Would You Want to Know?

There are many instances of "The Clash of the Cultures" as we go through our days.  For instance, the main grocery store in town decides not to open on time, people put mayonaise on pizza, etc.  However, at times it becomes more difficult to accept the Ecuadorian way.  According to medical ethics that I have learned and practiced over the past eight years, every person has the right to know everything about their own health.  This is not exactly true in Ecuador.  A few cases in point:

1) A few weeks ago I saw a patient in the hospital who was dying from metastatic stomach cancer.  She presented with some horrific symptoms, including a severe build-up of fluid in her abdomen (ascites).  The patient's family knew of her diagnosis, but nobody had told her that she was dying of cancer.  In this case, I was able to share the news with her.  She was extremely grateful for my honesty with her so that she could face her last days without the fear of the unknown.

2) A study done a few years ago in the major cancer hospital in Ecuador (the word "cancer" is in the hospital name) revealed that 40% of patients in the hospital did not know that they were there being treated for cancer.

3) Today we sent home from the hospital an elderly lady who presented three days ago with severe shortness-of-breath and a large mass in her neck.  We diagnosed her with terminal thyroid cancer.  The family, which consisted of eight children, insisted that we not tell their mother of her diagnosis.  According to them, if we were to tell her, she would die of a heart attack on the spot, leaving their other sibling (who was away in France) without the opportunity to visit her mother one last time.  The family was very heated in their discussion of this matter.  Even though the children admitted that their mother would probably want to know of her own diagnosis, they believed that they could better decide what was in her best interest.  After many prayers were lifted up with the family, with the patient, and with other doctors, we decided to tell the patient, "If you have questions about your diagnosis, please ask your children or return to the hospital.  We would like you to know as much as you want to know."  This decision definitely went against my American ethics.

These differences present some deep challenges, but they offer great opportunities for us to appreciate the diversity of God's people.  The tough cases are also opportunities for us to mentor the Ecuadorian medical residents spiritually.  I was encouraged today by the spiritual maturity that the resident doctor showed in the treatment of this situation.  Be praying for the residents.  Many of them are trying to figure out who God is.  Others are learning how to introduce their patients to Jesus.  One of the main reasons that the Lord led us here is to help them along the right path, no matter where they might be in their spiritual and professional lives.