Cultural Differences in Treatment of Brain Injury

BrainLine talked with Dr. Carlos Arango-Lasprilla about why people from non-US cultures get treated differently after a TBI.

I think it's very important, especially when you work with people with brain injury from different cultures, one of the more important things is to work with the family, and also talk with all the family members and provide them information about the recovery, about the prognosis. And also, yeah, ask questions and ask them what they think about the treatment, if they have suggestions. Yeah, we talk with the family. I think it's very important. In some culture, we don't use the informed consent--the informed consent form. Usually, when you go to the doctor in another country, you don't expect that you have to sign a consent form. In some cases, here in this country, when people are from a Hispanic background or people from Asia go to the doctor and they see that you have to sign an informed consent form, they start thinking about there's something weird here. There's something wrong. Why do I have to sign and give authorization to my doctor to provide service to me? An example is that, for example, some people from different cultures think that things that happen with their health problems, it relates to God. And when they have a TBI or a spinal cord injury or other kind of disease, they think that probably it's God, the person that you know, caused this thing or sent that problem to him, and they don't want to do anything to change the situation. They hope that God will help them to recover. They don't feel they need to go to a rehabilitation professional to receive services. For example, I can tell you that we have patients sometimes, Hispanic patients, that when the doctors prescribe the medication that they have to take, they don't want to take the medication. First they talk with their family members, especially with their mom or grandma, and ask them for advice, ask them if this medication is good for them, or if there is something that they should take instead of the medication that the doctor recommends. And sometimes, yeah, they think that God is the only person that can provide services to them, and you have to work with them and show them that, yeah, God wants him or her to recover, and God is working with the rehabilitation professional to to provide service to him to improve their lives. One of the advice that I can give to the family is that they should be persistent. They should try very hard to find professionals in the community that will be able to provide services for their family member. There are a lot of professionals in the community that speak different languages that will be willing to provide the same service that they provide for people in this country to people from other countries that don't speak the language, that don't speak English.
Posted on BrainLine April 1, 2009.