Cultural differences

[luckyPharmD.stu]

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To the doctors or anyone in residency, I've read a book dealing with doctors and patients; in one scenario, the superior court agreed to a doctor's request to take the patient away from her parents to a foster home when the parents continually gave the wrong amount of medicine and also refused to give recommended amount as well because of cultural differences. In their tradition, a shaman would perform a ritual to cure the disease; by the way, the patient who is an infant suffers from epilepsy. After realizing that the court would definitely side with the doctors, i decided to write a research report for my class about the rights that the doctors have and what the patients cannot do. any examples of a certain court case relating to this would be appreciated. So what are your opinions about patients; what rights do you doctors have that patients don't?

 

[CTKN2]

I think you're referring to the book, The Spirit Catches You and Then You Fall Down (or something like that). It's about a Hmong family in Merced County, California, and if it's not this book, well, then it's pretty darn similar. It's been a while since I read the book, but I believe that the Hmong family eventually got their child back and were allowed to care for her until she died (I think maybe 10 years later). It's more a case to illustrate the misunderstanding between two different cultures. I'm not sure if it's fair to say that the court will always side with the doctors. As doctors and medical students, we are particularly knowledgeable about biology and disease states, and so, when a patient or his/her family disagrees with treatment plans, we tend to think that they're not doing the right thing for themselves without trying to understand or be sensitive to the patient's expectations and wishes. We have a bias towards our own understanding of what is happening to a patient. And because our society views us as scientific and knowledgeable, the courts who also see us this way tend to side with the doctors. I don't really see it as doctors having more rights than patients do...

However, I have heard of cases of where misunderstanding leads to bad things....like intubation of a patient because they could not understand commands (they couldn't speak English and therefore could not follow commands!) or where bad interpretation leads to patients being treated without proper consent...

Any thoughts?

 

[Stillorgan]

I think you're referring to the book, The Spirit Catches You and Then You Fall Down

 

[CTKN2]

lol!

 

[8744]

Call me crazy but I think that if a foreign patient checks himself into a modern American hospital the presumption should be that he wants Western medicine and not a sprinkling of chicken blood or a poltice of yak vomit.

 

[8744]

In their tradition, a shaman would perform a ritual to cure the disease...

And yet, if I stormed into my program director's office and demanded that we troll the local churches for a couple of faith healers and a snake handler or two I'd be flatly refused.

Clearly, some cultural practices are sexier than others.

 

[monkey7247]

true, so true.

 

[EctopicFetus]

Call me crazy but I think that if a foreign patient checks himself into a modern American hospital the presumption should be that he wants Western medicine and not a sprinkling of chicken blood or a poltice of yak vomit.

So true.. By showing up you consent to CERTAIN care that doesnt require more care.

Also, keep in mind that when it comes to children things are quite different. It is hard for a parent to refuse treatment if the MD thinks it is necessary. See the rule on giving blood to Jehovahs Witness children. I would say that most MDs are more conservative with blood products in these kids but at the same time they can give it without parental consent.

 

[CTKN2]

Call me crazy but I think that if a foreign patient checks himself into a modern American hospital the presumption should be that he wants Western medicine and not a sprinkling of chicken blood or a poltice of yak vomit.

When someone comes into a hospital, it doesn't necessarily imply consent...example: someone hit by a car or in some other accident...they may find themselves checked into a hospital upon waking...

Making assumptions can lead you to a lot of trouble. Patients may assume that we see things the way they do...just the way we assume that they see things the way we do...example: medical jargon - we use it, not realizing that people don't know what the heck we're talking about...

 

[8744]

When someone comes into a hospital, it doesn't necessarily imply consent...example: someone hit by a car or in some other accident...they may find themselves checked into a hospital upon waking...

Making assumptions can lead you to a lot of trouble. Patients may assume that we see things the way they do...just the way we assume that they see things the way we do...example: medical jargon - we use it, not realizing that people don't know what the heck we're talking about...

True enough. On the other hand the what passes for cultural competance today reminds me of the guy who as a revolt from what he sees as the inconsistancies and irrationality of Chrisianity converts to Buddism.

In other words, some cultural practices are more trendy than others. The Hmong and their completely irrational, non-evidence based tradition of coining is particularly appealing now as a result of the above-mentioned book the reading of which is now practically required at the trendiest medical schools.

And yet the same people who will go into raptures over the ancient wisdom of the Hmong will fly into a rage over the not so ancient wisdom of the Jehovah's Witnesses.

I also imagine that even the most politically correct hospital would balk at performing an infundibulation on a young Sudanese girl even if it is part of their ancient cultural practice.

Personally, I am sick of hearing about the Hmong. Isn't it time we moved-hmong.org?

 

[mosche]

Personally, I am sick of hearing about the Hmong. Isn't it time we moved-homng.org?

Panda Bear, you always have a unique viewpoint that makes me laugh!