Health and Cultural Diversity

More than ever before, healthcare professionals are subjected to dealing with a wide variety of cultural diversities. As the cultures within the US continue to grow, so must the understanding of how to deal with them. If cultural differences are not properly communicated, they can create uncomfortable and confusing situations for both the healthcare provider and the patient. This can cause the patient to suffer due to loss of trust and respect, making the patient less likely to follow a treatment plan. Culturally competent healthcare is considered a human right, and more and more culturally inappropriate laws are being filed in court. Some cultures, such as Ethiopian, Islam, and Chinese, have very different laws, views, and beliefs about health care. Because there are so many differences, there are many legal implications that could possibly arise from cultural ignorance in healthcare.

The traditional Ethiopian belief is that health results from the balance between the body and the outside world and that disease arises from imbalance. Ethiopian culture also believes in the use of herbs and spices for medicinal purposes which can sometimes have adverse interactions with Western medicine. For example, large amounts of garlic and ginger are used for the common cold which can act as a blood thinner in high doses. Cinnamon is also used for the common cold, which increases stomach acid and can inhibit tetracycline (an antibiotic used for many bacterial infections). Basil is used for headaches and as an insect repellent, which acts as a blood thinner and has hypoglycemic agents due to the oil extract increasing blood clotting time and synergistic interactions with insulin. Most studies show that people from different cultures do not tell their doctor about the use of their traditional medicine for fear of being judged. One legal implication that can arise when treating an Ethiopian could be that a doctor treats a bacterial infection with tetracycline without knowing that he is taking large amounts of cinnamon for a possible cold. If cinnamon interacts with tetracycline, the bacterial infection can spread and cause further damage, even potentially fatal damage, resulting in a legal dispute.

Islamic culture considers illness as a punishment for your sins. Abortion and assisted suicide are not allowed. Pork and alcohol are prohibited and Muslim women may not be touched by men who are not direct family members. Muslims also fast from dusk to dawn for one month of the year. Some legal issues that may arise may be the result of a doctor prescribing insulin or heparin containing pork ingredients to a practicing Muslim, or a cough syrup containing alcohol. A Muslim may not know that our Western medicine contains these products. Also, if a Muslim is fasting at a time of illness causing weakness and dehydration, this can be seen as the doctor failing to provide proper care, possibly resulting in a legal dispute.

Some Chinese health theories are based on the observed effects of Qi. They believe that Qi defends the body from pathological factors, provides movement, and supports growth and development. They believe that things like a poor diet, poor lifestyle, or strenuous job can deplete Qi. Yin and Yang is probably the most significant theory followed, it is the balance between opposites like cold vs. hot or excessive vs. deficiency. The Chinese believe that some bodily organs contain more Yin and others have more Yang and will associate this with heat and cold with health problems. For example, you may complain of a “weak kidney” and insist that your kidneys be tested when in fact you may have back or knee pain or diarrhea. A “hot liver” is a common complaint that can refer to itchiness, skin rashes, or emotional stress. The medicine is also considered to have hot and cold effects. This makes it common for Chinese people to take less medication than prescribed to “balance out” the effects, and many would not tell their doctor because they believe they are in the best position to judge their own health needs. Therefore, there could be a possibility of legal disputes if a liver problem occurs and the doctor orders diagnostic tests and possible medications for the liver if, in fact, the problem was solely due to emotional stress or itching. There may also be a potential legal dispute if the doctor did not explain the importance of taking everything prescribed and the patient started taking less to balance their Yin and Yang and the medical problem persists or worsens.

In conclusion, as can be seen, there are many different beliefs about health care in different cultures. Some of these differences can cause confusion and misunderstanding for both the doctor and the patient. And while most Western doctors will try to address an ailment from someone from a different culture in their best interest, it may conflict with their beliefs. Health and cultural ignorance among all doctors is an issue that needs to be addressed. Proper training in intercultural healthcare will ultimately lead to a better understanding of patient needs and complaints, more respect for the doctor, and better adherence to treatment, leading to fewer legal disputes and a pleasant and successful patient experience. .

Here is a short video related to healthcare and cultural diversity http://www.youtube.com/watch?v=XF8yZRgcSkg