You are a general practitioner and a mother comes into your office with a child who is complaining of flu-like symptoms. Upon entering the room you ask the boy to remove his shirt and you notice a pattern of very distinct bruises on the boy’s torso. You ask the mother where the bruises came from and she tells you that they are from a procedure she performed on him known as “cao gio” which is also known as “coining”. The procedure involves rubbing warm oils or gels on a person’s skin with a coin or other flat metal object. The mother explains that cao gio is used to raise out bad blood, and improve circulation and healing. When you touch the boy’s back with your stethoscope, he winces in pain from the bruises. You debate whether or not you should call Child Protective Services and report the mother. Questions
Should we completely discount this treatment as useless, or could there be something gained from it? When should a physician step in to stop a cultural practice? Should the physician be concerned about alienating the mother and other people of her ethnicity from modern medicine? Do you think that the physician should report the mother?
Points to consider:
Mother’s belief in the cultural practice
Boy suffering from bruises but enduring until doctor’s touch Positive use of warm oil (aromatic oils)
Role of the doctor
Answer to questions:
Should we completely discount this treatment as useless, or could there be something gained from it? There is a positive use of massaging with aromatic oils. In this particular case it could be truly for the purpose of improving circulation. (Define massaging). The concern however is the mode of application. Yes, warm oil but to what temperature? Why rub with a metal or coin? The hot oil and the metal could have caused the bruises. When should a physician step in to stop a cultural practice? The public interest of the doctor should get him interested in preserving future...
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