Muslim Culture and the Practice of Medicine: Issues of Teaching a Muslim Medical Student in the United States
I teach first and second year medical students how to relate to patients, take a medical history and perform the physical examination. My medical school, as do all medical schools in the United States accept students from all different cultures and religions. There are various issues involved in teaching students which arise and need to be resolved despite they have already been accepted to medical school and have begun their studies. I have recently been made aware of medical student issues that happen to be related to students of Muslim culture and religion. The issues do not arise with every Muslim student as far as I know but it has arisen and I really don’t know what the issues represent and how to deal with them yet meet my responsibility to develop a professionally competent physician.
Some of the issues, occurring in Great Britain, are described in an article in the October 7 2007 issue of the UK TimesOnline an excerpt of which follows:
Some Muslim medical students are refusing to attend lectures or answer exam questions on alcohol-related or sexually transmitted diseases because they claim it offends their religious beliefs.
Some trainee doctors say learning to treat the diseases conflicts with their faith, which states that Muslims should not drink alcohol and rejects sexual promiscuity.
A small number of Muslim medical students have even refused to treat patients of the opposite sex. One male student was prepared to fail his final exams rather than carry out a basic examination of a female patient.
The religious objections by students have been confirmed by the British Medical Association (BMA) and General Medical Council (GMC), which both stressed that they did not approve of such actions
I am pleased to have visitors to my blog from all over the world including countries where there is a strong Muslim culture. I would most appreciate visitors from those countries to write here and educate me how medicine is practiced there in terms of for example, physical examination of patients of opposite gender. Is the body exposed in any way (if so, what way?) and what degree of touching (or what we call palpation) is carried out? Are there aspects of the history which are not allowed to be asked a patient? What are the standards of medical practice in Muslim countries? Are there special instructions that are given to medical students in those countries to be in keeping with the Muslim culture and religion? What do you think should be United States medical school teachers’ response to Muslim students’ requests for excluding asking certain questions or excluding examinations on certain genders? I truly look forward to learn. Please help me. ..Maurice.
posted by Maurice Bernstein, M.D. @ 9:27:00 PM
6 comments
6 Comments:
Hi Maurice,
I am a practicing doctor in private practice and an associate professor a medical school in Malaysia. As you are aware, Malaysia is an Islamic county where the dominant culture is Muslim. Malaysia is also multi-cultural with a large percentage of the population being Chinese, Indians and others. While Islam is the official religion, other people are free to practice their faith.
The medical education system in Malaysia is inherited from the British and is thus ‘secular.’ There is no ‘Muslim medical practice’ as distinctive from other types of medical practices. Muslim students study the same course subjects, and work in the hospital and clinics side by side with those of other races and religious persuasion. There are no special exceptions given to them. They are taught all aspects of medicine and they are taught to respect their patients. In their clinical practice, they are to touch patients. However the cultural norms are respected with respect to gender.
I do not know of any incidents in which the Muslim students have refused to study topics related to alcohol etc. There is however a few cases of Muslim female doctors refusing to touch male patients but the hospital solved it by transferring them to take care of female patients.
A medical education should be a comprehensive education. I do not think the Muslim religion and culture restrict their care and involvement only to the Ummah (Muslim community).
I have a thread on my blog about religion and patient privacy/modesty. Most of the problems are from the UK which seems to have a much more radical Muslim population than this country. I've linked several examples of Muslim hospital employees refusing to scrub properly because they say it is against Muslim standards of modesty. The British medical establishment has generally not supported them preferring safe medical practices over modesty.
I don't see how a western physician can function or even avoid liability if they refuse to ask about alcohol or other frowned on problems. A women physician could theoretically restrict her practice to women, but then should her license also be restricted if she had no training on men? The potential problems are endless and certainly would extend to abortion rights and other areas of controversy.
I recently had a doctor from India tell me that when he first arrived in North America he would never ask a woman if she drank alchol or smoked but he realised later that even Indian women in this country do both.
On 9/23/2008, Petter wrote the following: ..Maurice.
"I think that the Muslims should have to practice on all the medicines because no religion says don't save a life. And when they are going to save lives of people then they have to practice all medical sciences."
Hi,
I am surprised, yet not so surprised, at the sentiments of some of the (orthodox) Muslim medical students. The comment by the Malaysian physician is really how medicine is practiced in Pakistan as well.. there is no such thing as "muslim medical practice." My mother's ob/gyn doctor in Pakistan was male - he delivered all of her four children ( starting 28 years ago). My husband is a medical oncologist practicing in the United States; a good doctor as well as a good Muslim.
There are instances when "female patients" back home would refuse to be treated by male doctors, but I have never heard of it being the other way around. I suppose because when they enter the profession, it's a given that they will have to encounter such issues.
I am not an expert, but I do know that Islam does not prohibit treating patients of the opposite sex or with diseases or habits that might be deemed as "un-islamic."
However, like I said, I am not surprised to hear this either. Since the late 1990's a "Wahabi movement" began in Pakistan in which some of the "converts" acted in such a manner. I never met a "convert" medical student or doctor in Pakistan, however, I know of a female dentist born and raised here in the United States, who refuses to treat male patients. Perhaps it's like how some conservative Christian doctors refuse to dispense birth controls pills...After talking to some muslims who hold such orthodox views, I have come to the conclusion that it is best not to argue with them, for they ( and anyone who holds "orthodox" views) feel that they are a 100% accurate in their interpretations, and leave no room for discussion.
If reasonable accomodations can me made for your students, then that is great. If not, then they need to reconsider their profession. Hope this helps.
I think we shoud know the bioethics of medicine practice. thank you
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