Which term refers to the tendency for people to use their culture as the standard for evaluating other?

Ethnic Differences

According to the American Society of Plastic Surgeons, more than 3.2 million cosmetic procedures were performed on ethnic minority patients in 2010, an increase of 243% since 2000. Based upon US Census Bureau projections, by the year 2056, >50% of the US population will be of non-Caucasian descent. While mathematical anthropometric measurements of the ideal facial structure have been determined, most of these measurements were based on the Caucasian face. Future anthropometric facial analyses need to take into account not only ethnocentric variations in facial structure and the effects of aging, but also ethnically diverse perceptions of beauty. Ethnic patients do not necessarily desire a Westernized look, as what constitutes beauty is influenced by racial, cultural and environmental factors. Descriptions of ethnocentric variability in these ideals have begun to appear in the dermatologic literature24.

The cosmetic concerns of ethnic patients also vary due to inherent differences in skin structure and physiology [Table 152.3], mechanisms of aging, and facial anatomy [Fig. 152.9]25. In more darkly pigmented individuals, the initial signs of aging may consist of midface volume shifts rather than the solar lentigines and rhytides seen in lightly pigmented individuals. Due to the protective effects of melanin, lentigines and facial rhytides can appear decades later in darkly pigmented individuals. However, dyschromia can be a significant cosmetic concern in these patients.

Summary and Conclusion

Ethnocentrism is an important concept in the study of intergroup relations. William Graham Sumner introduced it, and he advanced the central theorem concerning the concept. In its simplest terms, he held that ethnocentrism—defined broadly as extreme attachment to the ingroup—led to outgroup hate. Moreover, he believed that this link was universal, ingroup attachment and outgroup hate being simply two sides of the same coin.

Research in the social sciences, however, fails to confirm Sumner's hypothesis. Both at the individual and societal levels of analysis, tests of the hypothesis demonstrate repeatedly that ethnocentrism and outgroup hatred are separable phenomena. Ethnocentrism develops first and has different correlates than outgroup hatred. To be sure, the two phenomena are closely related under certain conditions. External warfare and other forms of threat such as extreme famine typically enhance ingroup unity. The lack of contact between the groups also can connect the two phenomena. Similarly, those with authoritarian personalities are more likely to combine ingroup favoritism with outgroup rejection. But Sumner's assumption that the two processes are invariably and universally correlated is not correct.

The breadth of the general concepts involved in the Sumerian hypothesis invites a wide range of indicators for both ingroup and outgroup reactions. The present review suggests the use of multiple indicators for each of the key parts of the Sumnerian hypothesis. For direct indicators of ethnocentrism itself, numerous measures exist at both the individual and societal levels of analysis.

The Impact of Culture and Hand Therapy Intervention

Culture is described as a “blueprint for human behavior”49 and contributes to how one thinks, feels, and behaves.50 Culture operates at different levels—at the regional, community, family, and individual levels.51 Culture is dynamic and contributes to our present diversity of “health beliefs and practices.”52 This influx of multiple health perspectives means that hand therapists need to adapt their practices to meet diverse needs.53

Many commonly used hand therapy assessments have a cultural bias. For example, standard questions related to utensil use ignore the fact that people in many cultures use their hands to eat. Therefore, there is a need to use evaluations such as the COPM and the PSFS to ensure that identified problems and goals are culturally relevant to each person. When goals have been established, direct observation of performance and activity analysis is critical to highlight unique ways of performing activities. This information can be used to tailor hand therapy so that activities reflect culturally important patient goals.9

It is important to examine personal biases, such as assumptions about the beliefs and behaviors of various cultural groups, as well as the biases and assumptions embedded in Western health care systems. These assumptions can affect whether or not an intervention is accepted by the patient and ultimately successful.54,55 For example, the importance of “independence” is rooted in the cultural context of Western medicine and reflective of the sociocultural norms of a white middle-class population.56 A patient may be labeled as noncompliant with treatment such as the provision of adaptive equipment to improve her independence in activities of daily living when in fact the individual believes that it is her family’s responsibility to take care of her after her injury. Family values such as responsibility and role expectations supersede independence in this example.9

