One complication with regards to freedom of choice among patients is that there are also cultural variations in different places and countries around the world (Alverson et al. , 2007). Physicians should thus be aware that the Western approach to medical treatment may not be readily acceptable by patients of Australian Aboriginal origin, thus resulting in a higher incidence, for example, of upper respiratory diseases (Glasgow, 2008). In this particular population, trust appears to be the main driving force in the community, as this reflects the strength of the bond that has been established through time.
It can thus be claimed that equity in the field of healthcare is a societal phenomena, wherein trust should come first before any other action, such as healthcare services (Mooney and Houston, 2008). Paternalism or misuse of power can also be prevented by a healthcare professional if he is aware of the cultural background of the patient. Our case study is that of Millie Kelly, an 86 year old female patient of Australian Aboriginal origin. She was presented to the hospital in remarkably good health, yet with some dental problems.
Previous medical history included damaged to her right eye due to cataract removal. In order to fully provide healthcare to this patient, it would be helpful if the physician is aware and understands that history of each culture or subpopulation. For example, the Aboriginal communities carry a long history of oppression and discrimination from the English settlers, experiencing torture as they have been obliged to be educated and cultured by Western settlers.
It is thus possible that these patients may project some form of indifference to a physician of Western descent. The healthcare professional should thus approach this condition with full respect and understanding of this background and should put in extra effort to gain the trust of the patient with regards to the physician’s role in their health. The establishment of trust and confidence is very important in a physician-patient relationship because this influences the success or failure of a treatment.
Australian Aboriginals have been reported to experience a high incidence of internal disorders such as diabetes, kidney disease, as well as cardiovascular disorders. The mortality and morbidity rates of this population are further magnified by the manner in which healthcare services are delivered to these individuals. In addition, there is a need to improve the ways of caring for these indigenous individuals (Si et al. , 2008). Making a decision on a particular medical treatment should always be made by the patient himself (Murray et al. , 2007).
However, it is important that the patient is competent enough in understanding the medical condition itself and is capable of weighing the consequences of each option that he is given. However, it certain cultures and ethnicities, this simple and straightforward concept on medical ethics may not be easily applied. There are a significant number of ethnicities that look at the family as the center of their immediate society. Among Australian Aboriginal individuals, the positive diagnosis of a patient is perceived by the entire family as an illness that affects the entire social group.
It is thus a common occurrence that when a patient diagnosed with a mental disorder, the entire family will concertedly work on hiding this fact from the rest of the society because they feel that a mental disorder is a sign of weakness. Furthermore, mental illness is considered by their culture as a cause for shame and unfortunately, ridicule. Unlike Western cultures who do not feel ashamed of disclosing that a family member is suffering from a mental disease such as bipolar disorder or dementia, other cultures will even actively deny such fact and isolate their family member from society.
They might also prevent their family member from interacting with other individuals because this will serve as a venue for society to further scrutinize the weakness and shame of their family. If a patient comes from a certain indigenous culture, the disclosure of a positive diagnosis of cancer may be not performed directly onto the patient (Yousuf et al, 2007). The healthcare professional should understand that such grave news regarding a patient should be first discussed with the head of the family, or if not, the spouse of the patient.
A series of rules are then implemented, which starts with the head of the family discussing the condition with the rest of the members of the family. In most cases, it is the family who decides which medical procedure should be performed next. And sadly, the patient himself is the last person to know of the illness and in some cases the patient never knows his actual illness. Certain cultures also attempt to disguise the truth when it comes to medical diseases. The most plausible reason behind this action is that the family attempts to shield the patient from further anxiety and depression.
It is important for a healthcare professional to understand that in most indigenous cultures, a medical condition is a sign of weakness and thus it will never be easy for an Asian to disclose to his immediate environment that he is suffering from a certain ailment. The same attitude is portrayed by the family members of a patient when it comes to disclosing the actual diagnosis to the patient himself. The family thinks that their patient need not know his actual ailment, as long as the best course of treatment is being administered to him and that he is getting sufficient rest, nourishment and care.