Please read these two articles and respond to the issues raised therein in the context of the issues discussed in class today, especially the issues raised by the intersection of Non-Western cultural practices with Western medical practices. Please consider if/how cultural and moral relativism is relevant.
Article 1: "A Doctor for Disease, a Shaman for the Soul" here.
Article 2: "To Explain Longevity Gap, Look Past Health System" here.
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The first article, “A Doctor for disease, a Shaman for the soul,” raises really important issues. On a practical level, detached from ethics, I am encouraged to learn that Western medicine has finally begun to embrace eastern medicinal practices. I am not a biology major nor am I pre-med, but I think it is obvious that psychology and emotional states play a vital role in human health. If “laughter is the best medicine,” then why shouldn’t the American medical community use all types of alternative medicine to supplement physical treatment?
ReplyDeleteAs far as cultural relativism is concerned, obviously certain medicinal practices are more effective than others. I have never seen any empirical evidence that one of these Hmong ceremonies can cure cancer or alleviate the physical effects of a stroke. If there are people who only abide by these practices, then there needs to be a concerted effort to use these ceremonies and soft chants as a secondary aid only. If the Hmong are “fearful” of Western medicine, then they should be educated in its practices, as the article notes. For instance, the child with epilepsy should be informed of all available treatments. One form of treatment will conclusively stop the disease, another will not. Ethicists may be able to deal with cultural relativism if they stipulate that information needs to flow freely without labeling Western treatment as morally just.
Lastly, I think that the article, “To Explain Longevity Gap, Look Past Health System” does a poor job addressing Preston’s conclusions. I would first question Preston’s motives, but beyond that, the conclusions are narrow and dangerous, to an extent. Actually, the last line of the article is laughable: “If Americans keep shunning cigarettes, the longevity gap could shrink no matter what happens with the health care system.” The writer, John Tierney, gives almost no time to the counterargument by the two European critics, who rightly claim that America should prevent disease and not just treat it. I don’t understand the article’s real claim, but excusing the American health care system, because we should just stop smoking, is ridiculous and counter-productive.
I think these articles, in particular “A doctor for disease, a Shaman for the soul,” shine a light on the significance of cultural relativity. In class I feel that we quickly shut down the ideas promoted by cultural relativity because we had one example of how traditions of another culture should not be accepted, however I believe cultural relativism is an important concept as our world is becoming more globally accessible each day.
ReplyDeleteCultural relativism, or the idea that there is no one truth that can govern all humans worldwide, is displayed in the first article as quite beneficial in the practice of medicine. I for one do not believe in saying “our way is better” as far as medical practice is concerned. I think it is imperative for the growth of society that cultures share and blend practices and beliefs in order to move forward.
Integration of western and non-western practices has been going on for quite a while and has proved successful in many forms. The use of a shaman is just one example of how non-western medicine has seeped into our technologically centered treatment. Other traditional medicines have become quite popular in western society, such as acupuncture, an art performed and perfected by eastern cultures and is now used throughout the western world. Yoga is another craze throughout the western world that is simply common practice for many eastern populations. In non-western culture there has been a large deal of western influence as well. While living in Vietnam I spent the day at a hospital that was for decades dedicated only to healing with tradition medicine practices, but with the breaking down of barriers between societies this hospital has come to learn and accept many western practices which they have used to parallel what they are already doing.
The shaman’s job is not to cure the disease, but to protect the soul. To say that this cultural belief has no standing in western medicine would be like negating the success of placebos, and ignoring the importance of a healthy mind body connection that even we, in a technologically based society, understand as crucial. This patient would not have had the chance to get better even with western technologies if he didn’t believe it was possible through the help of the shaman. Therefore in this situation, and many others, cultural relativity is necessary and quite relevant.
To address the second article “To Explain Longevity Gap, Look Past Health System,” I do not agree with this author and believe he is drawing some unwarranted conclusions on the U.S. healthcare system. Maybe by actually learning about the workings of healthcare systems abroad and how they are much more successful than our current capitalist system, he would not be quite so quick to support a health care system that does not even support its own population.
~Jenna Freitas
The article "A Doctor for disease, a Shaman for the soul," emphasizes the existence of difficulties in the clash between western and eastern cultures. In this case, medicine is particularly interesting because of the various methods that some cultures implement in deciding how to act to prevent and treat illness. Cultural relativism is implied in this situation because of the large amount of people from Laos who have migrated to central California over the years. They use Shamans to perform various act of cleansing the soul and using forms vastly different to western medicine. As a morally significant feature, it can be stated that it is respectful to cultures to not discontinue, but rather raise awareness, such as the Merced hospital, and implement new policies integrating both cultural forms of medicine. Creating seminars and trainings for the Shaman's not only shows moral responsbility and respect, but it opens the doors for mutual learning and through measures like these, a clash between western and eastern medicine may not continue on as a difficulty in treating people of various cultures.
