GERMAN CASE STUDY-60-year-old Metastatic Breast Cancer

GERMAN CASE STUDY-60-year-old Metastatic Breast Cancer

GERMAN CASE STUDY-60-year-old Metastatic Breast Cancer

Margaret Schmidt, a terminally ill 60-year-old American of German descent, was recently admitted to a hospice service and is receiving care at home. Diagnosed with metastatic breast cancer, Margaret’s prognosis is less than 6 months. Margaret’s cancer has metastasized to her ribs and liver and often causes intense pain. Although Margaret speaks freely of her impending death, her family
has expressed their discomfort at her decision to secure hospice care. Over the last 10 years, Margaret, a nurse, has practiced homeopathy (for herself and others) and consults frequently with a medical intuitionist. She follows the medical intuitionist’s recommendations to attenuate her symptoms but avoids, when she can, the traditional cancer pain–management therapies.
Medical staff and her family have entered into continuous discussions with her about her lack of acceptance of traditional medical approaches. Margaret remains unconvinced of their value within her scheme of care. Margaret maintains a strong belief in an afterlife, believing that she will be reunited with her husband. Margaret meditates daily, calling upon her spiritual guides and angels for strength and peace in the dying process. She often asks those around her to join her during this time.

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Study Questions

1. What experiences have you had with patients of German descent?

2. How does Margaret’s German ancestry mold her beliefs about medical treatment?

3. What Western medicine concepts complicate the staff and family’s understanding of Margaret’s self-prescribed medical regimen?

4. How do you, as a health-care professional, feel about the use of homeopathic remedies?

5. What is your view of the use of medical intuitionists and other non- Western health practices?

6. How do Margaret’s health-care choices differ or match your own?

7. How do you deal with cultural health practices unlike your own?

8. Discuss Margaret’s desire to control her life even through terminal illness.

9. Relate Margaret’s strong spiritual beliefs in an afterlife to her ability to cope with her impending death.

10. Describe a plan of care that is culturally sensitive to the patient and her family.

11. How can your knowledge of the German American culture positively influence health outcomes for Margaret?

12. Discuss the cultural filters you may use as you assist Margaret in her health-care decisions.

13. Describe the enculturation you, as a health-care professional, have experienced and how this influences your own health-care decisions.