Читать книгу Pathy's Principles and Practice of Geriatric Medicine - Группа авторов - Страница 220

Both the provider and the older adult bring certain expectations to the clinical encounter based on prior experience. Both may be unaware that their own ethnic or professional culture influences the interaction. Problems often arise due to the knowledge and power differential between the older adult and the health care provider.

Older adults may distrust their providers based on their own or others’ previous encounters with biomedicine, such as the American experience with the Tuskegee Syphilis Study. This research study exemplifies several factors that have influenced African Americans’ attitudes toward the biomedical community in the United States,⁴⁷ although more recent research indicates that these attitudes may have ameliorated over the past two decades.⁴⁸ This may be due to acculturation by the younger generation, rather than forgiveness on the part of those who were directly affected.

Providers may view the patients’ ethnic cultures as an obstacle. For example, because Afghani Muslim women do not seek health care from male practitioners,³⁴ the woman receives care by proxy. Her husband describes her symptoms to the male practitioner, who then instructs the husband in the recommended treatment plan. Not all practitioners are comfortable practising medicine in this manner.