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  1. 1. Chapter Fourteen Culturally Appropriate Health Care
  2. 2. Transcultural Health Who besides the Native Americans and Eskimos are the “real Americans”? “Melting pot” or “fresh salad”?
  3. 3. 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?
  4. 4. Traditional Chinese Medicine The ancient traditions of Chinese medicine seem to follow a form of virtue ethics: Virtues of the “good practitioner”
  5. 5. 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
  6. 6. Two Traditions – East and West How they are the same? How they are different? Holistic nature of TCM
  7. 7. 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
  8. 8. Revolutionary Humanitarianism (continued) In this form of virtue ethics, how would the “good practitioner” act? How would this differ from a Western practitioner?
  9. 9. 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
  10. 10. 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?
  11. 11. 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
  12. 12. 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?
  13. 13. Islam Historical background Basic message
  14. 14. 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
  15. 15. Islam and Health Provider Guidelines Food service (halal and haram foods) Hygiene requirements Religious observance Modesty Grieving and bereavement Modifying conditions
  16. 16. Health Care Ethics: Islamic Perspective Abortion, euthanasia, suicide: “No Soul can die except by Allah’s permission” Abortion only to save life of mother
  17. 17. 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
  18. 18. Health Care Ethics: Islamic Perspective (continued) Transplants: Conditional acceptance Biotechnical reproduction: Conditional acceptance
  19. 19. 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?
  20. 20. 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 ?
  21. 21. Key Concepts (continued) What basic principles seem to require that we be culturally sensitive in our practice?