Skip to main content
PMC home page
The Western Journal of Medicine logoLink to The Western Journal of Medicine
. 1992 Sep;157(3):323–327.

Ethical dilemmas in a cross-cultural context. A Chinese example.

J H Muller 1, B Desmond 1
PMCID: PMC1011287  PMID: 1413778

Abstract

Considerable attention is now being given to ethical conflicts raised by such issues as the disclosure of diagnosis and prognosis, the role of the family in making medical decisions, and the withholding or withdrawing of treatment of terminally ill patients. Already complicated, these issues take on added complexity in contexts where medical professionals and patients have differing cultural beliefs and practices. Ethical dilemmas that develop in multicultural settings have been largely unaddressed. Through the analysis of a case involving the hospital admission and death of a Chinese woman with metastatic lung cancer, we examine some of these dilemmas and their effect on the patient, family, and physicians. Many issues were raised by this case regarding the relationships among ethnic background, bioethics, and medical care.

Full text

PDF
325

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Areen J. The legal status of consent obtained from families of adult patients to withhold or withdraw treatment. JAMA. 1987 Jul 10;258(2):229–235. [PubMed] [Google Scholar]
  2. Bedell S. E., Delbanco T. L. Choices about cardiopulmonary resuscitation in the hospital. When do physicians talk with patients? N Engl J Med. 1984 Apr 26;310(17):1089–1093. doi: 10.1056/NEJM198404263101706. [DOI] [PubMed] [Google Scholar]
  3. Blackhall L. J. Must we always use CPR? N Engl J Med. 1987 Nov 12;317(20):1281–1285. doi: 10.1056/NEJM198711123172009. [DOI] [PubMed] [Google Scholar]
  4. Brennan T. A. Do-not-resuscitate orders for the incompetent patient in the absence of family consent. Law Med Health Care. 1986;14(1):13–19. doi: 10.1111/j.1748-720x.1986.tb01666.x. [DOI] [PubMed] [Google Scholar]
  5. Brotzman G. L., Butler D. J. Cross-cultural issues in the disclosure of a terminal diagnosis. A case report. J Fam Pract. 1991 Apr;32(4):426–427. [PubMed] [Google Scholar]
  6. Cross A. W., Churchill L. R. Ethical and cultural dimensions of informed consent. A case study and analysis. Ann Intern Med. 1982 Jan;96(1):110–113. doi: 10.7326/0003-4819-96-1-110. [DOI] [PubMed] [Google Scholar]
  7. Hackler J. C., Hiller F. C. Family consent to orders not resuscitate. Reconsidering hospital policy. JAMA. 1990 Sep 12;264(10):1281–1283. [PubMed] [Google Scholar]
  8. Kim S. S. Ethnic elders and American health care--a physician's perspective. West J Med. 1983 Dec;139(6):885–891. [PMC free article] [PubMed] [Google Scholar]
  9. Kunstadter P. Medical ethics in cross-cultural and multi-cultural perspectives. Soc Sci Med Med Anthropol. 1980 Nov;14B(4):289–296. doi: 10.1016/0160-7987(80)90054-x. [DOI] [PubMed] [Google Scholar]
  10. Lee M. A., Cassel C. K. The ethical and legal framework for the decision not to resuscitate. West J Med. 1984 Jan;140(1):117–122. [PMC free article] [PubMed] [Google Scholar]
  11. Lo B., Jonsen A. R. Clinical decisions to limit treatment. Ann Intern Med. 1980 Nov;93(5):764–768. doi: 10.7326/0003-4819-93-5-764. [DOI] [PubMed] [Google Scholar]
  12. Louie K. B. Providing health care to Chinese clients. Top Clin Nurs. 1985 Oct;7(3):18–25. [PubMed] [Google Scholar]
  13. Meleis A. I., Jonsen A. R. Ethical crises and cultural differences. West J Med. 1983 Jun;138(6):889–893. [PMC free article] [PubMed] [Google Scholar]
  14. Muller J. H. Shades of blue: the negotiation of limited codes by medical residents. Soc Sci Med. 1992 Apr;34(8):885–898. doi: 10.1016/0277-9536(92)90257-q. [DOI] [PubMed] [Google Scholar]
  15. Rabkin M. T., Gillerman G., Rice N. R. Orders not to resuscitate. N Engl J Med. 1976 Aug 12;295(7):364–366. doi: 10.1056/NEJM197608122950705. [DOI] [PubMed] [Google Scholar]
  16. Reiser S. J. Words as scalpels: transmitting evidence in the clinical dialogue. Ann Intern Med. 1980 Jun;92(6):837–842. doi: 10.7326/0003-4819-92-6-837. [DOI] [PubMed] [Google Scholar]
  17. Tomlinson T., Brody H. Futility and the ethics of resuscitation. JAMA. 1990 Sep 12;264(10):1276–1280. [PubMed] [Google Scholar]
  18. Veatch R. M., Tai E. Talking about death: patterns of lay and professional change. Ann Am Acad Pol Soc Sci. 1980;447:29–45. [PubMed] [Google Scholar]

Articles from Western Journal of Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES