perceived failure of the mediator, who, merely on the basis of the knowledge of the woman´s religious affiliation, assumed that the woman wanted to continue her pregnancy and was therefore shocked when the decision made went against her assumption and expectation. Probably, her conclusions were based on a rapid linking of Islam and interrupted pregnancy. From her general cultural-religious knowledge, she assumed that the patient would naturally continue the pregnancy, solely making her decision on the basis of her religious affiliation. However, the narrator made an error of assessment by putting her impressions before the woman’s needs.

This case underlines a situation of self-shock, because the mediator did not expect herself to be acting from preconceptions and even prejudices on the precedence of religion over any other factor for a Muslim person.

Other angles: preconceptions of religiousness and also female subordination to religious (and patriarchal) rules.

The intercultural perspective and the professional skills of a mediator: we have to understand that intercultural understanding is not a question of “knowing about cultural, religious differences and diversity in the world”. Intercultural understanding represents the ability to put questions in an appreciative, non-hierarchical and equal manner, thus showing the respect for diversity.