Amish People and Healthcare

FEATURED BOOK: The Amish

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

his/her parents.

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.

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

school houses.

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

bills.

MEDICAL DECISION MAKING

The head of the family (the man) makes the medical decisions in Amish culture. It is a male-dominated

culture.