The Mount Sinai journal of medicine, New York
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Historical Article
Minority distrust of medicine: a historical perspective.
Recent philosophical work has disclosed a host of problems in our apparently natural ways of classifying things. The contemporary classification of certain groups as "minorities" exemplifies some of these problems. ⋯ Such classifications can play a destructive role in determining the sort of health care which minorities receive. Embracing them, even with the intent of improving the lot of those who do not fare well in the present health care environment, is subversive of the egalitarian stance which has been central to medical ethics since Hippocrates.
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The pregnant Jehovah's Witness patient's refusal of lifesaving transfusion creates a conflict for the physician. While legal steps may be initiated to address the problem, a medical approach stressing prophylaxis which anticipates and avoids the ethical dilemma of managing a hemorrhaging pregnant Jehovah's Witness is preferable.
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This essay explores the idea that it is possible for a patient to feel ill at ease with a health care professional, even though there is no active ill will on the part of the professional. Noting that the relationship between the patient and the health care professional, especially in the case of the physician, is an asymmetrical one, I suggest that it is incumbent upon professionals to take extra steps to insure that the patient feels at ease in the staff-patient encounter, notwithstanding the good will that health professionals may be assumed to have toward patients generally.
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Barriers to the delivery of health care services to the Latino community are described and analyzed. Fear of deportation, unfamiliarity with modern medicine, inability to speak English and reliance upon traditional curing practices all contribute to the harmful underutilization of medical services which we see in the Latino community. Health care providers who serve that community need to overcome these obstacles by expanding their cultural awareness and increasing the effectiveness of their communication.
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This presentation, relying both on personal experience and an array of studies, surveys the problems minorities face in trying to obtain adequate health care. From another viewpoint, these are problems that physicians have in trying to provide health care to persons they do not understand and cannot really see or hear. ⋯ Treating patients as they ought to be treated requires that physicians overcome many layers of prejudice and unfounded assumptions. Failure to overcome such prejudices distorts medical practice.