GERMAN CASE STUDY 

Margaret Schmidt, a terminally ill 60-year-old American of German descent, was

recently admitted to a hospice service and is receiving care at home. Diagnosed with

metastatic breast cancer, Margaret’s prognosisis less than 6 months. Margaret’s cancer

has metastasized to her ribs and liver and often causes intense

pain. Although Margaret speaks freely of her impending death, her family

has expressed their discomfort at her decision to secure hospice care.

Over the last 10 years, Margaret, a nurse, has practiced homeopathy (for herself

and others) and consults frequently with a medical intuitionist. She follows the medical

intuitionist’s recommendations to attenuate her symptoms but avoids, when she can, the

traditional cancer pain–management therapies. Medical staff and her family have entere

d into continuous discussions with her about her lack of acceptance of traditiona

l medical approaches. Margaret remains unconvinced of their value within her scheme

of care. Margaret maintains a strong belief in an afterlife, believing that

she will be reunited with her husband. Margaret meditates

daily, calling upon her spiritual guides and angels for strength and peace in the dying

process. She often asks those around her to join her during this time.

Study Questions

1. What experiences have you had with patients of German descent?
2. How does Margaret’s German ancest

ry mold her beliefs about medical

treatment?

3. What Western medicine concepts

complicate the staff and family’s

understanding of Margaret’s self

-prescribed medical regimen?

4. How do you, as a health-care professional, feel about the use of

homeopathic remedies?

5. What is your view of the use ofmedical intuitionists and other non-

Western health practices?

6. How do Margaret’s health-care choices differ or match your own?
7. How do you deal with cultural health practices unlike your own?
8. Discuss Margaret’s desire to control her life even through terminal illness.
9. Relate Margaret’s strong spiritual beliefs in an afterlife to her ability to

cope with her impending death.

10. Describe a plan of care that is culturally sensitive to the patient and her

family.

11. How can your knowledge of the German American culture positively

influence health outcomes for Margaret?

12. Discuss the cultural filters you may use as you assist Margaret in her

health-care decisions.

13. Describe the enculturation you, as a health-care professional, have

experienced and how this influencesyour own health-care decisions.