Ethical Implications of Cultural Barriers to the Depression Diagnosis: Conversations with Primary Care Physicians. Open Access

Abstract

The diagnosis of depression is based on Western medical definitions. It has changed over time within the medical culture, as can be seen in the changing categorizations in the various editions of the DSM. However, depression, like many mental health diagnoses, is often an illness that is not understood or accepted by all patients in the same way that a physical diagnosis may be. This project explored the experiences of Primary Care Providers caring for patients with the diagnosis of depression.  Through structured interviews the challenges and reasoning in diagnosing depression in patients from different cultural backgrounds were discussed to determine how the culture of the patient affects the understanding and diagnosis of depression. Potential ethical issues that arose centered on the mental health diagnosis, the misdiagnosis of individuals related to their cultural background, problems with the Western-centric care that is being provided by US doctors, issues with cultural sensitivity training experienced by healthcare workers, and the problems associated with a shift in mental health definitions.

Table of Contents

Ø  Introduction—pg. 1

Ø  Chapter 1: Ethical Considerations in Research with Culturally Diverse Communities—pg. 5

Ø  Chapter 2: How Cultural Syndromes and Idioms of Distress have been incorporated into Western Psychiatric Care—pg. 15

Ø  Chapter 3: The PHQ-2 and PHQ-9: Ethical Considerations for Depression Screening in Primary Care—pg. 22

Ø  Chapter 4: Culturally Sensitive Medical Training—pg. 34

Ø  Chapter 5: Cultural Barriers to the Depression Diagnosis: Conversations with Primary Care Physicians—pg. 43

Ø  Chapter 6: Ethical Implications—pg. 74

Ø  Conclusion—pg. 84

Ø  References—pg. 87

Ø  Appendix—pg. 94

About this Master's Thesis

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School	Laney Graduate School
Department	Bioethics
Degree	M.A.
Submission	Master's Thesis
Language	English
Research Field	Ethics
Keyword	Ethics Culture Primary Care Depression
Committee Chair / Thesis Advisor	Kinlaw, Kathy, Emory University
Committee Members	Hall, Pamela, Emory University Konner, Melvin, Emory University

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