Lias medical condition

- Severe hypoxic brain and seizures, leading to vegetative state

Harm could have been avoided by building a healthy, trusting relationship between her parents
and her doctors and clinical staff, and, in turn, the American health system
- Clinical staff = culturally relativistic conduct, e.g. patient and sympathetic to cultural
differences
- Interpreters present to prevent misunderstandings due to language/cultural barriers, thus
promoting compliance
- Show willingness to compromise to accommodate patient cultural and religious
background within framework of American medicine
However, Lias parents developed a deep mistrust for American healthcare (except Neil and Peggy)
due to negative, prejudiced treatment this impression is further reinforced by discriminatory
experiences reported by other members of the Hmong community

Clinical staff expressed callous disregard for the patients cultural/ethnic/religious background,
dismissing this while maintaining an ethnocentric attitude
- Lias parents were unwilling to cooperate, partly because they felt that the American
health system infringed on and disregarded their beliefs, developing an antagonistic
attitude towards American medicine in reponse
o Without explanation = Lias treatments, dismissal of parents desires or opinion
(local shaman, sacrificing, traditional food)
Clinicians made culturally insensitive decisions that strained the patient-doctor relationship that
bred distrust and unwillingness to comply in the patient. There was little intention from the
establishment to understand the Lees beyond Lias medical history and symptomatic presentation.

Parents left confused and uninformed until the end; frustrated because unable to effectively
communicate with clinicians, but also because felt powerless to help Lia themselves
- But this happened here in the US, and Americans have done this to her, and our
medicine cannot fix that.
- Western medicine is Cartesian, but Hmong beliefs are deeply spiritual and metaphysical
inconsistency disregarded, and along with communication barrier, this left parents
without follow-up
Compliance implies moral hegemony Western medicine treats any other system as morally and
intellectually inferior. Physicians should oppose traditional culture of emotional dissociation,
staying attuned to humanity of themselves and their patients ask not what disease the patient
has, but what patient the disease has. Patient realities should be ascertained piecing these
together allow physicians to establish better relationships with patients and their families.