{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T05:57:40Z","timestamp":1791266260230,"version":"4.1.0"},"reference-count":17,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001234","name":"Royal Australian College of General Practitioners","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001234","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003921","name":"Department of Health, Disability and Ageing","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003921","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Journal of Australia"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Culturally safe, racism\u2010free healthcare is essential in Australia, yet Aboriginal and Torres Strait Islander people continue to face inequitable access, experiences and outcomes. Although cultural safety is widely cited, implementation remains shallow and disconnected from patients' realities. We argue that meaningful cultural safety requires Aboriginal and Torres Strait Islander governance, robust measurement and institutional accountability. Evidence shows that culturally unsafe care, including racism, creates psychological distress, leads to care avoidance and results in poorer outcomes, whereas Indigenous\u2010led models perform considerably better. We propose a framework to strengthen cultural safety through Aboriginal and Torres Strait Islander community\u2010governed assessment, greater accountability, data sovereignty and mandated cultural safety and anti\u2010racism standards.<\/jats:p>","DOI":"10.5694\/mja2.70295","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T09:29:49Z","timestamp":1789378189000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Centring Aboriginal and Torres Strait Islander Voices: A Framework for Culturally Safe and Racism\u2010Free Healthcare"],"prefix":"10.5694","volume":"224","author":[{"given":"Elissa","family":"Elvidge","sequence":"first","affiliation":[{"name":"School of Medicine and Public Health University of Newcastle  Newcastle New South Wales Australia"},{"name":"Microbiome and Host Health Program South Australian Health and Medical Research Institute  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roianne","family":"West","sequence":"additional","affiliation":[{"name":"Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Nicholls","sequence":"additional","affiliation":[{"name":"Thurru Indigenous Health Unit, School of Medicine and Public Health University of Newcastle  Newcastle New South Wales Australia"},{"name":"Aboriginal and Torres Strait Islander Health Council Royal Australian College of General Practitioners  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiara","family":"Harvey","sequence":"additional","affiliation":[{"name":"Microbiome and Host Health Program South Australian Health and Medical Research Institute  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeena","family":"Thompson","sequence":"additional","affiliation":[{"name":"Office of Indigenous Strategy and Leadership, Vice\u2010Chancellor's Division University of Newcastle  Newcastle New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geraint B.","family":"Rogers","sequence":"additional","affiliation":[{"name":"Microbiome and Host Health Program South Australian Health and Medical Research Institute  Adelaide South Australia Australia"},{"name":"Flinders Health and Medical Research Institute, College of Medicine and Public Health Flinders University  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yin","family":"Paradies","sequence":"additional","affiliation":[{"name":"Faculty of Arts and Education, School of Humanities and Social Sciences, Alfred Deakin Institute for Citizenship and Globalisation Deakin University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,14]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12874\u2010019\u20100815\u20108"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fnhli.2026.100120"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/10376178.2022.2027254"},{"key":"e_1_2_10_5_1","volume-title":"Monitoring Aboriginal and Torres Strait Islander Mental Health and Wellbeing Around the Voice to Parliament Referendum","author":"Thurber K. A.","year":"2025"},{"key":"e_1_2_10_6_1","volume-title":"An Aboriginal Cultural Safety Framework for New South Wales Hospitals","author":"Elvidge E.","year":"2020"},{"key":"e_1_2_10_7_1","volume-title":"Determinants of Health for First Nations People","author":"Australian Government, Australian Institute of Health and Welfare","year":"2024"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fnhli.2025.100061"},{"key":"e_1_2_10_9_1","volume-title":"Health Inequities in Australia: A Scoping Review on the Impact of Racism on Indigenous and Other Negatively Racialised Communities' Health Outcomes and Healthcare Access","author":"Demant D.","year":"2024"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-025-02478-3"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1071\/AH21189"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajs4.350"},{"key":"e_1_2_10_13_1","volume-title":"NSQHS Standards (third edition) Engagement Hub","author":"Australian Commission on Safety and Quality in Health Care","year":"2026"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-021-01433-2"},{"key":"e_1_2_10_15_1","volume-title":"Exploring Aboriginal People's Experiences of Hospital Care","author":"Crook C.","year":"2025"},{"key":"e_1_2_10_16_1","volume-title":"About Us: Transforming Health for BC First Nations","author":"First Nations Health Authority","year":"2024"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/0840470415600131"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanwpc.2025.101796"}],"container-title":["Medical Journal of Australia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.5694\/mja2.70295","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.5694\/mja2.70295","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.5694\/mja2.70295","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T09:23:39Z","timestamp":1790328219000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.5694\/mja2.70295"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":17,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.5694\/mja2.70295"],"URL":"https:\/\/doi.org\/10.5694\/mja2.70295","archive":["Portico"],"relation":{},"ISSN":["0025-729X","1326-5377"],"issn-type":[{"value":"0025-729X","type":"print"},{"value":"1326-5377","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"2026-03-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70295"}}