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Culture in healthcare essay
Culture in healthcare essay
• What aspects of culture should be given consideration in the health care industry
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In America the clashing of cultures is inevitable due to the different backgrounds that make up the country --- especially when it comes to treating patients medicinally or through more traditional ways. The conflict occurs in The Spirit Catches you and You Fall Down By Anne Fadiman, when the culture of western medicine collides with Hmong practices. A daughter of a Hmong family, Lia, suffers from epilepsy and is brought to the Merced Community Medical Center (MCMC) to seek treatments that will alleviate the symptoms of her seizures. While the doctors and parents try to find ways to help Lia, they encounter cultural barriers such as their differences in practicing medicine that inhibit their ability to help her efficiently. The MCMC doctors and the parents are both responsible for the increasing cultural conflicts because of their negative biases towards each other long before they meet.These negative biases were later enforced by their lack of trust and respect as the book progressed. The Hmong have very little knowledge about American doctors, causing them to make negative assumptions about them. Their opinions about American doctors came from the limited encounters the Hmong had with them in the refugee camps. Since the camps were small refugee medical centers in which doctors could not cater to the needs of every patient, these interactions had “done little to instill confidence” (33) in doctors. The Hmong were taught to believe that American doctors could possibly eat their patients brains and “put their fingers inside women’s vagina” (33). Txiv neebs, their traditional doctors, would never dare to perform any acts that included them to take off their clothes for check up, or any procedures in which they would have to perf... ... middle of paper ... ...tandings that came with cultural it is important to build trust and respect between both parties’ otherwise it would only lead to more misunderstandings. The cultural barrier between the Lee’s and the doctors was result of their negatives assumptions about each other. Both parties believed that their own treatment was the best way to help Lia deal with her epilepsy. As a result of their inability to look past their own perspectives and remain in their own spheres they moved further away towards a mutual understanding. It is usually harder to trust someone when you already have negative assumptions about them, making the trusting each other near to impossible. If the doctors and parents look passed these assumptions and looked at the situation through an untainted perspective then they would have had better chances of having respect for each other in the beginning.
Dr. Roger Fife is liked by the Hmong because, in their words, he doesn’t cut. He is not highly regarded by the other doctors for many reasons. I believe Dr. Fife is generally a good doctor I would rate him about a 7 on a scale of 1-10 because he listens to his patients and takes his patients’ culture into consideration, but he does have certain weaknesses that makes him less than desirable to me. I believe he genuinely cares about his patients. He is a doctor that does not force certain medical practices because “it’s their body.” I believe every physician has their strengths and weaknesses. Dr. Fife has good strengths that makes him very well liked in the Hmong community. He builds his Hmong clientele by listening to his patients wants and
In conclusion, three things could have solved the cross-cultural problems between the Hmong and the American doctors. The doctors should have had more compassion toward the Hmong people, who have been discriminated and put down for very many years. They should have been more understanding toward the Hmong's belief and worked with and not undermine it. Lastly to compromise in all aspects in a relationship no matter what kind is a two way street, and if one party does not respect the other then the feeling will be reciprocated. You have to come to a middle ground or everything will fall apart like in Lia's case.
In Macklin’s “Ethical Relativism in a Multicultural Society,” she discusses the difference between cultural tolerance and intolerance in the medical field. The main argument that follows is if physicians are obligated to follow contemporary ethics or in the case United States medical ethics or respect cultural difference of their patients and give treatment accordingly, especially when dealing with children. Macklin argues that while cultural tolerance should be practiced it is the “obligation of the pediatricians to educate and to even urge parents to adopt practices likely to contribute to the good health…of their children, and to avoid practices that will definitely or probably cause harm and suffering (Macklin, pp. 125). To state simply, Macklin is trying to discern when culturally diverse treatment can be practiced under the universal code of ethics and which are culturally relative. Based on this case:
The two Hmong cultural values that were demonstrated by the Lee family are portrayed by their belief and view about the cause and method of cure for an illness. The Lee family comes from a culture that believes in holistic healing. They have an animalistic view about health and medicine. For instance an epileptic is seen as someone who has been chosen to be a healer. Most Hmong epileptic are shamans, therefore even though the Lee’s wish that their daughter’s illness will be cured, they also have a mixture of pride because “although shamanism is an arduous calling that require years of training with a master in order to learn the ritual techniques and chants, it confers an enormous amount of social status in the community and publicly marks the triv neeh as a person of high moral character since a healing spirit will never choose a no account host” (Fadiman,1997, p.21). It is not surprising that their view about health is reflected mostly in their traditional belief in the causes and the cure of an illness. For i...
