Chapter14

Preview:

Citation preview

Chapter Fourteen

Culturally Appropriate Health Care

Copyright ©2009 Delmar, Cengage Learning. All rights reserved.

Transcultural Health

• Who besides the Native Americans and Eskimos are the “real Americans”?

• “Melting pot” or “fresh salad”?

Copyright ©2009 Delmar, Cengage Learning. All rights reserved.

Transcultural Health (continued)

• Read over the case at the beginning of the chapter– How does this relate to the concept of

culture shock?– Why would the ethnocentric or

xenophobic practitioner be especially harmful in a nation such as the United States?

Copyright ©2009 Delmar, Cengage Learning. All rights reserved.

Traditional Chinese Medicine

• The ancient traditions of Chinese medicine seem to follow a form of virtue ethics:– Virtues of the “good practitioner”

Copyright ©2009 Delmar, Cengage Learning. All rights reserved.

Traditional Chinese Medicine (case problem)

• Review the case study “A Difference in Perception”

• Assume you agree that traditional practitioners are more humane, caring, and skillful than Western health care providers

• List three remedies that would not lower our standard of care

Copyright ©2009 Delmar, Cengage Learning. All rights reserved.

Two Traditions – East and West

• How they are the same?

• How they are different?

• Holistic nature of TCM

Copyright ©2009 Delmar, Cengage Learning. All rights reserved.

Revolutionary Humanitarianism

• Communist health care ethics were to be built upon:– Revolutionary zeal – classless society– Communist morality - serve the people

with all your heart, mind, and soul– Discipline – service before self-interest

Copyright ©2009 Delmar, Cengage Learning. All rights reserved.

Revolutionary Humanitarianism (continued)

• In this form of virtue ethics, how would the “good practitioner” act?

• How would this differ from a Western practitioner?

Copyright ©2009 Delmar, Cengage Learning. All rights reserved.

Modern Chinese Health Care

• In the early 1980s, the leadership of China began a program of fiscal reform that attempted to bring the free market economy into China

Copyright ©2009 Delmar, Cengage Learning. All rights reserved.

Modern Chinese Health Care (continued)

• Traditional and revolutionary ideas of health care provision call for practitioners to follow a set of virtues

• Review the virtues: Will they be sufficient to guide Chinese practitioners in free market medicine?

Copyright ©2009 Delmar, Cengage Learning. All rights reserved.

India

• Historical traditions:– Dharma: “It is better to do one’s dharma

poorly that to do another’s dharma well”– Samsara– Atman and Brahman atman– Three debts– Three paths to Moksha

Copyright ©2009 Delmar, Cengage Learning. All rights reserved.

Medical Ethics in India

• Abortion:– Opposing positions within the tradition – Current practice in India

• Euthanasia

• Hindu code of medical ethics: – What basic principles are promoted by

the directives contained in the Hindu Code of Ethics for Physicians?

Copyright ©2009 Delmar, Cengage Learning. All rights reserved.

Islam

• Historical background

• Basic message

Copyright ©2009 Delmar, Cengage Learning. All rights reserved.

Islam (continued)

• Five Pillars of the Faith:– Belief in Allah, and in his prophet

Muhammad– Prayers– Charity or alms – Fasting during Ramadan– Hajj or pilgrimage

Copyright ©2009 Delmar, Cengage Learning. All rights reserved.

Islam and Health Provider Guidelines• Food service (halal and haram foods)

• Hygiene requirements

• Religious observance

• Modesty

• Grieving and bereavement

• Modifying conditions

Copyright ©2009 Delmar, Cengage Learning. All rights reserved.

Health Care Ethics: Islamic Perspective

• Abortion, euthanasia, suicide:– “No Soul can die except by Allah’s

permission”– Abortion only to save life of mother

Copyright ©2009 Delmar, Cengage Learning. All rights reserved.

Health Care Ethics: Islamic Perspective (continued)

• Prolongation of life by artificial means:– Everyone has been created for a

particular lifespan– Quality of life is to be considered along

with quantity

Copyright ©2009 Delmar, Cengage Learning. All rights reserved.

Health Care Ethics: Islamic Perspective (continued)

• Transplants:– Conditional acceptance

• Biotechnical reproduction:– Conditional acceptance

Copyright ©2009 Delmar, Cengage Learning. All rights reserved.

Review Exercises

• Exercise B– What is to be done? Remember, many

of the specialty codes require you to obey the law.

• Exercise C– While tolerance is a virtue, is it possible

to cross the line in regard to traditional practices?

Copyright ©2009 Delmar, Cengage Learning. All rights reserved.

Key Concepts

• Why do American practitioners have a special obligation to provide culturally appropriate care?

• Culture shock:– Why would health care be an arena

where you might expect it to surface ?

Copyright ©2009 Delmar, Cengage Learning. All rights reserved.

Key Concepts (continued)

• What basic principles seem to require that we be culturally sensitive in our practice?