CULTURAL PERCEPTIONS AND MISCONCEPTIONS – CULTURE AS AN ISSUE FOR THE PATIENT (GENERAL INFORMATION)
More often the cultural issue arises obliquely. If a patient is in difficulties with her contraception it is often hard for her to be straightforward in discussing exactly why one method is unsuitable. This is made even worse if she does not speak very good English, and if she is not used to discussing family matters with people from another culture. It may well be easier to tell the doctor that your religion forbids the use of certain methods or devices in the hopes that she will offer something more acceptable without having to go into greater detail. Religious prohibitions concerning menstruation are often quoted as the reason for the coil or progestogen-only Pill being unacceptable, but most ethnic majority couples, too, would probably find prolonged or irregular vaginal bleeding a significant problem. Patients are often anxious to maintain their self-respect in the eyes of a professional. They may behave apparently irrationally in order to achieve conflicting goals of getting what they need, while displaying moral rectitude. Similarly, it may be easier to transgress their interpretation of religious dogma if a doctor gives them dispensation to do so. Thus doctors may be faced with a patient who has apparently come for help with family planning, but who says that it is against their religion. The doctor may be rather surprised to find that only a little more pressure on this point lands them in a full discussion of the pros and cons of various methods, with the fundamental moral question about whether it is permitted or not in the first place, left aside.
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