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Culture and Ethnicity in Clinical Care
Arch Intern Med. 1998;158:2085-2090.
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INTRODUCTION
AMERICAN medical practice is strongly influenced by the nation's historically dominant culture. Culturally based presuppositions of biomedical practice and its ethics, long neglected, are now under serious scholarly examination. For example, the primacy of individual patient autonomy is generally accepted as an enlightened perspective, particularly in the wake of earlier paternalism. However, this philosophy is not accepted by many ethnic groups in the United States and elsewhere who hold interpersonal and social responsibility in relatively higher regard.1-2 Assessments of good and harm are culturally mediated. Examples include general acceptance of euthanasia in the Netherlands, common use of fetal sonography for sex selection in India, African practices of female circumcision, and nondisclosure of cancer diagnoses in Italy and Japan.
Health care disciplines, particularly nursing, social work, and psychiatry, have joined medical and cultural anthropologists in recognizing the ethnocultural basis of illness and cultural factors that influence normative health practices.3-4 Health professionals . . . [Full Text of this Article]
ADVANCE DIRECTIVES
PREFERENCES FOR TREATMENT
HEALTH BELIEFS
AUTOPSY AND ORGAN DONATION
DISCLOSURE AND TRUTH TELLING
PHYSICIAN BIAS, BEHAVIOR, AND BACKGROUND
CONCLUSIONS
RELATED LETTER
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