PPE Case C:Paramedic Cultural Connundrum

Mrs Panachetta is a 69 year old Italian woman who has lived in Auckland for the past 2 months with her only son and daughter-in-law who settled in Auckland 8 years ago. Her husband died in Italy 6 months ago. Mrs Panachetta understands some English, but is not at all fluent. You are a paramedic who receives an emergency call to their house where you find Mrs Panachetta with severe back pain, and a dropping blood pressure. You suspect a ruptured aortic aneurysm which carries a high chance of death without immediate surgical treatment. You have attended many patients with ruptured aneurysms and are confident of your diagnosis and prognosis. Mrs Panachetta’s son approaches you, and asks to speak to you in private. You explain your suspicions about her diagnosis, and the urgency to get her to hospital for immediate treatment. Mr Panachetta begs you not to tell his mother your suspected diagnosis and poor prognosis. In Italian culture, serious matters belong to the knowledge and decision of the family, and patients are not told since they might be harmed by the information through emotional fright and worries. On returning to Mrs Panacetta, she is extremely pale and asks you; ‘What is wrong with me? Am I going to be alright?’ What should you do?