Hi, I’m Heather Haynsen and for my final project I’d like to discuss a situation that arose earlier this fall within my parent company, Pearson. On October 18th, a student tweeted a photograph from a page of our textbook “Nursing: A Concept-Based Approach to Learning,” and she called out racism in a passage intended to explain cultural differences. The next day, on October 19th, Pearson pulled the offensive content, and issued a public apology vowing to overhaul their content approval process. Then on the 20th, management issued an internal apology explaining the situation to employees, which is when I first heard of this crisis.
The ethical dilemma I’m interested in here is not Pearson’s reaction, but their publishing of racist text in the first place.
(2) Before I dig into that, I want revisit Dialogical Perspectives. Most of what we’ve discussed this semester involved mutual dialogue, either face-to-face or online interactions. But most, if not all, educational material exists in the middle of Buber’s Monologue-Dialogue Continuum, as Impersonal Communication, or “Technical Dialogue”. Textbooks focus on “objective understanding of information,” and assume that students will accept everything they learn. While there is dialogic communication involved in the creation of curriculum content, published educational material relies solely on imposing truth on readers and influencing their understanding of the world around them.
(3) Racial discrimination in textbooks is a systemic issue in our society, seen most often in History texts. In 2015 McGraw-Hill apologized for referring to slaves as “immigrant workers,” which they called an editing error.
(4) This so-called error pushed their textbook to the Monologue side of Buber’s scale, observing and classifying others without any pretense of authenticity or inclusion.
The earliest instance I could find of similar issues was a 1944 delegation with New York City Public Schools that sought to correct errors in history curriculum… one of the most egregious was a book that said slaves were “happy.” 70+ years of lying in history textbooks is not an ethical dilemma, it’s a societal epidemic of spouting whitewashing monologue. But that helps set the scene for the ethical dilemma Pearson recently faced.
(5) Now to the nursing textbook. This is the initial tweet on October 18 that led to public outry. As you can see, in a call-out box labeled “Focus on Diversity and Culture,” the text outlines extremely oversimplified and racially disparaging categorizations of different culture’s responses to pain. While I want to make it clear that I agree this content as written is discriminatory and indefensible… but the idea to include this content came from a desire to lean towards dialogue, encouraging students to “see the other” and “experience the other side.”
(6) Let’s listen to Pearson’s public apology. Tim admits that the content was wrong, unthoughtful, and in disagreement with Pearson’s core values. His apology seems sincere, and it earned him many positive comments from internal stakeholders. But the ethical problem persists because somewhere within the company, this content passed as fit for publication.
Ensuring that nursing students understand cultures different to their own is paramount to effective, respectful health care. Here I think the ethical dilemma stems not only from oversimplification of cultures, which can be considered unethical on its own for turning away from genuine dialogue, but more so unethical in utilizing the Universalist approach to multicultural communication.
The text box treats all cultural traits negatively, from remaining stoic to acting demanding while dealing with pain. While the text does not guide nurses towards a more favorable reaction to pain, it treats all reactions from minority cultures as universally unfavorable. However, if the text took a Relativist approach that all reactions to pain are equally valuable and therefore nothing to take note of, nursing students could miss valuable insight on how to deal with patients different from themselves.
(7) For example: in 2015, western health workers fighting Ebola in Africa needed to be both aware of and sensitive to local traditions that often involve touching the bodies of deceased loved ones to prepare them for burial, which was in turn spreading Ebola to the mourners. A Relativist approach would have let those cultural traditions continue unhindered out of respect, and a Universalist approach would have forcibly stopped all such traditions in the name of public health. Both happened. Education in transcultural communication could have helped health workers engage in dialogue and reach an ethical compromise sooner and more efficiently, and notably with fewer deaths.
(8) The ethical dilemma of how to address cultural differences, especially in professions such as nursing, will not disappear anytime soon. Educational materials have a track record of leaning unethically towards racism, making the dilemma even more acute. I do not believe that Pearson made the best, most ethical choice when writing and approving the content for this textbook. Authors and editors would have better served their nursing students by infusing the text with authenticity and inclusion, treating all cultures respectfully and describing differences as accurately as possible, without stereotypes or oversimplification. Pearson could have also included guidelines for nurses to engage in genuine dialogue with patients who are in pain.
(9) Pearson did their students a disservice by presenting cultural differences through a Universalist lens. The authors should have sought a transcultural approach to ethics, teaching nurses that all cultures act rationally and to employ the Platinum Rule towards their patients. More empathetic than the Golden Rule, the Platinum rule states: “Do unto others as they would have you do unto them, not as you would have them do unto you.” This requires understanding and respecting the needs of others, which can be especially effect in caregiving professions.
(10) I realize this was a bit of a convoluted presentation, but I wanted to show this issue in the appropriate contexts. Students want sensitive, not discriminatory curriculum. Pearson and other publishers agree, yet continue to publish materials that, as Tim Bozik admits in Pearson’s public apology “reinforce stereotypes about ethnic and religious groups.”
So, as professional communicators and as students, I have two questions for you: Should educational material be held to different ethical standards than other communication? How do you suggest authors create educational material that is ethically sensitive of race and culture but not discriminatory? Thanks for listening, and I look forward to your feedback!
Bozik, T. (2017, October 19). Apology for nursing textbook issue. Retrieved December 03, 2017, from https://youtu.be/PnXjq6XdLw8
Bradford J. Hall, “Culture, Ethics, and Communication,” in Fred L. Casmir, ed., Ethics in Intercultural and International Communication (Mahwah, NJ: Erlbaum, 1997), pp.11-42.
Hills, K. (2017, October 18). HOLY SHIT! @pearson actually published this racist bullshit in a nursing textbook. #bioethics pic.twitter.com/EtC6BuDHyy. Retrieved December 03, 2017, from https://twitter.com/rocza/status/920708665233039361
Inside Higher Ed. (2017, October 23). Anger Over Stereotypes in Textbook. Retrieved December 03, 2017, from https://www.insidehighered.com/news/2017/10/23/nursing-textbook-pulled-over-stereotypes
Isensee, L. (2015, October 23). Why Calling Slaves ‘Workers’ Is More Than An Editing Error. Retrieved December 03, 2017, from https://www.npr.org/sections/ed/2015/10/23/450826208/why-calling-slaves-workers-is-more-than-an-editing-error
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