Another social worker was able to persuade a patient with tuberculosis to take her medication by working within the family's belief system; like Jeanine, she loved her clients.In Fadiman's opinion, Lia's doctors, Neil Ernst and Peggy Philp, liked the Hmong, but they didn't love them.It may have been this lack of love that hindered them from considering their patients' points of view and adjusting their methods accordingly.
Most importantly for the Lees, they were no longer considered the ultimate decision makers for their children. Doctors have the power to call the police and to access state power which Hmong parents do not have" (84).
A Minnesota physician summarized this view: "Once the police are called and court orders are obtained… reveals that Western doctors' knowledge is considered superior to Hmong beliefs.
Welfare made them dependent upon others for sustenance, with few jobs available that did not require English proficiency and other skills they didn't have.
They feared the American penal system, which punished crimes far differently than they had done in Laos.
The story therefore begs the question of whether it is in the patient's best interest to privilege Western knowledge.
Lia's story reveals the strength of the family within Hmong culture.
Such illnesses require spiritual healing, which can be rendered less effective by medication.
Foua felt that the doctors wouldn't let them give just a little medication because they didn't understand about the soul.
Certain aspects of Hmong culture, such as taboos against medical procedures, beliefs about the origins of diseases, and power structures within the family and the clan often conflict with the culture of western medicine, resulting in misunderstandings between doctors and patients.
Other aspects, such as utilizing animal sacrifice in shamanic ceremonies, have lead to conflicts between the Hmong and their American neighbors; for instance, some Americans believe the Hmong are kidnapping and killing neighborhood dogs.