Reference no: EM133265876
Mohammad Kochi's Story
Mr. Kochi's daughter Noorzia seemed shocked to learn that he still had the cancer. In fact, the cancer had been there all along, even after the surgery, but
the family members serving as interpreters had not translated this to Mr. Kochi nor to the rest of the family at home.
How does culture influence the way patients and families discuss medical information and make medical decisions?
What are some reasons why information might be withheld from a patient by the doctor or the family?
Is it ever acceptable to withhold information from a patient? Why or why not?
How is Noorzia's perspective on her father's health, and the medical system in general, different than her father's?
How important are professional interpreters (as opposed to family members or no interpreter) in medical interactions like this?
Mr. Kochi: "We believe our day has been chosen for us "We believe our day has been chosen for us
and it cannot be pushed up or forced back."
Dr. Fisher: Dr. Fisher: "Our goal is to help you feel as well as you "Our goal is to help you feel as well as you
can feel until that day comes."
6. How might Mr. Kochi's perspective on spirituality and health affect his decisions about chemotherapy?
7. Is what Dr. Fisher said the usual perspective of American medicine?
8. What aspects of the biomedical culture did you feel were represented in the video?
9. How does the "illness" of gastric cancer (through the eyes of Mr. Kochi and his family) differ from the "disease?"
Justine Chitsena's Story
What are the grandmother's beliefs about the illness itself and the surgery?
How do they differ from the medical perspective?
What was your impression of negotiation that took place between the family and the medical staff?
What did you think was appropriate/effective in the staff's approach?
What would you have done differently?
Robert Phillips's Story
What do end-stage renal disease, dialysis, and renal transplantation mean for Robert Phillips and how are these meanings likely to be different for health care professionals?
What is the distinction between "disease" and "illness?"
Why might African-Americans have to wait longer for renal transplants, and be less likely to receive them overall than whites?
For what conditions or procedures have racial/ethnic disparities been documented?
"So in the African-American community, you know,Tuskegee is a big part of our experience...particularly for a generation of African-Americans, (it) has colored their
behavior when it comes to medicine, right? And that generation just implicitly doesn't trust doctors."
5. What are the different ways you might expect patients to act when they are mistrustful?
Alicia Mercado's Story
What are some of the reasons (from Mrs. Mercado's perspective) for her lack of ideal adherence to medical therapy and follow-up?
What are some other reasons why patients are non-adherent to medical therapy, especially for chronic diseases?
Put yourself in the position of Dr. Forson caring for Mrs. Mercado when she was missing appointments and not caring for herself. How would you discuss her situation and what could you do to help (i.e., what is your role as a physician)?
Mrs. Mercado: "When I feel my sugar level rising I drink "When I feel my sugar level rising I drink lime juice and I can control it. Or water, lots of water. I control my high blood pressure with pills, and also with garlic. Garlic is good for that. It controls it very well. In reality, I couldn't do it with one thing alone. Not only the garlic, nor only the pills."
4. What are your views on the use of complementary/alternative medicine in general, and in this case specifi cally?
5. What home remedies did your family use when you were growing up?
6. Why is it important to know about thesepractices and how do you approach patients about them?