Table 4.

Indicative quotations: a balancing act: values, beliefs, trust and respect in everyday practice

Participants	Quote
P51 (female, medical practitioner)	So, we get taught a lot in terms of the indigenous cultural sensitivities about discussing it with the right people, but it’s very much in conflict with our own ethics about autonomy and we can’t really override a patient’s autonomy. It’s really important that their wishes are being granted. So, it’s often this internal conflict for us and also trying to do the right thing by the patient (FG8).
P11 (female, medical practitioner) P8 (female, nurse) P9 (female, speech pathologist)	… toe that line (FG2). It’s all about crossing that bridge and make sure you don’t fall (FG1). … treading a fine line (FG1).
P13 (male, medical practitioner)	I think you have to be culturally sensitive, but you also have to disclose information in an honest, open manner, and that’s the first step of establishing, I guess, trust. Sometimes it can lead to families being very angry, but there may be ways of discussing cancer, not using the word cancer, but explaining to them what cancer means more than anything. That’s generally how a lot of us are trying to get around that (FG2).
P41 (female, social worker)	I think what you were saying before about a level of distrust, there’s a lot of that as well. Because revealing what (alternative medicine) you’re taking has the danger of being told not to use it and perhaps, because it’s very much a medical model here, they may not feel there’s a sympathy towards that perspective either. So that unfortunately then can set up an adversarial relationship where they’re feeling that their beliefs aren’t being respected and their way of managing health is not being respected and then the gap gets wider (FG6).
P8 (female, nurse) P2 (female, physiotherapist)	P8: … respecting what they want to know, not what you think that they should know. P2: Yeah, get rid of that maternalistic stuff. P8: Exactly. It’s like, I know that you want to do your job, but, really, are you doing your job if you’re distressing them? No, you’re not (FG1).
P15 (female, medical practitioner)	… he’s getting something and they’re happy with that, and I put clear boundaries of, “But if he becomes symptomatic and it makes him sick I will need to stop it because I don’t want to hurt him”. But sometimes you just need to let go of what you think is medically most appropriate, as long as you’re not causing harm (FG2).
P48 (female, nurse)	I think you’ve got to acknowledge and respect those patients for their beliefs and cultures. In my experience and the way I’ve been trained is to try and respect those patients, but then balance it with, “Well at the moment you’re receiving this special chemo that will help. You might need to lay off your complementary medicine just while you’re receiving the treatment because we’re not sure how it will make you feel”. So try and let them know that it has a place, but maybe at that stage of their treatment it’s not necessarily the right thing (FG7).