The cultural and individual connotations of amputation, and perceptions of “mutilation anxiety” and “coping styles,” should also be considered when trying to comprehend the patient's point of view. Cultural connotations of amputation differ with ethnicity and religious beliefs. For example, many Native American tribes embrace the physical truth of the body as sacred and surgery is considered taboo. African American patients may feel that they have been robbed of control over their bodies (even invoking memories of historical subjects of unethical research); these cultural susceptibilities must also be viewed in light of cultural resilience. Hispanic patients (in a U.S. study of patients with ESRD) had a greater rate of amputations identifiable
