How Cross Cultural Issues affect Physician-Patient Relationship

Posted: December 22nd, 2022

How Cross Cultural Issues affect Physician-Patient Relationship

Student’s Name

Course Title

Date

How Cross Cultural Issues affect Physician-Patient Relationship

Physicians and other healthcare workers usually experience ethical dilemmas in many aspects of patient care, and it is up to the service providers to find appropriate ways of dealing with emerging issues. Physicians and nurses always interact with patients from diverse cultures in all areas of health care, including an outpatient clinic, emergency room, rehab facilities, inpatient centers, hospices, and nursing homes. Even though developments have occurred over the years to achieve equality in offering and receiving medical service, claims still exist that some patients fail to get proper services because of their cultural affiliation. Patients, in some instances, may generate complications in handling their medical problems because of the different views their culture has on particular treatment approaches, which could derail the intervention process. Cases of discrimination or difficulty in offering care due to cultural differences would reduce if medical workers acquire insight on how to address the ethical concern from various sources, and when medical students get enough idea on how to deal with the matter.

Brief History of the Topic

From the start, the social work profession has offered services to patients from diverse cultures. Healthcare workers in the initial parts of the 20th century provided care to immigrant communities in small and large settlements. The late 1960s saw the introduction of the NASW Code of Ethics, which transformed people’s perception regarding discrimination in all areas, including health care provision (Congress, 2004). The legislation achieved a remarkable outcome in lowering segregation based on cultural terms in the next ten years of its implementation (Congress, 2004). The most recent modifications of the Code of Ethics require medical workers to understand cultural dissimilarities among clients and to participate in culturally competent practices. Furthermore, the Council on Social Work Education started to urge accredited schools of social work to educate trainees on how to foster diversity at the place of work (Congress, 2004). Despite the many hurdles towards offering healthcare without cultural discrimination, America continues to make significant strides towards ending ethnicity in health provision. 

Problems Arising

Patients may bring ideological, religious, and cultural beliefs with them as they form a relationship with physicians. Occasionally, the ideas may conflict or challenge what the healthcare giver believes to be the excellent approach to medical care (Prather et al., 2018). Whereas understanding and appreciating the patients’ beliefs forms a vital aspect of creating and sustaining a therapeutic relationship, that is not the case in all instances (Prather et al., 2018). Sometimes, patients fail to secure appropriate medical services because they belong to a particular culture, or because they are part of a group the physicians do not support.

Many other reasons could also affect a person’s likelihood of getting medical services that relate to cultural affiliation. People from different cultures who have spent less time in the community are likely to face some hardships getting medical services, especially if they are not able to communicate well in the dominant local languages. Language serves as the mechanism by which individuals interact with each other, and in many situations, people would use their native language (Prather et al., 2018). The interaction becomes difficult when the patient cannot speak in English, and the physician lacks knowledge of the client’s way of communication. Often locals who are more accustomed to the cultural practices and beliefs have better chances of getting medical services (Prather et al., 2018). The problem is even serious when the immigrant comes from a minority cultural group. 

Even though discriminatory healthcare practices of African Americans were rampant during the slavery period and the Civil Rights era, the historical injustices appear to influence current service delivery. Prather et al. (2018) feel that studies rarely explore how historical factors supporting racism adversely affect the contemporary health results of African American women. They argue that whereas several measures already exist to improve health delivery without considering cultural variations, the historical underpinnings offer an unexplored context for explaining present-day epidemiology of reproductive and sexual health inequalities among African American women. The claim pushes Prather et al. (2018) to perform a review of online databases for books and peer-reviewed sources to explore the connection between the historical and present encounters of reproductive health and sexual outcomes and racism.

Ethical Arguments

Physicians should understand that respecting the values and beliefs of their patients is an essential aspect of forming an appropriate therapeutic relationship. Failure to take the patients’ views and perceptions seriously can affect the patient’s level of trust in the caregiver (Shippee et al., 2019). Social discrimination and insensitivity may also appear from the patient or client, thereby affecting healing processes (Shippee et al., 2019). A White American, for example, may show some form of insensitivity when seeking medical intervention from an African American physician because of the commonly held perception that the latter’s culture is inferior to the American. Such indifference could harm the physician-patient relationship, and the interaction may not yield the anticipated outcome.

A question that emanates due to the ethical concerns arising from cultural differences in healthcare settings is what physicians ought to do in circumstances where a parent refuses their child to get treatment because of their cultural beliefs. The caregivers should know that parents have the moral and legal authority to make health decisions for their offspring, provided those decisions do not create a risk of harm to the young one’s heath (Prather et al., 2018). Parents, for example, have the right to refuse repeated immunization for their children on cultural or religious grounds. Healthcare givers should encourage parents not to deny their children the right to medical care, especially when the intervention is likely to improve health or prevent substantial suffering (Prather et al., 2018). The physician may have to secure a court order if necessary to proceed with treatment against the parents’ wishes. The physician, however, should always take care to show concern for the family’s beliefs and should always be willing to find suitable alternatives with the close relatives.

