The Spirit Catches You and You Fall Down Case Study Over the semester, we talked about the impact of culture/cultural norms and religion on peoples’ approa

The Spirit Catches You and You Fall Down Case Study Over the semester, we talked about the impact of culture/cultural norms and religion on peoples’ approach to health and wellness. What are some most important driving and restraining forces towards certain health behaviors? It would differ among individuals and their perspectives.

The following assignment will require you to comprehensively approach this topic and demonstrate your ability to critically analyze evidence from a diversity of perspectives to formulate a position related to an issue of personal and social responsibility . The assignment may also require some additional research outside the class material.

Please read the following case study and respond to all questions listed at the end. As you are responding to questions, please keep the following in mind:

1. You must respond to ALL questions using a comprehensive approach. It is expected that your responses will include at least 2 solid paragraphs per each listed question.

2. When responding to questions, you need to clearly defend your position, which should be supported by literature.

3. You must respond to at least 3 of your classmates’ posts. When responding to your classmates, be respectful and acknowledge their point of view although you may disagree with their position on the topic. Your responses to your classmates’ posts must be comprehensive as well (this is not a simple agree/disagree task).

4. Avoid attachments — write (copy/paste) your responses in the discussion box.

5. The evaluation rubric is provided as a guide regarding expectations. I strongly encourage you to use the rubric as you are preparing and writing your responses.

CASE STUDY: The book titled The Spirit Catches You and You Fall Down, by Anne Fadiman, tells a story of Lia Lee, a Hmong child with epilepsy, who lived in Merced, California. When 3-month-old Lia Lee arrived at the county hospital emergency room in Merced, a chain of events was set in motion from which Lia, her parents, and her doctors would never recover. Lia’s parents, Foua and Nao Kao, were part of a large Hmong community in Merced, refugees from the CIA-run “Quiet War” in Laos. Her parents and doctors both wanted the best for Lia, but their ideas about the causes of her illness and its treatment were very different.

The Hmong see illness and healing as spiritual matters that are linked to virtually everything in the universe, but the U.S. medical community marks a division between body and soul and concerns itself almost exclusively with the former. Lia’s doctors attributed her seizures to the misfiring of her cerebral neurons; her parents called her illness “qaug dab peg” – the spirit catches you and you fall down – and ascribed it to the wandering of her soul. The doctors prescribed anticonvulsants; her parents preferred animal sacrifices. The Spirit Catches You and You Fall Down moves from hospital corridors to healing ceremonies, and from the hill country of Laos to the living rooms of Merced, uncovering in its path the complex sources and implications of two dramatically clashing worldviews.

Lia’s doctors prescribed a complex regimen of medication designed to control her seizures. However, her parents believed that the epilepsy was a result of Lia “loosing her soul” and did not give her the medication as indicated because of the complexity of the drug therapy and the adverse side effects. Instead, they did everything logical in terms of their Hmong beliefs to help her. They took her to a clan leader and shaman, sacrificed animals, and bought expensive amulets to guide her soul’s return. Lia’s doctors believed that her parents were endangering her life by not giving her the medication, so they called child protective services, and Lia was placed in foster care. Lia was a victim of a misunderstanding between these two cultures that were both intent on saving her. The results were disastrous: a close family was separated, and Hmong community faith in Western doctors was shaken.

Lia was surrounded by people who wanted the best for her and her health. Unfortunately, they involved parties disagreed on the best treatment because they understood her epilepsy differently. The separate cultures of Lia’s caretakers had different concepts of health and illness.

This example illustrates how culture and health influence each other and at times clash. To help ensure good care for diverse patients, health care providers must address cultural issues and respect the cultural values of each patient.

There are several issues to consider about this case:

How can health care providers prepare for situations like Lia’s?
Should child protective services have been contacted?
Were Lia’s parents irresponsible?
How did the parents’ belief system affect Lia’s health care?
Were the parents’ decisions morally and legally wrong?

> Please post your original response to these questions by April 23 (10 a.m.).

> Respond to your classmates’ posts (at least 3) by April 28 (10 a.m.).

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