ReplyDeleteThe idea of medical morality, which was discussed in class, is a prevalent theme in the issues brought about in the first article, "A Doctor for disease, a Shaman for the soul". As mentioned in class, other cultures, like the Chinese culture, focus on a better quality relationship between the patient and doctor; one that involves great trust and no risk benefit calculation. If a person were to have been brought up in a society based off of these beliefs, a different medical system would cause the patient to become uneasy, uncomfortable, and untrusting of the new practices. The article mentions the books written by Anne Fadiman about the little Hmong girl who suffered medically due to the "hospital’s failure to recognize the family’s deep-seated cultural beliefs". Every culture has its own preference to which heals the body more efficiently. American culture requires surgeries, drugs, and invasive treatments to cure the sick. I believe that Merced Hospital's policy allowing Hmong practices in the hospital provides a healthy medium to the disparity between cultures. With this practice, American doctors can perform their methods, while the patients are confident and more accepting of their medical treatment due to the presence of their common rituals.
ReplyDeleteWith regards to the second article, "To Explain Longevity Gap, Look Past Health System", I agree with the article in that the shrinking longevity gap is not solely due to "worse" healthcare. I think that it is not a fair comparison to compare the United States Health Care System to other health care systems. All health care systems are set up differently. Although the US does not have a universal health care plan, that does not mean that patients are getting less treatment because less patients are being covered by insurance. Other factors such as health, dietary habits, and culture, as the article mentions, influence a country's overall longevity.
In response to Brendan's argument, I completely agree that more types of alternative medicine should be used to supplement physical treatment. In some situations, giving a patient medicine or injections seems frivolous. Certain illnesses can be cured by proper treatment with vitamins, certain types of food, and high spirits. Although actual medicine should still be used to treat illnesses, alternative medicine should be implemented more in a doctor's prescribed medical treatment.
When Faith Becomes The Only Medicine
ReplyDeleteIn spending a few summers shadowing an American doctor in Tegucigalpa, Honduras, I have been able to observe first-hand the implications of cultural beliefs and faith in medical care. In Honduras, a devoutly Protestant country, it is hard to find a medical professional that does not cure both by medicine and faith. Although the doctor I shadowed was not a ordained Priest or Deacon, her large, wooden cross allowed her the opportunity to be both doctor and spiritual healer. Here we can see the direct effects of cultural relativism, which are an even larger “doctors playing God” complex. Even though I do agree that for many cultures, faith and cultural beliefs do have a place in healing, I think that when doctors appear to patients as both doctors and priests, a moral and ethical line is crossed, one that should not be sanctioned on the basis of cultural relativism. If we allow this duality of roles, I have observed that patients commonly choose applied faith, such as prayer, over medical treatments and surgeries. To many, doctors can provide no absolute guarantee, but God or deities can. Although we must acknowledge that sometimes these are financially motivated decisions, the article brings up the point that many medical procedures are taboos for cultures and religions; and if the doctor were using faith as a form of medicine and care, then in the majority of cases, the patient would not want to break taboos. Moreover, we must consider the recent rise of “faith deaths” as a result of some cultures and religion’s beliefs against seeking medical treatment.
It is hard to come to a conclusion of the role of faith in medicine. However, by drawing from experiences involving cultural relativism, we can see that faith can be necessary, but must be regulated and practiced by someone other than the doctor. In the article, we see that there is a separation between doctors and shamans in these new hospital programs, and the result that seems to be better care and accommodation of cultural beliefs. However, in examples that I have observed, when a doctor truly plays God, one can observe a difference in the type and motivation of care that is provided, which I believe to be at the detriment of the patient.
The article "A Doctor for disease, a Shaman for the soul" demonstrates how cultural relativism is relevant in the western medicine. The article explains the growing trend of how hospitals are trying to gain a deeper understanding and trust with their patients through connecting with their own cultures and beliefs. In particular the article talks about how Hmong shamans are using their spiritual rituals to reduce the fears the Hmong hold against western medicine. Cultural relativism basically states that different cultures each have their own inherent beliefs and traditions; these beliefs cannot be judged because they each culture will have a different outlook on another’s culture. The hospitals referred to in the article obviously cater to the Hmong’s beliefs and the hospitals believe that bringing the patient’s own healing into the hospital will benefit the patient. Since the hospitals use the patient’s background to help determine the kind of religious or spiritual healing they require, the hospital understands cultural relativism. They understand that the patient’s own personal beliefs or their own cultural beliefs are relevant in the clinical setting.
ReplyDeleteThe second article “To Explain Longevity Gap, Look Past Health System” draws unwarranted conclusions on the U.S. healthcare system. The author does not give reasons of why other countries have such an outstanding record of life expectancy compared to the US. He just states that Americans are unhealthier and have more diverse foods. The author doesn’t say what other countries are doing right. He just attributes that the cancer and heart disease is the cause of the reduced life expectancy. The author just bases his conclusions on assumptions that build on demographic problems of U.S citizens. He should look further into the details of each individual healthcare system before judging them.