The term ethnocentrism passed from social science theory into common English usage during the twentieth century. In present usage it means the belief that one's culture is superior to others the use of a frame of reference derived from one's own culture to judge the arrtibutes of another culture, often in disparaging terms. The term was apparently invented in 1906 by the sociologist William Grham Sumner, who conceptualized it as a means of promoting solidarity within what he called ‘ingroups’ and antagonism toward ‘outgroups.’ He claimed ethnocentrism in this sociological as well as cultural sense to be a universal tendency of intergroup relations among humans. After 1950, Sumner's theory came under criticism from sociologists, who argued that individuals often belong to multiple groups and often admire outgroups, and from anthropologists, who described parts of the world in which ethnic identities, and thus alliances and antagonisms, were unstable historically. As Sumner's sociological formulation and claims of universality lost credibility, the vlaue of the ethnocentrism concept as a descriptor of recurrent attitudes gave it a permanent home in the English language.

Cognitive Assessment and Delirium Risk

In the immediate perioperative period, occult preoperative cognitive impairment in older adults is common; the incidence is more than 20% of patients over 65 years of age presenting for presurgical testing with the highest prevalence in the oldest patients.45 However, talking with patients and families about cognitive health before and after surgery is a new challenge for anesthesiologists. In 2016, the ASA launched the Brain Health Initiative, which is a “low barrier access program to minimize the impact of preexisting cognitive deficits, and optimize the cognitive recovery and perioperative experience for adults 65 and over….” The basic principles of the program include screening for preoperative cognitive impairment and that anesthesiologists lead discussions regarding the potential for postoperative delirium and cognitive dysfunction.

The cognitive assessment of patients prior to surgery can be challenging. In-depth neuropsychiatric testing is not practical for most pretesting centers since it often involves an hour or more of tests administered by a trained individual. More practical for the presurgical arena is the use of brief screening tools that are meant to identify patients who are likely to have cognitive impairment [Table 65.1]. A recent large study suggests that cognitive screening in a pretesting clinic is practical and well accepted by patients and staff members.45 An obvious but difficult question for anesthesiologists is how to proceed when a patient is identified as likely to have cognitive impairment. Informing patients and offeringthem postsurgical follow-up with an expert in cognition is important. The same study showed that patients believe that screening before surgery is important and that they want to know their results. Baseline cognition is also important for delirium-risk stratification; patients with cognitive impairment are at higher risk and therefore may benefit the most from delirium prevention programs. Additionally patients, caregivers, and the perioperative team should have this information since these patients are more likely to require a higher level of care after surgery such as a skilled nursing facility.46 The ACS guidelines strongly recommend performing cognitive assessment early in the patient evaluation because impairment suggests that medication information and functional status reporting may be unreliable, although in the latter there is some evidence to the contrary.47

Although preoperative cognitive impairment is a risk factor for the occurrence and severity of postoperative delirium, it is not the only risk factor.48 There are several delirium-risk prediction indices and examples of two delirium prediction tools are listed inTable 65.2. Whereas each index is a bit different, most include age, cognitive status before surgery, then some index of medical illness, and the invasive nature of the surgery.49-51

10.01.2.13 An Integrative Example of These Definitions

The ethnocentrism mentioned above is an etic. It is accentuated by two other phenomena, which are also probable etics: [i] we have a tendency toward naive realism which limits our capacity to appreciate the extent to which our construals are subjective [Robinson, Keltner, Ward, & Ross, 1995]; and [ii] we have a tendency toward false consensus, which is to think that other humans agree with our positions more than is true, and disagree with our position less than is true [Kruger & Clement, 1994].

In short, we tend to think that the way we see the world is both valid and universal. Our culture provides the “lenses” for seeing the world in a particular way and that way of seeing is so obvious that it is not questioned.

Consider this example. In Orissa, India, most of the population believes that widows must not eat chicken [Shweder, Mahapatra, & Miller, 1990]. When asked if this behavior should be universal they say: “Of course. It is a great sin for widows to eat chicken.” When told that Americans do not believe this, they look down upon Americans, and explain this “moral deficiency” by noting that America is a young country which has not yet reached the level of moral maturity found in India.

Now, consider what happens when Illinois participants are asked whether widows must not eat chicken. They say that this belief is silly. When asked if this rule should be universal, they object vehemently. When told that people in Orissa, India, strongly believe that widows must not eat chicken, they look down upon these Indians, and point out that they are not sufficiently developed to have “correct views.”

