Clinicians who have understanding and insight into the social and cultural background of their patients will be better prepared to foster the mutual respect required for effective chronic disease management. This paper will develop an argument linking respect in patient-physician relations to the social determinants of health.
Difficulties in the provider-patient relationship arise from many sources, and pose various challenges to the integrity of the medical encounter. When these issues are especially sensitive or important to the patient's health and well-being, a complete breakdown in the therapeutic relationship may result. The goal of the emerging field of cross-cultural healthcare is to improve providers' ability to understand, communicate with, and care for patients from diverse backgrounds. We should weave the concepts of cross-cultural care into the ethics of caring if we truly hope to have a positive impact on the health status of diverse patient populations.
Adverse encounters with patients can frustrate any physician. The dilemma arises, however, when physicians allow these frustrations to negatively affect their practice of medicine. Treating all patients respectfully should be the standard, but maintaining this standard is difficult for some physicians.
Staff of long-term care facilities and family members have a common responsibility to ensure the best course of treatment and everyday care for residents who often cannot speak for themselves. Understanding the difference between instrumental and preservative care, and who the proper agent is to provide care in each category will not only improve staff/family interactions, but residential care in general. The Resident Enrichment and Activity Program improves the family/staff relationship obliquely by involving family in social activities; the Family Involvement in Care program, and the Patterns in Caregiving program directly target the relationship and involve the facility's administration to effect policy change.
Bioethicists have generally looked after the contractual and fiduciary obligations of health care professionals to patients by their adherence to and insistence on the principles of ethical action--autonomy, nonmaleficence, beneficence, and justice. But these principles, while necessary, only serve the best interests of people already recognized as patients. If we truly want to help vulnerable populations--those who fall outside the margin--then we need to go beyond justice to embrace the theological principles of mercy and grace; that is, we need to rely more completely on the way medicine was before secularization and commercialism. Competency and compassion intertwine in western medicine.
Delivering health care to non-English speaking immigrant populations requires knowledge and appreciation of the patient's culture. Acquiring the skills to bridge the two worlds calls for self-awareness by the practitioner and a commitment to cultural competence by the organization.
Project BRIDGE is a complex of activities through which individuals affected by major mental illness, developmental disability, or the effects of aging become engaged in their health care decision making. This article explains the development of BRIDGE through the profound stories of Julia Warren, Theresa Draper, and Jim Overstreet.
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：