Question

• Are there any moral dilemmas? • What are the ethical implications? Case #5 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 d 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?

Answer 1

Answer) 1) No, this should not be the case when it is to be dealt with the cultural belief of people. This treatment must have been developed by their ancestors and it may be useful.

2) Physician should step in to stop a cultural practice when it seems to go out of proportion for the child and it must be question of consent also. Several cultural belief may also involve some pain but it should not interfere in any physical and physiological function of child.

3) No, physician should not alienate the mother and other people of her ethnicity from modern medicine. However, other concerns for child such as his health must be raised toward the child protective services.

4) Yes, the case must be reported in a way of concern and not alarm. This is because various cultural belief are practiced across all the religions and they sometimes involves pain. However, it should not be overdone and does not cause harm to any physical and physiological activity of the person.

5) Yes, there is a moral dilemma as it can be considered as discrimination against the patient based on their belief. So, there is a dilemma that at which point these practices must be reported to the legal authorities and specially in case of children as they are not aware of the phenomenon of consent.

6) Ethically, physicians should report this incidence. Also, In my opinion at first he should talk to the child about if he is experiencing any pain or if he is afraid of his mother. If the child is having discomfort or he is afraid of his mother then it is duty of physician to report mother to child protective services.