Cultural and ethical differences in EU-projects: unexplored potential and methodological consequences

Background: Cultural differences across Europe strongly influence healthcare and palliative care, shaping values related to health, gender, family, religion, life patterns, and language. These differences raise ethical issues in patient’s vulnerability, equity, autonomy, and distributive justice. While ethical approval is often used as a checkpoint to counter differences, patients, families, healthcare professionals, and researchers can also learn from these diverse perspectives. As researchers from different countries bring diverse cultural and ethical perspectives to international collaborations, would this not be a unique opportunity of learning from these differences?
Aim/Research question or hypothesis: To explore the way cultural and ethical differences among nine European countries are reflected in palliative care and propose a better way of incorporating these differences in research.
Methods: The RAPHAEL-project integrates palliative care services for people with heart failure in nine European countries. An ethnographic research design was employed. The study population included all research partners within the RAPHAEL consortium. Participatory observation was used to monitor ethical and cultural values, and structured Discussion s with the partners were facilitated, and their outcomes incorporated into the project’s deliverables.
Results: The ethical analysis explored the influence of cultural and structural biases on international research collaborations. By comparing nine countries, it identified potential epistemic and cultural biases that could distort the fairness of collaboration and the validity of findings. These insights are integrated in the project’s structure to mitigate the impact of such biases. This strengthens the project’s ethical foundations and generates insights into cultural biases in communication, data interpretation, and knowledge exchange.
Discussion: Equity is central to patient care and research partnerships. Without addressing cultural and structural inequalities, dominant perspectives can marginalise others. Variations between healthcare systems demonstrate the need for context-specific approaches. The RAPHAEL project recognises and actively integrates diverse professional and cultural viewpoints, promoting ethical fairness and methodological rigour and fostering equitable and context-sensitive palliative care research.