Ontological personalism and identity–safety conflicts in multicultural clinical environments

Globalisation and migration have transformed healthcare environments into increasingly multicultural settings where health professionals, healthcare students, institutions and patients may hold different understandings of identity, responsibility and professional obligations. These encounters frequently generate tensions that are often interpreted as conflicts between competing autonomies, rights or claims. Although such situations are commonly approached through Principlism and deliberative ethics, the possibility of reaching different yet ethically defensible conclusions may leave important normative questions unresolved. This article explores Ontological Personalism as an alternative framework for analysing such situations. Using the triangular method and a hierarchy of ethical principles, the paper examines three documented cases involving tensions between personal identity and clinical requirements: two Muslim healthcare professionals facing restrictions associated with ‘bare below the elbows’ policies, a Catholic nursing student required to modify religious attire during clinical training and Sikh healthcare professionals confronted with personal protective equipment requirements during the COVID-19 pandemic. The analysis suggests that these situations should not be understood merely as conflicts between competing autonomies and institutional rules, but as ethical tensions involving multiple actors, responsibilities and goods in need of reconciliation. By integrating respect for life, freedom and responsibility, totality and proportionality, and sociability and subsidiarity within a structured ethical framework, Ontological Personalism provides a coherent approach for analysing identity–safety conflicts across diverse cultural contexts. The article argues that Ontological Personalism offers a coherent framework for analysing identity–safety conflicts by integrating empirical information, anthropological understanding and ethical obligations within a structured methodology.