...ation could have been improved between doctors and patients in simple ways. Interpreters were used and children went to school and helped translate for family members. These helped communication somewhat, but it wasn’t enough. There may not have been any other way to help, but some people tried to and doctors tried to be patient with the Hmong to understand what they wanted and to make them understand what was going on.
Kleinman, A. 1980. Patients and Healers in the Context of Culture: An Exploration of the Borderland between Anthropology, Medicine, and Psychiatry. University of California Press.
In the novel, “The spirit catches you and you fall down”, Anne Fadiman was brilliantly able to capture how communication between other cultures takes place in the medical community. She writes about the experience of a Hmong family, the Lee’s, to portray the dissimilarities between two distinct cultures, Hmong and American. Throughout the novel she takes us on a rollercoaster of a journey as problems arise due to many barriers that naturally occur when collaborating two very divergent ways of life. Unfortunately the journey she takes us on does not come with a happy ending as we all expect. the edifying friction between the young girl’s parents and her doctors caused her to wasted away because of medical conditions, epilepsy and septic shock, which could have been treatable. Nevertheless, although Fadiman’s book depicts an unambiguous state of affairs, it is an eye opener to the nuisance of cultural conflict that can be practical to all circumstances and can be utilized by all nurses to provide cultural competent care.
The prejudice facing the Chinese, Native Americans, and Hispanics defined western society with different forms of legislature or economic pressures on these groups. The group had been subjugated since the formation of the United States and during its latest expansion was the Native Americans, who in this most recent expansion were moved to reservations, engaged in several bloody wars with white Americans, and forced to give up their lifestyle or their new created one in the land that was promised to them, like Oklahoma. Hispanics, though they had once dominated western society, soon lost control of their land, either due to seizure by whites or through economic competition, and found themselves on the bottom pegs of society, serving as farmhands or industrial workers; they were also excluded from the early governments in New Mexico and other areas. The Chinese, arriving from across the Pacific, found their treatment change from being welcomed to being seen as economic competition and being forced into lower jobs. Throughout the country, the Chinese were considered unwelcome as seen in the Chinese Exclusion Act. Western society found itself to be a society in which many races congregated to work together but also found itself to be a society built on racial tensions.
Though Lia’s parents and her doctors wanted the best for her, the above barriers were creating a hindrance to her treatment. They both were not understanding each other and the interpreter was also not there, doctors wanted to transfer her to another best hospital because they were not getting with her disease but her parents misunderstood the situation and thought they were shifting her for their own benefit. In expansion to these convictions, Hmong likewise have numerous traditions and folks that are negotiated by those of the American standard and therapeutic groups; for instance, some Hmong customarily perform custom creature sacrifice and in view of extremely particular entombment customs and the alarm of every human's numerous souls potentially getting away from, the accepted Hmong convictions don't consider anybody experiencing obtrusive restorative surgery. The Hmong medicinal framework is dependent upon nature-based hypothesis that lets life stream as it may be, while the western restorative framework is dependent upon the modernized humanism-based medicinal science. So when Lia was dealt with by the American specialist with western pharmaceutical, Lia's guardians don't concur with them....
