Question

You are a general practitioner and a mother comes into your office with her child who is complaining of flu-like symptoms. Upon entering the room, you ask the boy to remove his shirt and you notice a pattern of very distinct bruises on the boy's torso. You ask the mother where the bruises came from, and she tells you that they are from a procedure she performed on him known as "cao gio," which is also known as "coining." The procedure involves rubbing warm oils or gels on a person's skin with a coin or other flat metal object. The mother explains that cao gio is used to raise out bad blood, and improve circulation and healing. When you touch the boy's back with your stethoscope, he winces in pain from the bruises. You debate whether or not you should call Child Protective Services and report the mother.

Questions for Case # 5
•   Should we completely discount this treatment as useless, or could there be something gained from it?
•   When should a physician step in to stop a cultural practice? (If someone answers "when it harms the child" remind that person that there is some pain in many of our medical procedures, for example, having one's tonsils removed)
•   Should the physician be concerned about alienating the mother and other people of her ethnicity from modern medicine?
•   Do you think that the physician should report the mother? Discuss the moral & empirical judgment of the case.
•   Are there any moral dilemmas?
•   What are the ethical implications?

Case # 6 (Euthanasia)

The word "euthanasia" draws its roots from Greek meaning "good death." As it is used in this discussion, it means "the act of ending the life of a person suffering from either a terminal illness, or an incurable disease." The American Medical Association is against physicians assisting in euthanasia. There is currently only one state in the US that allows for euthanasia, and that is Oregon, where in 1997, the "Death With Dignity Act" went into effect. Euthanasia advocates stress that it should be allowed as an extension of a person's autonomy. Those who are against euthanasia often say that it can lead to the devaluation of human life, and to a slippery slope in which the old and disabled will be killed on the whims of healthy people. We examined one case and the Oregon law to view the ethics of euthanasia.

A woman was diagnosed with motor neurone disease (the same
disease that Stephen Hawking has) 5 years ago. This is a condition that destroys motor nerves, making control of movement impossible, while the mind is virtually unaffected. People with motor neurone disease normally die within 4 years of diagnosis from suffocation due to the inability of the inspiratory muscles to contract. The woman's condition has steadily declined. She is not expected to live through the month, and is worried about the pain that she will face in her final hours. She asks her doctor to give her diamorphine for pain if she begins to suffocate or choke. This will lessen her pain, but it will also hasten her death. About a week later, she falls very ill, and is having trouble breathing.

Answer 1

Case study 5 :-

1. This treatment should be considered useless, as its based on blind superstition causing pain only to the boy because of which he developed flu.

2. A physician should step into stop a cultural practice when it becomes harmful to the health of the individual .

3. No, the physician should not be concerned about alienating the mother and other people of her ethnicity from modern medicine rather than make them understand about the harmful effects of the cultural practices on the health and provide them guidance and education .

• Yes , the physician should report the mother so that they don't repeat this in future . Moral and empirical judgement of the case is that no individual should be harmed for the sake of cultural practices .