Essay on Hispanic/Latino Health Promotion Intervention Ethical Dilemmas

Rapid Tissue Donation (RTD), as Schabath et al. (2013) note, is one of the technologies that can be used in the treatment of cancer. As the authors note, it involves the procurement of a fresh tissue within two to six hours following the death of a patient. The main aim of RTD programs is obtaining high quality and quantity tumor tissue from the primary metastasis and tumor. The tissue from these programs has more benefits not seen in paraffin-embedded or frozen tissue samples, and thus, can be used studying cancer types and how to cure them, thereby helping medical and healthcare practitioners in studying the disease. Making a decision to donate the tissue for Latinos/Hispanics can present an ethical dilemma for healthcare practitioners because the practitioner has to obtain the tissue within six hours. The purpose of this paper is to showcase a practical ethical dilemma situation when dealing with Latinos/Hispanics in RDT programs.

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According to Taira (1999), Latinos and Asians constitute the largest portion of non-English speaking patients in the U.S. The researcher also pointed out that fewer Latinos had cancer screening tests, even in instances where the patient had a prepaid health plan where financial considerations were ostensibly not an issue. Also, Guntzviller (2011) the Latino population in the US has been identified as high-risk in receiving and accessing quality healthcare and it the fastest growing in the US. Besides, Guntzviller (2011) also points out that out of the Latinos living in the US, who reportedly speak Spanish in their homes, half have problems in communicating in English. In effect, this presents a communication barrier between them and the healthcare practitioners. Regarding cultural beliefs, Guntzviller (2011) notes that there are five main themes that apply to the culture of Latinos/Hispanics in medicine, which is personalism, simpatia, fatalism, respect, and familismo. Permilismo refers to trust and quality connection between a patient and physician. Familismo refers to how the population holds high-value family members while the tendency to agree with physicians through passiveness conveys and nonverbal messages is simpatico, and revolves around friendliness. Fatalismo refers to the belief that the locus of control is outside the individuals reach. Also, as Rastogi, Massey-Hastings, and Wieling (2012) note, cultural miscommunication is a common problem encountered by health practitioners when dealing with Latinos/Hispanics.

For this reason, when a Latino patient dies of cancer and the healthcare practitioner wants the cancerous tissue for research via the RTD program, there is a high likelihood that the Latino family of the deceased will not reach an agreement before the six-hour period when the tissue can be retrieved from the patient. As such, the healthcare practitioner can just perform the RTD without the familys knowledge, which presents an ethical dilemma. In essence, this is the hope that the benefits of the research can help many patients. Even so, the problem of miscommunication can hamper the RDT process from being completed. The Latinos may not understand the importance of the program. As Carnevale et al. (2009) noted, in a cross-linguistic scenario, five ethical norms exist. These are respected for patients, compliance with the right to self-determination, privacy, and confidentiality, the responsibility of personal judgment, competence, and action, as well as the responsibility of promoting action better to meet the needs of families, groups, and patients (Carnevale et al., 2009). For this reason, the healthcare practitioner has a responsibility of meeting these aspects to uphold ethics.

However, various actions can be taken to address the ethical issue. One of them is asking a Latino health practitioner to communicate with the family of the diseased. Weitzman et al. (2008) noted that having a caregiver who can speak the native Latino language can help solve the problem of cultural miscommunication. In essence, since the Latino practitioner comprehends personalism, simpatia, fatalism, respect, and familismo of the fellow Latinos, there will not be any misunderstanding, and they can educate the family of the deceased on the importance of the RDT.

As Carnevale et al. (2009) note that it is the responsibility of a practitioner to exercise the best judgment. In this case, the practitioner can take the tissue without consent from the family to avoid unnecessary bureaucracy and still obtain the tissue within the required six hours, but this would be unethical. As such, asking the family would be ethical. However, there can be miscommunications between him and the family. According to Ravazzani (2016), it is advantageous to have practitioners from different backgrounds, which helps solve the issue of miscommunication between patients and healthcare providers. Besides, as Deeb-Sossa and Billings (2014) noted, hiring an interpreter can also contribute to solving the problem of miscommunication in instances when there is no Latino, health practitioner. In essence, Carrasquillo et al. (1999) noted that using language interpreters is important for non-English speaking people in the medical field.In essence, as the researchers noted, it increased their understanding of the situation in hand. For this reason, the health practitioner would benefit a lot if they included an interpreter in the situation as it would enable the family to make a decision on whether to donate the cancerous tissue for RDT. In essence, this would have solved the ethical dilemma faced by the healthcare practitioner. As such, to solve the issue, it is recommended that the practitioner ask for consent from the family, which would require explanation and understanding before the patients death.

References

Carrasquillo, O., Orav, E. J., Brennan, T. A., & Burstin, H. R. (1999). Impact of language barriers on patient satisfaction in an emergency department. Journal of general internal medicine, 14(2), 82-87.

Carnevale, F. A., Vissandjee, B., Nyland, A., & Vinet-Bonin, A. (2009). Ethical considerations in cross-linguistic nursing. Nursing ethics, 16(6), 813-826.

Deeb-Sossa, N., & Billings, D. L. (2014). Barriers to abortion facing Mexican immigrants in North Carolina: Choosing folk healers versus standard medical options. Latino Studies, 12(3), 399-423.

Guntzviller, L. M. (2011). Increasing medication adherence in LEP (Low-English Proficiency) Latino populations: Merging speech act theory and cultural competency. International Public Health Journal, 3(1), 17.

Rastogi, M., Massey-Hastings, N., & Wieling, E. (2012). Barriers to seeking mental health services in the Latino/a community: A qualitative analysis. Journal of Systemic Therapies, 31(4), 1-17.

Ravazzani, S. (2016). Exploring internal crisis communication in multicultural environments: A study among Danish managers. Corporate Communications: An International Journal, 21(1), 73-88.

Schabath, M. B., McIntyre, J., Pratt, C., Gonzalez, L. E., Munoz-Antonia, T., Haura, E. B., & Quinn, G. P. (2013). Healthcare providers knowledge and attitudes about rapid tissue donation (RTD): phase one of establishing a rapid tissue donation programme in thoracic oncology. Journal of medical ethics, medethics-2013.

Taira, D. A. (1999). Improving the Health and Health Care of NonEnglishSpeaking Patients. Journal of general internal medicine, 14(5), 322-323.

Weitzman, P., Neal, L., Chen, H., & Levkoff, S. E. (2008). Designing a culturally attuned bilingual educational website for US Latino dementia caregivers. Ageing International, 32(1), 15-24.