In the class discussion regarding cultural relativism there was discrepancy regarding if cultural practices should always be accepted because there is no universal moral compass to tell us who is right and who is wrong. In the case regarding how two different cultures give respect to their dead, there was no one in determining which way was the better way or morally acceptable way. But, as the practice brought no harm to living people and as each practice was intended to bring honor to the deceased then who is to say which culture’s way was right or wrong? In the other case discussed concerning female circumcision, it was agreed that this cultural practice does bring physical and emotional harm to the women involved in this practice. It also brings about an issue that these women are often forced to have this procedure done or may not know the long-term consequences of the procedure. The practice of female circumcision, in my view, cannot simply be justified as an acceptable practice that is allowed to continue because under culture relativism we have no right to judge. In the instance that a cultural practice is directly harming people, partly due to lack of education of the ill effects of the practice, it is the responsibility of other cultures to bring awareness to the group about the harm that they are causing. I find that as long as a cultural practice does not bring harm to individuals or to the community as a whole then that practice should not be morally condemned just because it may differ from our own cultural practice and our own moral compass.
ReplyDeleteAn example of when cultural relativism should be respected is represented in the article “A Doctor for Disease, a Shaman for the Soul”. This article shows that a tradition of healing by a Shaman is being incorporated into the treatment of patients, at their consent, in hospitals. This practice may differ from the beliefs of the Western world but as no harm is being brought to the patients and as the intent is to promote healing I find that this incorporation is morally permissible. As the article stated the placebo effect is an effective force in healing so even if the Shaman is not able to help the patients, the belief that they are being treated may assist in their overall recovery. The Shaman may even be able to act as a sort of interpreter between the spiritual practices of his patients explaining to them the necessity of certain Western medical procedures. To promote patients health and healing seems to be a norm that can be accepted cross-culturally as morally good. Even if the means vary, the improved health of a patient can come from a Western doctor or possibly a Shaman, and better still to have both work together.
The second piece “To Explain Longevity Gap, Look Past Health Systems” was an unconvincing article. Being that there is so much evidence to the contrary of this article the underdeveloped argument by Tierny was weak at best.
-Olivia
Culture and belief creates many basic standards for many different people. There is no answer in defining who is right and wrong when it comes to culture. Not that I am saying that shamans are wrong or trying to ruin the sacred nature of their beliefs, but a lot of the time, a person's illness may rely on their mentality and their perceptions of their illness. For example, placebo pills may help people believe they are getting better and making a terminal patient believe that they have a simple problem such as indigestion may help them live a longer life. Merced Hospital to carry out the shamanism policy may be another way to say that the health of the patient is the foremost concern more than anything else. It means that the hospital is more than willing to cure patients using whatever method it would take whether it is western medicine or shamanism. This may also be the hospitals intentions to show respect towards the culture and the patients who strongly believe in the effect of shamans' treatment. The shamanism policy will give the patients a sense of assuring of the treatment the hospital offers. In terms of cultural relativism, the belief of certain people affect much of their health and I think it never would be a cost just to follow the belief of a patient for the sake of their well being. It is, of course, the hospital's responsibility to cure patients as much as possible.
ReplyDeleteI found the first article, "A Doctor for Disease, a Shaman for the Soul," to be incredibly relevant to our most recent class discussion. The policy of merging shaman traditions with Western medical practices is an example that, in my opinion, highlights the importance and benefits of cultural relativism. By understanding an individuals beliefs and/or actions in terms of their culture, it becomes possible to help that individual on a larger, more holistic scale. I find that many health care providers have faith only in science and can often overlook the spiritual and emotional needs of their patients. As the article points out, treatment based on a patient's beliefs can truly contribute to their overall health, as seen in the "placebo effect" and can also be the key to a strong and trusting relationship between patient and provider.
ReplyDeleteOn the other hand, I found the second article, "To Explain Longevity Gap, Look Past Health System," to be somewhat irrelevant to the topics we've discussed thus far. I agree that the United States does a good job detecting and treating major diseases for the most part, however, I completely disagree with the authors claim that our health care system is blameless when it comes to the longevity gap that exists between the US and other industrialized countries. It is no secret that over 40 million Americans are uninsured and I think this major flaw in our system does in fact greatly contribute to our low international health scorecard. This is not, however, an ethical issue and so I digress...
One statement that stuck out to me was when the author wrote that Americans are more ethnically diverse. This obviously came as no surprise, however, it got me thinking about how a lack of cultural relativism may in some way contribute to inferior health outcomes in the US. In other affluent countries, where populations are somewhat more homogeneous (perhaps culturally, religiously, etc.), it is likely that their treatments and medical practices reflect the beliefs and values of the individuals seeking care. In this case, the care provided may improve one's health in the same way that the placebo effect and the shaman interventions do. While I don't know whether it was the authors intent to emphasize cultural relativism and it's effect on a nations health, I do think it's something to think about when analyzing our countries differences and potential downfalls when it comes to providing health care.