There is a general practitioner who sees a mother who has come into the ER with her child who is complaining of flu-like symptoms. Upon entering the room, he ask the boy to remove his shirt and you notice a pattern of very distinct bruises on the boy’s torso. He 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 he touches the boy’s back with his stethoscope, the boy winces in pain from the bruises. He debates whether or not he should call Child Protective Services and report the mother.
Comment on the following 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? (If someone answers “when it harms the child” remind that person that there is some pain in many of our medical procedures, for example, having one’s tonsils removed)
• 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?