Patient Conversations: Why Cultural Safety Matters in Medical Cannabis Prescribing

Published: July 2025

As medical cannabis becomes an increasingly accepted therapeutic option in Australia, healthcare professionals should consider not only the clinical aspects of prescribing, but also the cultural safety of their practice. For many patients, particularly Aboriginal and Torres Strait Islander peoples and those from culturally and linguistically diverse (CALD) communities, engaging with the healthcare system can carry risks of misunderstanding, harm, and marginalisation if cultural needs are not recognised and respected.^1,2

What exactly is “Cultural Safety”?

Cultural safety is a patient-led concept that focuses on whether individuals feel respected, heard, and safe during healthcare encounters.³ It goes beyond merely being aware of cultural differences (i.e. "cultural awareness”) and requires healthcare professionals to reflect on their own biases, power, and privilege while actively adapting their care to meet the needs of the patient’s cultural identity and lived experience.⁴ Ultimately, it is the patient, not the healthcare professional, who determines whether an experience is culturally safe.³

Why is this important for medical cannabis?

Medical cannabis use can be influenced by personal, cultural, legal, and social factors. Patients may have concerns regarding stigma, legality, or family and community expectations.⁵ For some, complementary medicines may resonate with cultural healing traditions.⁶ For others, medical cannabis may invoke social stigma from within their communities.⁶

For Aboriginal and Torres Strait Islander peoples, the impacts of colonisation, systemic racism, and intergenerational trauma can contribute to distrust of mainstream healthcare.¹ For CALD communities, differing views about health, medicine, and healing may shape how medical cannabis is perceived.⁶

Practical considerations for culturally safe medical cannabis prescribing

Stigma

• Acknowledge the historical criminalisation of cannabis and its disproportionate impact on some communities^6,7: Be prepared to address patient concerns about legal issues, confidentiality, and fear of judgement.
• Recognise that concerns around stigma may be heightened among Aboriginal and Torres Strait Islander peoples and CALD patients, who may have previously experienced discrimination within healthcare and legal systems.^8,9
• Creating a safe, non-judgemental space is essential. This involves using inclusive and respectful language, and reassuring patients about the confidentiality of their care, and the legal and clinical appropriateness of prescribed medical cannabis.⁸
• For Aboriginal and Torres Strait Islander patients, it is important to understand the impact of intergenerational trauma and to approach care with cultural humility and respect for their lived experiences.⁹

Access and equity

• Understand that cost, geographic barriers, and language barriers can impact access to medical cannabis.¹⁰
• Share options and advocate for equitable prescribing pathways, such as the Compassionate Access Schemes offered in some states¹¹ and through selected medical cannabis organisations.
• Provide translated information where available, engage with interpreters, and guide patients through application processes.⁸
• For Aboriginal and Torres Strait Islander patients, consider the added importance of family and community in decision-making and support models: Collaborate with Aboriginal Health Workers or Aboriginal Community Controlled Health Services (ACCHSs) to provide culturally appropriate care.⁹

Cultural perceptions

• Some patients may see cannabis as an extension of traditional medicine⁶, while others may associate it with substance misuse or illegality⁶: Approach these discussions with curiosity, not assumptions.
• Explore patients’ beliefs about healing and medicine, and be open to integrating their cultural practices with medical care where safe and appropriate.⁸
• For Aboriginal and Torres Strait Islander patients, acknowledge the importance of connection to Country, spiritual wellbeing, and traditional healing, and consider these when framing discussions about treatment.⁹

Supporting cultural safety with SPIKES

When introducing sensitive treatments like medical cannabis, healthcare professionals can enhance cultural safety by using structured communication tools. One such tool, the SPIKES framework, was originally developed to aid communication of ‘bad news’ in healthcare¹², and can be applied to fostering effective communication with diverse patients.

Adapted from Buckman 2005

Summary

Medical cannabis may offer symptom relief for some patients when clinically appropriate, but how it is introduced matters. Culturally safe practice, guided by structured, empathetic communication models such as SPIKES¹², ensures that care is not only clinically sound but also respectful, empowering and patient-centred.³

Cultural safety isn’t a checkbox; it is an ongoing commitment to reflection, understanding, and partnership. Every conversation is an opportunity to make healthcare a safer, more inclusive space for all.

Job code: MONT-SGD-2025-0005 | Date of preparation: July 2025