However, they actually illuminated the fallacy in thinking that there is a "typical" American approach to healthcare. For example, the Muslim family did adhere to many gender-based behaviors that led to an impression that the women were not respected in the same way as women in other communities. However, one of the issues that the family discussed was routine healthcare for women, and one of the women in the family made a distinction between traditional Muslims and fundamentalist Christians and their rules about abortion; I was surprised to learn that abortion is not prohibited in Islam prior to about 120 days of gestation (Sachedina, 2013). However, they also informed me that for medical decisions concerning the family, the male spouses are considered part of the decision-making process, and may even want to sign consent forms (Sachedina, 2013). In addition, there were cultural norms regarding females disrobing for male doctors. In fact, the family indicated that male family members, particularly the older members, might find it uncomfortable to disrobe for female doctors, though they stressed this was more of a cultural norm than a religious norm. One issue that they discussed had to do with life support; life saving measures are permissible under the religious traditions. However, removing a patient from life support can be a very difficult religious issue, so that the consideration to utilize life support becomes critical. That would suggest that patients from these backgrounds be instructed to leave detailed descriptions of their wishes. Muslims do experience some dietary restrictions, such as an absolute prohibition on pork and pork products. This not only impacts what they can eat, but may also impact their ability to utilize certain vaccines; the family said that a vaccine that is necessary for travel to Mecca on pilgrimage actually uses some type of pig product in production, and indicated that it was a substantial healthcare barrier for many Muslims.
The Indian family described a healthcare tradition that was very different from a Western medical approach. They believed in health maintenance, but had a belief about "hot" and "cold" foods and when they could be eaten, which differed from Western understanding of which foods are healthy and unhealthy. They also believed that illnesses and maladies could have non-scientific causes, and in the efficacy of folk medical treatments, even if those treatments have no proven record of success (Sharma, 2002). I was actually surprised to hear about the role of faith healers in their lives, and concerned that such an approach might delay seeking out healthcare. They also described a number of practices that could negatively impact health. For example, one woman in the family was diabetic and had been instructed by her doctors to maintain a consistent blood sugar level, but still engaged in fasting for religious purposes, which made it very difficult to control her blood sugar during those times. Moreover, the family was vegetarian. Rather than promote a healthier diet, the family had otherwise very American eating habits, and they described a diet that was very heavy in simple carbohydrates. The family indicated that, for their family that still resides in India, mental health issues, particularly depression, are viewed as stigmatizing. However, several of the family members discussed having used anti-depressants, suggesting that they did not agree with this cultural approach to depression.
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