The Amish people are a conservative
Christian group that mostly reside in Ohio and
southeast Pennsylvania. They are famous for
their rejection of the conveniences of modern
society. For example, Amish people use a
horse and buggy to travel rather than a car.
Their cultural attitudes are based on strict
interpretation of the Bible. This article focuses
on medical issues in the Amish community.
RESTRICTED GENE POOL & MEDICAL DISEASES
Almost all of the current Amish people in the United States today are descendants of the
same few hundred founders of this religion in the 18th century. Since the Amish do not
reproduce with non-Amish people, the gene pool is limited. Genes are units of material
contained in a person's cells that contain coded instructions as for how certain bodily
characteristics (such as eye color) will develop. All of a person's genes come from
If there are limited variations of genes, this increases the risk of genetic (inherited)
disorders and other medical illnesses. This risk is further compounded by inbreeding
(breeding of closely related individuals such as family members) because the gene pool
is further restricted. The restriction of genes does not permit genetic disorders to move
out of the Amish community. As a result of some of these rare (and sometimes unique)
medical problems, the death rate of Amish children is higher than average.
An example of a rare genetic disorder in the Amish people is Ellis-
van Creveld syndrome. This disorder is characterized by very short
arms and legs, additional fingers or toes, abnormally formed wrist
bones, abnormal formed heart, abnormal development of the
fingernails, upper lip deformity, and the teeth being present before
birth. Ellis-van Creveld syndrome is often found among the Old Order
Amish people of Lancaster County, Pennsylvania.
Most Amish do not practice birth control and they have the highest
incidence of twins in a defined subgroup of the human population.
The Amish people have a very unusual distribution of blood types and they have a tendency to be
afflicted by a high number of metabolic disorders (disorders of metabolism). Metabolism refers to the
chemical actions in cells that release energy from nutrients or use energy to create other substances.
The majority of Amish people passively accept the medical problems associated with their community as
“God’s will.” As such, they refuse to participate in genetic testing during pregnancy or prior to marriage
that would predict the occurrence of these disorders in children. However, the Amish people have
increased their realization of the importance of marrying outside of one’s own sub-community (a
community within the Amish culture). This is because genetic diseases common in one sub-community
may not be present in another. Choosing spouses from another, unrelated, sub-community can reduce
the chances of producing children with genetic disorders.
ACCESS TO HEALTH CARE
There are no Amish physicians. This is because Amish people do not educate their children beyond the
8th grade since they believe that this level of education is sufficient enough to teach one how to live
within the Amish lifestyle. Also, they are fearful that additional learning beyond the 8th grade would teach
them information that would corrupt their own value system. The Amish educate their children in one-room
The Amish rely on their own traditions when making medical diagnoses, but will also seek the advice of
trained physicians. There is nothing in their interpretation of the Bible that forbids them from seeking
modern medical assistance or hospitalization. They seek trust over knowledge when seeking medical
care. They are large consumers of vitamins and food supplements, sold by sales representatives within
their community. They also rely heavily on home remedies passed down from generation to generation.
Thus, it is not uncommon for them to use herbs and potions made from plants growing on Amish farms to
treat medical problems. The Amish believe that medicine may help the ill, but that only God heals.
It is not uncommon for an Amish person to travel very far away to another Amish community to receive a
form of treatment that modern medicine would regard as atypical, unusual, or unproven in effectiveness.
They seek out services of physical therapists and chiropractors much more than people in the general
population and they expect a higher rate of relief from such services. Many Amish also use reflexology,
which is an ancient Chinese massage technique applied to the feet, hands, and ears to “restore the flow
of energy” to the entire body.
Amish people do not have health insurance. This makes it difficult for them to receive formal medical care
or obtain prescription medication. As a result, the Amish children are behind on receiving childhood
immunization shots, which would prevent numerous childhood diseases. In the mid 1990s, a few hospitals
began to offer special outreach programs to help the Amish. The first such program began at the
Susquehanna Health System in central Pennsylvania. It was organized by James H. Huebert. When the
program received national media attention, similar programs spread to surrounding hospitals/clinics.
As an example of the above, Dr. D. Holmes Morton began The Clinic for Special Children, which
specializes in treating genetic problems in Amish children, such as maple syrup urine disease. This
disease is so-named because the urine literally smells like maple syrup. The disease used to be fatal
before this clinic began developing effective treatments for it. The clinic and surrounding programs have
been favorably received by most Amish people. This has helped greatly reduce situations in which
parents felt it necessary to leave the community to get their children proper medical care. Such an action
(leaving the Amish community) would normally result in being shunned.
In May 2002, another research and primary care clinic was established to help the Amish, patterned after
The Clinic for Special Children. This is the DDC Clinic for Special Needs Children located in Middlefield,
Ohio. The clinic focuses on treating genetic and metabolic disorders in Amish (and non-Amish) children.
Educational services are also provided to patients and families.
The hospitals and clinics that provide care to the Amish are supported by grants and charitable donations.
However, sometimes the Amish need treatment from more mainstream hospitals. For example, an Amish
boy from Nappanee, Indiana, was one of the first in the state to receive a heart transplant. The
community raised many fundraisers to pay for his medical expenses. Unfortunately, the boy died from
heart complications. The Amish will usually make charitable donations to one another to pay for medical
MEDICAL DECISION MAKING
The head of the family (the man) makes the medical decisions in Amish culture. It is a male-dominated