256 M. Coombs and M. Woods
individuals who ‘always want[ed] to help others’ even after death. It may
be argued that this willingness to contribute to the public good spans
all cultures, although clearly there are considerable social, cultural, and
religious factors that influence decisions about organ donation (Cooper
and Kierans 2016 ). However, organ donation and the receiving of organ
transplants is not a cultural norm in every society, as evidenced by the
reluctance and unease among Asian and Muslim peoples (Vathsala
2004 ).
Although it is less common to donate body parts after death among
Māori (Mauri Ora Associates n.d.), Clifford’s case demonstrates that
it inappropriate to assume a blanket refusal (or acceptance) from any
given socio-cultural group towards a particular ethical position. Indeed,
the particulars in Clifford’s case appear to indicate a growing acceptance
of organ donation within some Māori communities. As rates of end-
organ failure continue to rise dramatically in such populations, organ
donation and transplantation may become more acceptable (Mauri Ora
Associates n.d.). Nevertheless, cultural sensitivities are not to be overrid-
den, and the beliefs and value systems of members of any social group
must be given full ethical consideration.
All of this brings to mind a particular ethical model expressed across
all three cases: the need for a greater appreciation and application of
a more ‘socially orientated ethic’ (Woods 2010 : 722). This approach
advocates the importance of three major ethical principles necessary in
the decision-making process to enable a socio-cultural ethics perspec-
tive to flourish. The principles are the promotion of social justice and
empowerment, a greater recognition of both individual and collective
cultural autonomy and identity, and the everyday pursuance of trust
and respect within healthcare and societal contexts between providers
and recipients. As such, this ethical approach signifies an alternative and
complimentary ethical perspective to those approaches more tradition-
ally used (e.g. Beauchamp and Childress 2013 ).
However, Clifford’s whānau had little difficulty in feeling empowered
to exercise their autonomous right as a collective to donate organs at the
time of Clifford’s death (‘We discussed organ donation as a family ...
there was no doubt in my mind’). In doing so, as in the previous cases, the
common driving force behind the decision was to do good (‘it would be
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