Who are the Amish?
The Amish migrated from Europe to the United States before the Revolutionary War. Their religion dates back to 1693 when Jakob Ammann founded the Amish church. The formation of the Amish church imposed religious restrictions: non-resistance, non-swearing of oaths, non-secrecy, and non-conformity to the world.
The Amish are a God-fearing, family-loving group of people. Their church doctrine states that "It is easier to stay pure and focused if we set ourselves apart from everyday society, not taking advantage of advances in technology." Their ethics stress self-sufficiency, altruism, and the need to put the community first above oneself.
What are some of the characteristics of the Amish?
- Pennsylvania Dutch is the spoken language.
- Once married, Amish men are required to wear a beard. This is based on the biblical passage: "They should not mar the hair on their face." (Wearing a beard reflects the image of the Lord.)
- Many homes do not have electricity.
- Individuals do not own telephones. The use of cell phones for business purposes is beginning to be a growing trend. (These phones are not considered public utilities and therefore can be used.) They may have a community phone for emergencies. If a phone call is received from an Amish person, it has to be an emergency. Do not ask them
to hold or to call back later.
- Ice blocks are used to keep food cold in the refrigerator and freezer. Some homes might have kerosene refrigerators.
- Heat is generated from oil, kerosene, wood, or coal. Some homes have gas ovens.
- Although marriage between first cousins is not forbidden, marriage beginning with second cousins is more accepted.
- The average family consists of seven members.
- It is customary for Amish women to bottle and can the food they grow.
- Smoking, drinking, and swearing are forbidden. Smoking, however, is permitted where tobacco is grown.
- Some 66 percent of Amish children leave their religion for the modern society.
How do the Amish feel about seeking medical attention?
- The Amish believe in folk medicine: faith healing, pow-wows, and herbal treatments. They believe that a higher level of medical science is simply not necessary. However, they also believe that good health (mental and physical) is a gift from God, and needs to be taken care of. They believe that medicine helps, but God heals.
- The Amish are very careful medical consumers. If an Amish person is seeking medical treatment, it indicates that it is an emergency or a very important concern.
- The Amish religion does not forbid its people to seek modern medical care. When necessary, the Amish can have surgical procedures, dental work, anesthesia, or blood transfusions. Organ transplants are permitted, except for the heart. The Amish believe the heart is the soul of the body. (Exception: Pediatric patients who have not been baptized can receive a heart transplant.)
- In some Amish districts, all forms of insurance are discouraged, including medical insurance. The Amish believe insurance is a "worldly product," and purchasing it shows a lack of faith in God.
- The Amish pay little attention to preventative care. It is hard to impress upon them the importance of immunizations, cancer screenings, PAP smears, and mammograms. This is largely because they believe that God heals them, but also because they might not be able to afford preventative care.
- Many Amish will refuse an autopsy.
- The Amish do not believe in birth control.
- Most Amish need to have church permission to go to a hospital because the church pays for such care.
- Amish discourage the use of Life Flight helicopters.
As a health care provider, how should I treat the Amish?
- The Amish do not like to be seen by a health care provider who is in the "learning" process. The Amish believe if they are going to pay out-of-pocket for their health care, they want to be seen by an experienced practicing physician. Use interns as observers.
- Amish patients prefer to be on a first-name basis. They also prefer doctors who will sit with them and discuss their health care questions one-on-one.
- Speak to them at an eighth-grade level. The Amish learn well with demonstrations, picture stories and role modeling. Take time to educate them.
- Speak to both the husband and wife if a response or health care decision is needed. If the church is paying for the care, you will also need to speak with the church’s clerical representative.
- When seeing an Amish patient, do not discuss money first . Educate the patient and family on the condition, the healing process, and the signs and symptoms of an emergency.
- Allow more than the regulated number of visitors in the hospital. Because the Amish have to pay for someone to bring them to the hospital, it is not uncommon to have the whole family present.
- Because the patient and family can only make limited Clinic visits, try to incorporate as much as possible into one appointment (such as assessments, test, educational sessions, etc.).
- The elderly believe in rationing care near the end of life because they do not want to waste the family’s, church’s, and community’s money.
- Discuss all possible treatments and interventions. However, realize the Amish might refuse treatment due to lack of electricity, money, or understanding of their condition or treatment options.
- If the Amish patient refuses treatment but you feel treatment is needed, speak to the patient about his or her potential disability. The Amish fear disability more than the threat of death. Also speak to the patient’s clerical representative.
- Let the Amish patient know in advance when he or she is being discharged so transportation arrangements can be made. Drivers are not easy to hire on short notice.
- The Amish prefer to die at home rather than in a hospital.
- Encourage home health care whenever possible. Home health care can be less expensive than a hospital stay and care delivered in their environment could lead to a better understanding of their illness and how to care for it.
- When prescribing medicines, keep in mind that they might not have a means of keeping them consistently cold.
- Because the Amish pay in cash, they expect discounts on the bill. Many
times they will refuse treatment if they feel it will cost too much. Ask the
patient and his or her family if they will have difficulty paying their
hospital bills, then offer whatever assistance is possible (for instance,
recommend the BCMH Fund [Bureau for Children with Medical Handicaps] or the
Crippled Children Fund. The Ohio Crippled Children Fund, run by the state of
Ohio, provides free medical care for children up to the age of 17 who have
long-term illnesses. Free medical care is also available at the Shriners
Hospitals.) Some liberal Amish do have limited health insurance, with a $500
to $1,000 deductible before the church or work insurance coverage begins.
Contact social services to assist with billing questions and problems. The
Amish take their financial obligations seriously. Paying bills is more than
just a family affair, it’s the whole community’s and sometimes the church’s obligation.
What are the different sects of Amish in Ohio?
The Amish community differs in many practices and beliefs due to the different break-offs in their religion. Many forms have developed new orders of the Amish including Beachy Amish, Mennonites, Old Order, and the Swartzentruber Amish. This has caused many practices that are not uniform throughout the Amish society.
The New Order Amish are more progressive than Old Order and are more likely to have telephones and electricity. The Old Order Amish sect does not have electricity or telephones. The strictest Amish sect is the Swartzentruber. They do not use electricity, telephones, refrigerators, iceboxes or motorized equipment; they also avoid indoor plumbing and wear conservative clothing.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 10/7/2009...#6955
