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2008). Developing cultural competency -- the ability to understand or even achieve the point-of-view of a different culture -- is an essential skill for doctors, and even more so as globalization continues to bring people of disparate backgrounds and belief into contact more and more every day. Proper training and exposure to the techniques of eliciting perspective-demonstrating comments has become increasingly standard practice in Western and non-Western medical schools, which can only lead to the better health and overall well-being of patients worldwide (Ho et al. 2008). Had these methods been employed in this scenario, the outcome for all concerned could have been very different.
When it comes to the parents' decisions and attitudes throughout the ordeal of their daughter Lia's illness, there are also some choices that could have been made better and more effective. The very perspective that created the term "cultural competency" is inherently Western, however, as have been research methods into the area of bridging cultural gaps in medicinal and social work practice (Schulze 2009). It is therefore highly improper to expect the Hmong immigrants, who still find the Western world and its belief systems largely alien and even aggressively oppositional to their own beliefs, to bear the larger burden of cross-cultural understanding here. The doctors involved saw the Lees' migration as an isolated occurrence within their larger biographies, and...
That is, the very alien-ness that the Lees felt as immigrants was a large source of the difficulties in this case, and the burden must lie with those working within the system that the Lees were subjected to -- i.e. The doctors.
There is not really a need to assign blame in this case, nor can blame truly be allocated in a manner that is fair and equitable. Both the Lees and Lia's doctors made decisions that adversely affected her health and well-being. when it comes to the need to work in tandem, the arrogance of Western medicine and the stubbornness of the Hmong culture clashed in an epic manner. Ultimately, however, it was up to the doctors in this situation to work with their patient's parents rather than acting as adversaries, as they did in many instances.
References
Fadiman, A. (1998). The Spirit Catches You and You Fall Down. New York: Macmillan.
Ho, M.; Yao, G.; Lee, K.; Beach, M. & Green, A. (2008). "Cross-cultural medical education: Can patient-centered cultural competency training be effective in non-Western countries?" Medical Teacher 30(7), pp. 719-21.
Schulze, H. (2009). "From biographical research to cross-cultural competencies in counseling." Tiltai / Bridges 45(1), pp. 115-24.
Hmong Culture Health Hmong Health Culture The Hmong people are a group of Asian-Americans who have been living in the United States since an immigration program was started in 1975. Because of their strong animistic faith and beliefs in the supernatural, they have been slow to adapt to the healthcare practices of the United States. The Hmong continue to rely on alternative medicine and faith healers to cure illnesses. Health Beliefs and Practices
Lia Lee could not be seen alone, as the doctors saw her. Their obligation was not only to her, but to her whole family. Lia Lee's brother aptly writes: I do recall everything from the door slamming incident to the day the doctors told my family that it was okay for her to come but she will not live pass 7 days. I will never forget that week or those
When the Hmong refugees encounter the peculiarities of the Western medical system, their entire worldview is called into question. Yet it is mainly the Americans who struggle. The Hmong view of health, healing, and wellness differ so sharply from that of the Americans that it is we who must examine our beliefs, not the Hmong. History has not been kind to the Hmong. Yet in some ways, this cruelty has
arrival of Hmong to the United States and delves briefly on the earlier conditions of the Hmong in Laos and Southeast Asia, their region of origin. The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures, by Anne Friedan is a book about the encounter between a Hmong family and the American medical community. It also goes into great detail
We know that we do not know everything in the West. However, many aspects of the Hmong are also just coming out of the Middle Ages and there is only so much that can be tolerated and there must be a demand for a middle ground in the way that western medicine and culture deals with medical issues when the science and the treatment regimen is clear. For instance,
Spirit Catches You and You Fall Down by Anne Fadiman is a groundbreaking book about cross-cultural communication in health care. The book is about Lia Lee, who was the first in her Hmong family to be born in the United States. Her parents spoke no English. When Lia Lee was three months old, she had her first seizure. Due to misdiagnosis, a string of unfortunate events prevented Lia Lee from