There are many ethical dilemmas throughout The Spirit Catches You and You Fall Down. One of the biggest difficulties is the cultural barrier that exists between the Hmong people and the people treating them. Even if they were able to communicate effectively, there were many differences in opinions that would have caused problems. Eshiett and Parry (2003) believed the behavior of healthcare professionals towards those of a different culture could lead to feeling of discrimination and a lack of sympathy, causing a separation to develop. This was apparent in Lia’s case. What the Hmong people saw as taking care of their loved ones is considered abuse and neglect in out culture. For example, in the book Lia was taken from her family due to noncompliance
