This article explores ethical issues raised by Primary Care Physicians (PCPs) when diagnosing depression and caring for cross-cultural patients. This study was conducted in three primary care clinics within a major metropolitan area in the Southeastern United States. The PCPs were from a variety of ethnocultural backgrounds including South Asian, Hispanic, East Asian and Caucasian. While medical education training and guidelines aim to teach physicians about the nuances of cross-cultural patient interaction, PCPs report that past experiences guide them in navigating cross-cultural conversations and patient care. In this study, semi-structured interviews were conducted with seven PCPs which were transcribed and underwent thematic analysis to explore how patients’ cultural backgrounds and understanding of depression affected PCPs’ reasoning and diagnosing of depression in patients from different cultural backgrounds. Ethical issues that arose included: limiting treatment options, expressing a patient’s mental health diagnosis in a biomedical sense to reduce stigma, and somatization of mental health symptoms. Ethical implications, such as lack of autonomy, unnecessary testing, and the possible misuse of healthcare resources are discussed.

中文翻译：

---

抑郁症诊断的文化障碍的伦理意义：与初级保健医生的对话

本文探讨了初级保健医师（PCP）在诊断抑郁症和照顾跨文化患者时提出的道德问题。这项研究是在美国东南部主要大都市地区的三个初级保健诊所进行的。PCP来自各种民族文化背景，包括南亚，西班牙裔，东亚和高加索人。尽管医学教育培训和指南旨在向医生讲授跨文化患者互动的细微差别，但PCP报告说，过去的经验指导他们在跨文化对话和患者护理中进行导航。在这个研究中，对七种PCP进行了半结构化访谈，对这些PCP进行了转录并进行了主题分析，以探讨患者的文化背景和对抑郁症的理解如何影响PCP对不同文化背景的患者进行抑郁症的推理和诊断。出现的伦理问题包括：限制治疗选择，以生物医学的方式表达患者的心理健康诊断以减少耻辱感，以​​及心理健康症状的躯体化。讨论了诸如缺乏自治权，不必要的测试以及可能滥用医疗保健资源等伦理问题。和心理健康症状的躯体化。讨论了诸如缺乏自治权，不必要的测试以及可能滥用医疗保健资源等伦理问题。和心理健康症状的躯体化。讨论了诸如缺乏自治权，不必要的测试以及可能滥用医疗保健资源等伦理问题。