The Hmong people, an Asian ethnic group from the mountainous regions of China, Vietnam and Laos, greatly value their culture and traditions. The film “The Split Horn: Life of a Hmong Shaman in America” documents the seventeen year journey of the Hmong Shaman, Paja Thao and his family from the mountains of Laos to the heartland of America. This film shows the struggle of Paja Thao to maintain their 5000 year-old shamanic traditions as his children embrace the American culture. Moreover, the film shows that one of the major problems refugees like Paja Thao and his family face upon their arrival to the United States is conflict with the American medical system. Despite the dominant biomedical model of health, the film “The Split Horn” shows that
As our textbook states, “Communication includes the willingness of individuals to share their thoughts and feelings” (Purnell, 2103, p. 21). To that end, the Hmong people are primarily illiterate. For this culture, they have a belief that Americans are rude because direct eye contact is maintained when conversing, as well as asking direct questions. In order for there to be successful education regarding the risks of cupping or coining as well as needle pricks, it is important to know that when speaking to someone of the Hmong culture to use quick glances without starting and to initiate a light conversation prior to asking anything regarding their beliefs, health, etc. The Purnell Model of Cultural Competence states that the domain of high-risk behaviors is one area that healthcare providers can make a significant impact on a patient’s health status (Purnell, 2013, p. 30). Advice to the parents, under these circumstances along with other obstacles that could potentially be faced due to the very different cultural aspects, would best be given via one-on-one or through family counseling techniques. From what I have learned so far from our readings, spirituality plays a very important role in a cultures health and well-being. Knowing the beliefs pertinent to the culture you are treating allows you as the provider to better assist them to attaining better health and well-being. Trust is also paramount and it is very clear that to interfere with a person’s spirituality could possibly hinder their physical recovery and actually cause physical
From one of these interactions another ethical issue emerged. During Lia’s worst seizure, the Lee’s were told that she needed to be transferred to a specialized unit at another hospital. As the doctor, Neil, explained this to the Lee family, he mentioned that he was leaving town. This was an ethical issue. Expressing his personal plans with a patient’s parents is crossing professional boundaries. This was expounded when the Lee’s indicated that the reason Lia had to be transferred was because her primary doctor was going on vacation. This was a fine line that every individual walked when working with the Hmong. When the doctors introduced themselves by their first name, they disassociated with their professional self. This gave them the opportunity to have less status, as Sukey Walker, a psychologist described as critical to becoming accepted within the Hmong population. However, it also looked poorly on the doctor if they lessened their status according to the American way, as in wearing blue jeans under their white jackets. This was an ethical dilemma at its finest. The doctor either sought acceptance from the Hmong family by initiating a partnership to facilitate better care the patient, or clung to their beliefs to maintain what they thought were professional
When individuals or groups from different cultures communicate, this process is called intercultural communication. The transaction process of listening and responding to people from different cultural backgrounds can be challenging. The greater the difference in culture between two people, the greater the potential of misunderstanding and mistrust. Misunderstanding and miscommunication occur between people from different cultures because of different coding rules and cultural norms, which play a major role in shaping the patterns of interaction (Jandt, 2012).
Most people find stereotypes to be obnoxious, especially when they have to do with sensitive subjects like gender or race. “Stereotyping is a generalization about a group or category of people that can have a powerful influence on how we perceive others and their communication behaviors” (Floyd, 61). Because they underestimate the differences among individuals in a group, stereotyping can lead to inaccurate and offensive perceptions of other people. Although stereotypes are prevalent in almost every society, becoming aware of our perceptions of others, as well as differentiating between both positive and negative stereotypes can help us overcome those stereotypes.
Effective communication with people of difference cultures can be especially challenging. The way people interpret the world can be strikingly different between cultures. Intercultural communication occurs when a member from one culture produces a message that is absorbed by a member of another culture. How that message is understood by the communicating party is a vital part in intercultural communication. For example, in Cambodia it would be considered rude to discuss business in a social setting (Language, culture, customs and etiquette, n.d.). However, in the United States this is a common practice and is almost an encouraged event. Another important factor and consideration in intercultural communication is the importance of understanding cultures, values, history and beliefs. For instance, in Cambodia, if you deliver a present that is wrapped in white paper, this is considered to represent mourning. This is one of the many reasons why it is important to assimilate into a culture and be mindful of communication between cultures (Language, culture, customs and etiquette, n.d.).