Basing on your own references and the

Basing on your own references and the events in Anne Fadiman’s The Spirit Catches You and You Fall Down, discuss the following comments i) The parents of Lia Lee belonged to the Hmong community and immigrated to the US. Their cultural beliefs differed immensely compared to the traditional Western medicine practice. Since they now lived in the US, the healthcare for Lia went against their beliefs and helped lead to the mistrust between her family and her healthcare team. Trust is a major component in healthcare, the family must trust the providers and the providers also must trust the family. There was little to no trust between these parties which created a negative relationship between them. With the lack of translator resources, the family was often unaware of the situation and care their daughter was receiving. There was massive misunderstanding between the healthcare team and her family, leading to her parents to believe that the team was harming their child rather than healing her. It can be scary for parents to see their child in distress but being unable to understand the language of the healthcare team only makes their healthcare experience much more negative. Their cultural beliefs were not respected by the hospital staff, and often were not even acknowledged. It is important for the providers to incorporate the traditions of patient’s cultures to give holistic and individualized care. A critical factor in the Hmong community is the emphasis on their soul. Throughout Lia’s care, the family did not believe that the providers had her soul in mind when treating their child. The lack of effort by the providers to understand their cultural beliefs and practices created more harm for Lia than good. Lia’s parents ended up taking her home after the providers determined that she would die and declared her in a permanent vegetative condition. While caring for her at home, Lia’s condition improved and they provided her with constant love and attention, which was like the type of care parents give their children in Laos where they were from. With no medications given, Lia was able to gain back her gag reflex which allowed the parents to feed her without the NG tube. Being able to care for Lia the way they believed was best helped restore the family’s belief that Lia would be able to reconnect with her soul once she passed away. Fadiman, A. (1997). The spirit catches you and you fall down: A Hmong child, her American doctors, and the collision of two cultures. Farrar, Straus, and Giroux. ii) Westernized medicine values a doctor who will not compromise the quality of care they provide to a patient due to barriers, but that idea is a double-edged sword. The rigidity of the doctors in the case of this patient was identified to be the “fatal flaw” of these doctors in the treatment of Lia. The doctors utilized their medical knowledge and prescribed medications that were the standard of care for the treatment of epilepsy and ordered tests and procedures that westernized medicine taught them to do. However, the doctors on the case failed to ask the parents what they believe caused the sickness and how they would like to treat Lia. It was assumed that the parents would recognize the advanced knowledge and expertise of the doctors and follow their instruction, but this is not what happened. The Hmong people are described as very independent and self-sufficient, these traits made them seem uncooperative and noncompliant to the western world. In the eyes of the western doctors, when the parents were not administering the medications, they ordered and were instead performing rituals and giving the patient herbs and the seizure activity continued to worsen, the doctors suspected the parents were neglectful and called Child Protective Services to take Lia to a foster home to protect her health. The parents felt betrayed and angry with the social services and the doctors for taking her away because there was no lack of love or care for her, they just did not understand the purpose of giving her these medications that appeared to make her worse in their eyes. Evidence shows the effectiveness of patient centered care in healthcare, which means putting the patient above all else and incorporating them into the decision-making process. The doctors in the book saw health care in terms of what it is and what it isn’t based on their medical degree, but they did not stop to think about what health care could mean to other people, and that is one of the factors that lead to the tragic ending. As future nurses, we understand the role we will hold as patient advocates. This family needed a health care professional to look at Lia as more than the disease, more than her seizures, and understand the reassurance that can be provided by performing cultural practices. Although we may not believe in the ways of the Hmong, we can respect that they believe it and performing these rituals bring them comfort and understanding. When the parents brought Lia to a shaman in Minnesota, her seizures stopped for months, and the parents were so relieved and were more compliant with the medication regimen at home. The doctors knew that the lack of seizures was a result of medication compliance at the foster home. The lesson to be learned from Lia’s story is for healthcare providers to expand their knowledge beyond the known and concrete science and be willing to accept that health care and healing have different meanings and expectations for different cultures and to lend a listening ear and learn what health care means to their patient. Fadiman, A. (1997). The spirit catches you and you fall down: A Hmong child, her American doctors, and the collision of two cultures. Farrar, Straus, and Giroux. Haddad, L. M., & Geiger, R. A. (2018). Nursing Ethical Considerations. Europe PMC. Retrieved September 26, 2022, from https://europepmc.org/article/nbk/nbk526054

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