When we think of medical care, we picture pill bottles, bandages and surgical instruments. But, as we are just beginning to explore, good medical care takes into account much more than antibiotics. Multiculturalism is also a factor.
It's important to note that science-based medicine is a culture of its own -- and it's the minority view. In many places, germs aren't even considered to be the cause of disease. Instead, the cause of an illness might be pinpointed as sin, or perhaps it isn't an illness in need of treatment at all -- it's God attempting to speak through someone's body. Our culture determines our attitude toward disease.
Religion is tied strongly to physical well-being for people the world over. It isn't as strange as it might sound -- the first hospitals, after all, were founded mostly in monasteries, and missionaries hoped that sharing their medical skills would give them a chance to bring their religious messages to new converts.
But, often, people think of religious belief as an enemy to good medical care -- Jehovah's Witnesses who refuse life-saving blood transfusions, for example. It isn't that simple. Studies have shown a positive connection between strong religious beliefs and religious practices and health. In that case, a physician must take into account the perhaps surprising idea that ignoring someone's religious beliefs is neglecting their care.
We come back to the question from the first page: What is a doctor's responsibility to his or her patients? To give good care. And if it's true that what is best for a patient may not be a purely medical decision, then the need for cultural sensitivity must be emphasized. For example, if a Muslim is fasting for Ramadan, that might be a bad time to schedule certain surgical procedures. This doesn't mean that the Muslim person is making it more difficult to care for him or her, as medical culture may have shaped the physician to believe -- it means that doctor and patient have to work together to come to the best decisions.
This holds true for military medicine, as well. Even in a military culture that emphasizes oneness, there is diversity among the troops -- not to mention civilians and prisoners -- that a physician could be required to treat. In stressful situations like war, these differences actually become more, not less, important.
On the next page, we have links and resources to help you learn more about this complex issue.
- American Medical Association. "AMA's Code of Medical Ethics." (April 10, 2011)http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics.page?
- American Medical Association. "Original Code of Medical Ethics." May 1847. (April 10, 2011)http://www.ama-assn.org/resources/doc/ethics/1847code.pdf
- Annas, George J. "Military Medical Ethics -- Physician First, Last, Always." The New England Journal of Medicine. Sept. 11, 2008. (April 5, 2011)http://www.nejm.org/doi/full/10.1056/NEJMp0805975
- DeDonato, David D. and Rick D. Mathis. "Religious and Cultural Considerations in Military Healthcare." Military Medical Ethics, Volume 2. Borden Institute. (April 5, 2011)http://www.bordeninstitute.army.mil/published_volumes/ethicsVol2/Ethics-ch-21.pdf
- Sidel, Victor W. and Barry S. Levy. "Physician-Soldier: A Moral Dilemma?" Military Medical Ethics, Volume 1. Borden Institute. (April 6, 2011)http://www.bordeninstitute.army.mil/published_volumes/ethicsVol1/Ethics-ch-11.pdf