Question 1
You are caring for a 30-year-old transgender woman who wants to pursue gender reassignment surgery. She is otherwise healthy except for a history of obesity and high serum lipids. In discussing her case during a preclinic huddle with your healthcare team, it is clear that most members are unfamiliar with transgender health issues, and two teammates make inappropriate comments.
In my perspective, I would first respect the patient's interest in having gender reassignment surgery. I would apologize for the teammates' remarks and privately discuss with them about healthcare issues associated with transgender patients. This would help eliminate gender bias remarks and help them understand the importance of her transition which they also are bound to respect. Respecting each patient's dignity and providing culturally-sensitive care are key missions when dealing with transgender population. Secondly, I would ask her to provide a preferred name and identity, while ensuring that any decision she makes and information she gives remain confidential. A brief explanation and apology to the patient would be to ease psychological suffering attributed to the inappropriate comments ( Eliason & Chinn, 2017) . According to IPC, prioritizing the patient's interest in gender reassignment, respecting her dignity, privacy and upholding confidentiality to ensure adequate communication and positive approach to healthcare. I would also replace incompetent workmates who fail to respect diversity and lack proper skills in such relating to transgender patients. Throughout the care process, I would ensure that I maintain ethical practice through learned competencies such as honesty and trust.
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Question 4
A patient under your care is an outspoken racist. She is outspoken in her feelings and hateful towards you based on your looks. The healthcare team that day is a mix of races.
First, I would respect her opinion and shift focus in establishing quality care based on communication and trust. This would relate to making my teammates comfortable around the patient despite their diverse cultural backgrounds. I would maintain professionalism through ethical practice, by respecting her cultural background and informing her about the importance of cultural diversity and competence ( Paul-Emile et al., 2016) . I would have the patient get care from a preferred medical profession, who she would feel comfortable to connect with. Since I am obligated to moral and ethical care, I would have her enjoy the right to informed consent if the situation persists and if she also discriminates against my teammates. I would integrate a family member to help her understand the importance of culturally-diverse care, and also help create a respectful and non-racist environment to accommodate care providers. In embracing her individual difference, I would also strive to maintain self-respect and dignity while maintaining mandated obligations to all patients regardless of their ethnic background or appearance. I would motivate the team by making them understand individual differences among patients and assisting them recognize and solve such ethical dilemmas through professional practice.
References
Eliason, M. J., & Chinn, P. L. (2017). LGBTQ cultures: What health care professionals need to know about sexual and gender diversity . Lippincott Williams & Wilkins.
Paul-Emile, K., Smith, A. K., Lo, B., & Fernández, A. (2016). Dealing with racist patients. New England J. Med. , 374 , 708.