Do you see the ethnocentrism in both perspectives? The Indian view stems from the basic assumption that people are interdependent. Married individuals are supposed to be linked to each other for ever. For a widow to eat chicken is a sin because they believe that eating chicken makes one sexually aroused, and such arousal will result in the widow having sexual relations with someone, and thus breaking the eternal bond with her husband. Note that cultures often have sets of beliefs which are supportive of each other.

Now consider the American view. The basic assumption is consistent with American individualism [Triandis, 1995] which assumes that people are autonomous entities. Widows can do their own thing. If Indians have an idea that is different from the American idea, it is because they are not sufficiently developed!

Thus, both cultures conclude that their views are superior and the views of the other culture are inferior. Ethnocentrism leads to prejudice, and attempts to impose the subjective culture of one's own culture on other cultural groups.

This is not the place to debate the merits of individualism and collectivism. Hofstede [1980] linked these concepts with many ecological variables. Triandis [1995] has suggested that individualism is associated with high levels of achievement, creativity, self-actualization, and democracy, but also with high levels of crime, divorce, and child abuse. Collectivism is associated with high levels of social support, cooperation, interpersonal sensitivity, and pleasantness in social relationships, but also with extreme conformity, low creativity, and ethnic cleansing. In short, both cultural patterns have both positive and negative elements, and it is natural for most people from all types of cultures to prefer their cultures. As scientists we can examine the links of ecology, culture, and social pathology, but preferences for social pathology are matters of taste, not scientific judgment!

4.3 Pluralism and Multiculturalism

Yet philosophers who reject ethnocentrism, relativism, and isolationism must still confront the persistence of ethical diversity and disagreement and the challenges they pose, especially in the culturally complex societies found in large, modern nation-states. An increasingly influential response, associated with some forms of ethical pluralism, is the doctrine of multiculturalism, which recommends that we act and judge on the presumption that the ethical beliefs and practices of every way of life are in principle valuable and worthy of respect. But compelling philosophical discussions of multiculturalism have construed this presumption as, at best, a ‘starting hypothesis,’ maintaining that a final verdict on the worth of any practice must always await the results of respectful, but sustained, critical reflection [Taylor 1992]. In response, some philosophers have urged adoption of a critical multiculturalism [as a form of objectivist ethical pluralism] which leaves open the possibility that reflection on almost any practice might generate rationally compelling grounds on which to reject the practice as ethically indefensible [Moody-Adams 1997]. The question of how to put this critical multiculturalism into practice—how to articulate and apply plausible principles for tolerating some stances, rejecting others, and intervening in practices deemed intolerable—will be a central topic of debate in the normative ethical and political philosophy of the twenty-first century.

2.4.3 Universality

Kohlberg has been accused of ethnocentrism and gender bias in claiming universal validity for a stage model that was initially developed from interviews with males in the USA only. Two issues are at stake: first, is there a universal core to morality, and second, is Kohlberg's stage sequence universal? The first issue is dealt with theoretically in moral philosophy and practically in endeavors to win worldwide acceptance for human rights. The second issue sparked extensive empirical research [see Ethnocentrism; Gender and Feminist Studies in Anthropology; Gender Differences in Personality and Social Behavior].

The universal presence of stages 1–4 is reported in a review of 45 studies from 27 widely diverse cultures involving over 5,000 subjects. Postconventional thinking was found in urban samples only, not in traditional tribal or village societies either in Western or non-Western cultures [Snarey 1985]. Principled thinking thus seems a ‘metalevel’ feature necessary for adjudicating conflicts between subculture-specific norms and not required in normatively integrated and isolated cultures.

Gilligan [1982] has claimed the existence of two moralities: a rigid justice orientation more typical for males [corresponding to stage 4] and a flexible morality of care and responsibility more typical for females [corresponding to stage 3]. Empirically, reviews of research involving 19,000 subjects have shown that either there are no stage differences between the sexes [Lind et al. 1987 ] or else they tend not to disadvantage women, or to disappear when education and employment are controlled for [Walker 1984]. Conceptually, Gilligan starts from a more encompassing understanding of morality than Kohlberg by including questions about the good life. Also, there are some theoretical confusions: ‘care’ often is experienced as a ‘duty’ by women, and flexibility—if not a mere reflection of powerlessness—seems a correlate of a modern secularized moral understanding [‘ethics of responsibility’, Max Weber] rather than of sex membership.

