Intended for healthcare professionals

Observations Ethics Man

How to treat a Pirahã: medical ethics and cultural difference

BMJ 2015; 350 doi: (Published 18 February 2015) Cite this as: BMJ 2015;350:h850
  1. Daniel K Sokol, medical ethicist and barrister, 12 King’s Bench Walk, Temple, London
  1. daniel.sokol{at}

Respecting a patient’s culture can conflict with an ethical or legal duty

Deep in the Amazon rainforest the Pirahã (pronounced “pee-da-HAN”) people speak a language unlike any other. The language has only three vowels and eight consonants and has no numbers, no counting, and no words for colours. A Pirahã would refer to red, for example, by saying, “That is like blood.”

The Pirahã have minimal art and no musical instruments. They have no interest in the distant past or future. They ascribe scant value to privacy and show little fear of death. They have no doctors or hospitals. Yet, even the Pirahã have principles of medical ethics. The linguistics expert Dan Everett, who spent many years among the Pirahã, tells of a group of men killing a very sick baby by pouring copious amounts of alcohol in its mouth.1 He explained: “They felt certain that this baby was going to die. They felt it was suffering terribly […] So they euthanized the child.”1 All cultures have moral rules about the practice of medicine.

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