Culture is defined as a particular way of living which incorporates beliefs, standards, values, language, behavioral norms, styles of communication and thinking patterns. Cultural diversity is evident in various manifestations such as language, ethnicity, religion and gender. Sometimes it is also evident by an individual’s level of education and even age.
Consideration to differences in culture is important in the delivery of healthcare. This is because culture often determines an individual will respond to communication by a health professional which in turn has a bearing on the outcome of the patient’s condition. Sensitivity to cultural differences is necessary to ensure accurate and effective communication on the client’s health.
Treating the patients with respect is not sufficient to avoid cultural problems. It is necessary to also be familiar with various cultural customs so that misunderstandings can be avoided and health practitioners can provide their clients with better care. Galanti (2009) described a case where cultural issues were not considered resulting in a misunderstanding between the client and health care professionals.
A Hispanic lady, had to give confirmed consent so that she could go a hysterectomy. The lady, Maria Ramirez, being able to communicate in Hispanic only had her son serve as her interpreter as he was bilingual. The young man when describing the procedure seemed to be accurately translating as he indicated the correct body parts. The mother agreed to sign the consent form. The next day, she learnt that she could not have children anymore because her uterus had been removed. She was very angry and even made threats to sue the hospital.
In Hispanic culture it is not appropriate for a man and his mother to talk about private parts. The son, being in an awkward position told his mother that the surgery would involve removal of a tumor from her abdomen. He pointed in this general area. The Hispanic woman was upset because in Hispanic culture the status of a woman is derived largely from the children she can produce.
The health care provider and management managed the situation by offering apologies, but the damage miscommunication had already occurred. Fortunately, the lady did not pursue the issue further, though for her it was a painful loss as she was not aware of what surgery she had agreed to. In this case the appropriate thing to do would have been to not involve members of the family when discussing anything sexual with a client. If family members must be present, then the family members should be of the same gender to avoid embarrassment and miscommunication.
In another incident, a woman called Susi in her thirties had a horse riding accident where the horse threw her off its back upon being startled by a snake. The woman fell on a stump and sustained massive injuries with internal bleeding. Upon being rushed to hospital, the surgical team found that she had bled into her abdomen severely and her kidney would have to be removed.
The woman had a medical card which identified her as Jehovah’s Witness. It stated that she was not to be transfused, no matter what the circumstances. Despite knowing this, the physician, Dr Andrews, felt compelled by the Hippocratic Oath to transfuse her. Her husband could not be reached so the doctor proceeded with the transfusion, and in so doing saved the woman’s life. The woman however was not grateful; she instead sued the doctor for battery and assault. She won a $20,000 settlement (Galanti, 2009).
A study conducted in the 1980s amongst Jehovah Witnesses indicated that they would sue if they were transfused. A physician, who finds himself in a situation where he/she finds it necessary to transfuse a Jehovah Witness, ought to think of the possible consequences by going against the patient’s will, especially the legal ones.
In addition, by violating the wishes of the client in order to fulfill the Hippocratic Oath (which in this case is a personal belief), is an indication of arrogance and ethnocentricity. No group has the right to impose their beliefs on another.
There lies in a danger in considering cultural differences when providing healthcare. This danger is one of stereotyping people. Even though someone may belong to a particular religion or ethnicity, everyone is unique and it would be dangerous to assume that “Chinese believe this” and “African Americans do this”.
It is therefore necessary for health professionals to differentiate between generalizations and stereotypes. If upon meeting a Mexican woman, a doctor assumes she has a large family, that is a stereotype, but if the doctor says to himself/herself that, “Mexicans tend to have large families, I wonder if Maria has a large family”, then the doctor has generalized (Galanti, 2000).
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