Healing by Heart: Clinical and Ethical Case Stories of Hmong Families and Western Providers

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Kathie Culhane-Pera
Vanderbilt University Press, 2003 - Medical - 368 pages
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Healing by Heart is a book of stories--stories of people's search for culturally responsive health care from U.S. providers. It offers resources to providers and institutions committed to delivering culturally responsive health care, paying special attention to building successful relationships with traditional Hmong patients and families. It makes available extensive information about the health-related beliefs, practices, and values of the Hmong people, including photographs of traditional healing methods.


Ranging in age from young infants to older adults, the patients in the stories present a wide range of health problems. The clinicians are from family practice, internal medicine, pediatrics, emergency medicine, surgery, obstetrics-gynecology, psychiatry/psychology, and hospice.


Each of the fourteen case stories is accompanied by discussion questions as well as two or three commentaries. The commentaries--written by patients, family members, shaman, Western clinicians (including Hmong physicians, nurses, and social workers), medical anthropologists, health care ethicists, social workers, psychologists, and clergy--are rich in personal reflections on cross-cultural health care experiences. Readers are rewarded with a combination of perspectives, including those of Hmong authors who have not previously published in English and scholars with years of professional experience working with the Hmong in Laos, Thailand, and the United States.


The editors offer a model for delivering culturally responsive health care with special attention to matters of cross-cultural health care ethics. The model identifies questions health care providers can focus on as they seek to understand the health-related moral commitments and practices prevalent in the cultural groups they serve, ethical questions that arise frequently and with great poignancy in cross-cultural health care relationships, and points to consider when a patient's treatment wish challenges the provider's professional integrity.


By sharing stories of suffering, confusion, and success, Healing by Heart couples an accessible method of learning about others with concrete recommendations about how to enhance cross-cultural health care relationships.

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About the author (2003)

Kathleen A. Culhane-Pera, M.D., M.A., is a family physician at Ramsey Family and Community Medicine Residency and West Side Community Health Center.

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