The other ethical concern regarding offering treatment to patients with diverse cultural beliefs is whether a patient can demand that they receive a form of therapy that the health caregiver is not comfortable providing. The healthcare giver should know they are not under any obligation to offer treatment they do not recognize, provide many benefits to the patient, or could cause more harm to the person in question (Prather et al., 2018). Physicians also have the right to decline to offer treatment; they do not feel confident or competent to provide or prescribe (Prather et al., 2018). Nevertheless, it is vital to take the patient’s desires seriously, consider requests that are not likely to cause much harm to the patient, and try to create a plan that would be acceptable to both the patient and the physician.

Relevant Ethical Principles and Concepts

Healthcare workers are more likely to achieve little problems dealing with issues emanating due to cultural differences when they understand the various ethical theories guiding the work of clinicians. Applying such methods and principles would help healthcare givers to provide the best decisions when ethical concerns are in play. Medical workers should borrow some lessons from the ethical principles that guide the activities of such workers in the U.S. and many other nations as well. One of these principles is beneficence, which conducts a person to indulge or do what is right and acceptable (Chonko, 2017). The priority and desire to do hood creates an ethical sense and makes solutions to ethical dilemmas acceptable. The principle of beneficence develops a similar impression as the concept of utility, which holds that people should try to act in ways that would benefit many people and yield the best results (Chonko, 2017). Medical providers, therefore, would not see any good in discriminating against people from other cultures if they follow the teachings of the principle of beneficence. Applying the concept of least harm is also likely to guide healthcare workers in the right direction while relating with people from other cultures (Chonko, 2017). The principle would guide the physician to make decisions that result in the least harm possible, and if significant, harm the fewest people. The principle, for example, would guide service providers to avoid sentiments or behaviors that would offend the other because of the cultural differences that exist between the client and the caregiver.

Applying the ethical principles of respect for autonomy and justice may also go a long way in creating an excellent physician-patient relationship in situations both sides belong to different cultural groups. Respect for independence allows people to make decisions that benefit them and which apply to their lives (Chonko, 2017). Using the concept would improve the interaction between a patient and caregiver from different cultures because the practitioner learns to appreciate their client’s perceptions that are as a result of cultural influence (Chonko, 2017). The ethical principle of justice, on the other hand, calls on people to make decisions that are fair to everyone involved. Employing the principle of justice would guide medical practitioners to relate to every patient in the same manner without considering their cultural variations.

Personal Solutions

The ethical concern shows the need to act quickly to build a physician-patient relationship that is not based on cultural similarities or differences. An effective way to achieve cultural diversity in a healthcare setting is for physicians to seek information that would help them change how they perceive people from other cultures. The caregivers should understand that many groups have common beliefs based on ethnical, ideological, or religious factors, while others may present unusual opinions that are not part of widely known and accepted belief systems (Congress, 2004). Understanding the beliefs and how they differ in their interpretation of doctrines because this may help to determine if it is necessary to respect unusual ideas (Congress, 2004). Physicians may get valuable information about how cultures differ from patients, their parents or family members, employees with knowledge of how cultures work, social workers, and hospital chaplains, among others. Beliefs that are not usual or fall outside widely embraced systems should compel the healthcare givers to acquire more information and to engage in more detailed discussions to make sure the reasoning is reasonable. 

It may also be helpful to impart medical students with adequate knowledge of how to deal with clients from diverse backgrounds while they undergo training. Congress (2004) writes that even though healthcare professionals have paid much attention to the effects of cultural diversity on medical care, some concerns still exist that the curriculum of medical training schools does not cover adequate aspects of cultural issues workers could experience at the place of work. It is encouraging the U.S. Department of Education funded a Diversity in Medicine program to develop a suitable curriculum for medical trainees, but is still essential to equip learners with more insight and skills on how to deal with cultural factors that could affect communication, diagnosis, and treatment between the patient and physicians (Congress, 2004).

Conclusion

The study pays particular attention to the cross-cultural issues affecting service delivery when the medical worker and the patient belong to different cultures. Despite the attempts to achieve diversity in healthcare settings, some loopholes still exist, which put some people at risk of not receiving appropriate medical care because they belong to particular ethnic groups. Sometimes the healthcare provider shows laxity when attending to patients from minority groups; the same way patients may discriminate the caregiver because of their ethnicity. More need to happen to avoid the historical injustices, including the need for medical practitioners to learn other cultures and increased sensitization on cultural issues during training.

References

Chonko, L. (2017). Ethical theories. Retrieved from https://www.dsef.org/wp-content/uploads/2012/07/EthicalTheories.pdf

Congress, E. (2004). Cultural and ethical issues in working with culturally diverse patients and their families: The use of culturagram to promote cultural competence in healthcare settings. Social Work in Health Care, 39(3), 249-262.

Prather et al. (2018). Racism, African American women, and their sexual and reproductive health: A Review of historical and contemporary evidence and implications for health equity. Health Equity, 2(1), 249-259.

Shippee, T., et al. (2019). Beyond the barriers: Racial discrimination and use of complementary and alternative medicine among Black Americans. Social Science Medicine, 74(8), 1155-1162.