Cultural identity: concepts, formation, and expression

Cultural Identity

In the case of Justine, cultural / religious beliefs could stand in the way of saving Justine's life. But if her grandmother insists that cultural beliefs (cutting the skin to open a place for surgery of the heart will ruin her life when reincarnation happens) prevent the possibility of closing the hole in her heart, and the mother of Justine agrees, healthcare professionals have no choice but to postpone surgery for the hole in the heart muscle. It is not the place of Western medicine to pass judgment on Laotian / Buddhist values and beliefs, no matter that a child's life may hang in the balance.

In the case of the Puerto Rican immigrant, who resists coming to the doctor's office for reasons that are very vague, she clearly has an aversion to modern medical procedures. If she truly has diabetes, hypertension, asthma and depression, she is in dire straits medically. But who is to tell her that her home remedies are wrong and she should adopt modern medical competencies?

Question Two: In the Justine video, the cultural values and beliefs and traditions really did not contribute to the health of the little girl. In fact since the ceremony at the Buddhist temple did not close the hole in Justine's heart -- not that anyone in professional Western healthcare believed it would or could -- it is clearly shown to the family that if they want their little girl to live, they may have to acquiesce to modern medicine's strategies. These are difficult matters for doctors and nurses, because they should never be condescending or pushy, just because they believe and know that Western healthcare and medicine is quite far advanced juxtaposed with the rituals and cultural values of Buddhism in Laos.

The Puerto Rican woman's situation is not helpful at all to the doctors. This is a very difficult situation for healthcare professionals. But according to The California Endowment (Gilbert, 2010), the doctors in cases like this must understand what "Cultural Competence" means in the context of these situations. Culture is easily understood in this context, but "competence" implies "having the capacity to function effectively as an individual or an organization within the context of the cultural beliefs, practices and needs presented by patients and their communities" (Gilbert).

Question Three: The healthcare professionals in the video were very patient, kind, and careful in presenting their medical assessment of the little girl Justine. In fact in the meeting with the doctor after the ceremony in the Buddhist temple had not successfully closed the hole in the little girl's heart, the doctor brought in an interpreter to be certain that the mother of Justine understood all the ramifications of the proposed surgery. However at the end of that video, there was no resolution of the issue of whether or not Justine would undergo surgery. In the Puerto Rican woman's video, the healthcare people used an interpreter, and were very patient.