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Indian Health Center’s Case from Legal Viewpoint

Choosing the proper treatment for Native American patients seems to be a complicated task. Physicians have to compromise between the allopathic medicine that they practice and traditional medicine which constitutes an essential part of patients’ lives. Indeed, it is necessary to remember that the patients’ welfare is a priority, and the discovered health issues should be solved as soon as possible. Nevertheless, a physician should respect the patients’ freedom of choice and the ethnic features reflected in their attitude to healthcare.

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Health practitioners are often equipped with little knowledge of traditional medicine and face trouble working with Native American patients. This can be illustrated in the case of Ms. Q., “a 72-year-old Navajo woman seeing Dr. S., a new physician at an Indian Health Service unit in New Mexico” (Esposito & Kahn-John, 2020, para. 2). Ms. Q. feels unsure about pursuing the proposed procedure (ERCP) and wants to talk to her medicine man, which makes Dr. S. feel puzzled. It may be helpful to consult the Indian Health Center’s federal guidelines for a better understanding of the physician’s responsibilities in such a situation. It is said that the IHS aims to broadcast educational information to all American Indians and Alaska Native people, but the provided healthcare should be culturally appropriate (Indian Health Service, 2020). From the professional point of view, there exists an Association of American Indian Physicians, which combines modern medicine with traditional healing to enhance health care delivery (Association of American Medical Colleges, 2018). Considering this evidence, the decision that seems reasonable is a discussion between Dr. S. and the traditional medicine healer-practitioner.

The mentioned legal and professional arguments are consistent with the ethical side of the problem. On the one hand, Dr. S. is responsible for telling his patient the truth about her health state. He represents allopathic medicine characterized by modern technologies, evidence-based practice, and reliable treatment methods. The knowledge he possesses is exceptionally valuable for Ms. Q., who cannot access such information. On the other hand, he should demonstrate to the patient he respects her autonomy and does not try to influence her worldview. Consulting the traditional medicine healer-practitioner from her tribe will help “co-create and prioritize a safe, comprehensive, culturally sensitive or congruent, integrative and medically necessary treatment plan” (Esposito & Kahn-John, 2020, para. 2). Therefore, the optimal strategy is to consider both modern and traditional approaches, which are likely to have a comforting, reassuring effect on the patient. Dr. S. should explain to Ms. Q. that any medical intervention on his part is focused on her welfare, but it will not be undertaken without talking to her, her family, and her health practitioner. The patient needs to feel that her interests are considered.

This case brings to light an ethical issue of contradictions that can arise between religion and medicine. Some confessions and sects do not allow people to receive serious medical interventions, calling them for humility and self-sacrifice. That is why, for instance, mothers may be in a complicated situation when their children need an operation such as a blood transfusion. They face a moral choice of whether to save a life or to stay loyal to their religious beliefs. It seems that the decision in this situation should be based on love and compassion. The human life’s value must be prioritized, no matter what religion is practiced. The same is true for the present situation with Ms. Q. Even if traditional medicine health practitioners may be distrustful of new methods, it is better to explain to them the importance of adequate medical intervention in the name of human life.

Working in such organizations as Indian Health Service requires physicians a lot of understanding and respect for the patients’ cultural, social, and mental backgrounds. When Native American patients are struggling to make a decision their life depends on, it is vital to show them that as soon as their tribe permits, they will be provided with high-quality healthcare. As both traditional and allopathic medicine aims at physical, emotional, mental, and spiritual welfare, all medical interventions should be justified by science and approved by local customs.

References

Association of American Medical Colleges (2018). Reshaping the Journey: American Indians and Alaska Natives in medicine [PDF document]. Web.

Esposito, M. L., & Kahn-John, M. (2020). How should allopathic physicians respond to Native American patients hesitant about allopathic medicine? AMA Journal of Ethics. Web.

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Indian Health Service (2020). National Indian health outreach and education. Federal Register. Web.

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