6.5 Xenophobia and ethnocentrism

The perceived threat of disease also has implications for xenophobia and ethnocentrism. There are many examples of a general tendency to link subjectively foreign peoples with disease. This link is evident in xenophobic propaganda, in which ethnic outgroups are explicitly likened to pathogenic species or to nonhuman vectors of disease, such as rats, flies, and lice [Goldhagen, 1996; Suedfeld & Schaller, 2002]. The associative link between foreign peoples and disease is also a recurring theme in the social science literature on immigration [Markel, 1999]. In ancient Rome, outsiders were likened to detritus and scum [Noy, 2000]. And in the United States, “foreigners were consistently associated with germs and contagion” [Markel & Stern, 2002, p. 757].

There are at least two reasons why a subjective sense of “foreign-ness” may implicitly connote an increased risk for infection. First, historically, contact with exotic peoples increased exposure to exotic pathogens, which tend to be especially virulent when introduced to the local population. Second, outsiders are often ignorant of local behavioral norms that serve as barriers to pathogen transmission [e.g., norms pertaining to hygiene, food-preparation]; as a consequence, they may be more likely to violate these norms, thereby increasing the risk of pathogen transmission within the local population. Thus, in addition to other threats connoted by outgroup status, people perceived to be subjectively foreign are likely to be implicitly judged to pose the threat of infection.

If so, prejudice against subjectively foreign peoples is likely to emerge most strongly when people are, or merely perceive themselves to be, especially vulnerable to infection. Many studies support this hypothesis. One study examined changes in xenophobia and ethnocentrism over the course of pregnancy. A woman's body is naturally immunosuppressed during the first trimester of pregnancy. This temporary vulnerability to infection results in a variety of functionally adaptive psychological responses, including “morning sickness” and a greater sensitivity to disgust in general [Fessler, Eng, & Navarrete, 2005; Flaxman & Sherman, 2000]. It also results in an exaggerated intergroup prejudice: Compared to women in later stages of pregnancy, women in their first trimester exhibit higher levels of xenophobia and ethnocentrism [Navarrete, Fessler, & Eng, 2007].

Additional studies reveal that increased xenophobia also occurs among people who merely perceive themselves to be vulnerable to infection [Faulkner, Schaller, Park, & Duncan, 2004]. In one experiment, Canadian students completed a task that assessed their attitudes toward immigrants from countries that were either subjectively familiar [e.g., Poland, Taiwan] or subjectively foreign [e.g., Mongolia, Peru]. Immediately prior to this task, participants watched one of two slide shows, designed to make two different kinds of threats salient. One slide show depicted the threat posed by disease-irrelevant mishaps [e.g., electrocution]; the other slide show depicted the threat posed by infectious diseases and the pathogens that cause them. This manipulation influenced responses on the immigrant attitudes task: Compared to the accidents-salient control condition, when the threat of infectious disease had been made salient, people exhibited an exaggerated preference for immigrants from familiar places, to the exclusion of immigrants from more subjectively foreign locales [see Fig. 1.6].

2.2 Consequences

The best studied and most powerful relation is the one obtained for authoritarianism and ethnocentrism. Ethnocentrism is an attitude characterized by the glorification of one’s own group [in-group] and the defamation and discrimination of other groups [out-group]. Xenophobia, racism, and nationalism are other orientations similar to ethnocentrism. An authoritarian personality tends to be more ethnocentric. In certain circumstances [situational factors], the just mentioned attitudes can lead to discrimination, violence, and hate crimes.

Authoritarianism is also connected to other attitudes, namely sexism, anti-Semitism, cognitive rigidity [dogmatism], and political and economic conservatism. Authoritarian personalities tend to devalue women, homosexuals, and Jews. They strongly support the market economic system and back conservative political movements. Authoritarianism also may explain oppression, chauvinism, and negative put-downs on the individual level and the level of society. Many of the empirical findings on consequences of authoritarianism may, however, rightly be accused of bearing an element of tautology because almost all consequences addressed could also be seen as elements of the authoritarian syndrome per se.