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May 19
2010
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To what extent Individual beliefs and practices based on one’s religion can be acceptable especially when the life of the individual is in danger or the person in question needs immediate Hospital admission and attention? Are these beliefs and practices interfering with timely medical diagnosis and treatment?
If the patient refuses Medical advice on religious grounds, are doctors subjected to liability?
Situation 1
Patient A came with severe abdominal pain .He was vomiting continuously and screaming with pain, making fellow patients in the Reception area restless. He was accompanied by four attendants, adding to the confusion and chaos, (by their constant shouting and questioning why the delay in taking the patient in for scanning, and that doctors are heartless souls etc,).
I was already doing scan on x and rest of the rooms were also occupied by the patients and Assistants attending on them.
Suddenly there was commotion in the Front Office with lots of shouting as if the patient is going to die in the centre itself, if the scan was not done immediately.
So I requested Patient x, on whom I had done partial study, to excuse me and requested him to wait for some time in the Front Office, since I had to undertake this emergency case without delay. This person was very understanding and told me to finish the Emergency case and that he won’t mind waiting.
Now I asked my staff to shift the emergency case to the scan room.
To my surprise my staff told me that Patient is not willing to undergo scanning. I was worried that something had happened to him.
My staff then gave me the explanation. Since “Rahukaal “had set in he can not have the scan rather wait till it is over.
So his screaming and shouting continued for another 2 hours causing agony to his relatives and fellow patients.
The case later turned out to be a ureteric calculus!
Indeed “Raahukaal” has played a major role in delaying scan for this patient.
Situation 2
That day I had a very hectic time, and at the end of the day I was planning to go home, hoping to have a fresh bath and relaxing...
Suddenly a patient was brought in with severe abdominal pain. Clinically suspected to have intestinal obstruction.
He was advised to have Erect abdominal x –ray and also Ultrasound to rule out ureteric calculus/ intussusception.
We shifted the patient to x-ray room first and took erect abdomen which showed multiple fluid levels confirming the clinical suspicion.
When we wanted to take him to the scan room, suddenly he refused to have the scan, citing that he had to go for ‘Namaaz’. When I told him that I can provide a room for ’Namaaz’, he told me he is more comfortable in performing ‘Namaaz’ in the mosque located in the next street. I explained to him the serious nature of his condition which required admission and if necessary operation, and it is impossible to sit down and bend the body, he won’t budge. He even requested us to lend the Wheel chair. His atttenders also told me that he is a very religious man and he won’t listen to anybody.
What I am supposed to do?
Nobody can replace the Strength and Confidence that ‘religion beliefs’ can give!
Situation 3
This lady was advised to have CT scan Neck to rule out Neck Secondaries.
This lady wore lots of Jewelry (distracting our lady staff members) and many ‘Sacred strings’ covering almost all parts of the entire neck.
No amount of explanation that …with these heavy shining metals around her neck…. scan can’t be done since lots of artifacts are produced and it is difficult to interpret the results.
This lady started shouting…. telling how dare we ask her to remove ‘Mangalsutra” and she would rather suffer Cancer than remove it etc.
Heavy sentiments causing stumbling block…….
Situation 4
This particular lady patient, while I was doing Ultrasound study went on chanting ‘Spiritual Songs’ so loudly that I just could not concentrate on the study.
When I asked the lady why she is singing so loudly distracting my concentration…she told me to mind my business (i.e. doing the scan).
When I protested that it is difficult for me to concentrate…she told me that, by singing the Hymns so loudly ,she can be near to God…so that nobody can declare that she has got Cancer, and pleaded me to allow her to sing.
Somehow I completed the Scan.
Looks like cancer phobia!
Situation 5
This bright young boy who is 25 yrs old and drawing a handsome salary is diagnosed to have Hypertension. He came for Renal Doppler, Echocardiogram, TMT and related Blood tests.
I told him to be careful, and to take regular medication (TMT showed changes) and follow the dos and don’ts as for the Hypertension as advised by cardiologist.
This boy laughed at me and said he was proud that he belonged to the family whose members lived beyond 80 yrs and he carried these same strong genes. And if at all he dies or becomes paralytic it is only because of his ‘Karma’
You won’t believe me…he refused to take medicines for Hypertension and continued his usual life style.
Imagine… what happened… He died 2 yrs later of brain hemorrhage.
This strong belief in ‘Karma’ added by the confidence of Family trait of Longevity killed this young bright boy.
How sad!!
Again religious sentiments playing the role of a culprit!
“The beauty of religious mania is that it has the power to explain everything. Once God (or Satan) is accepted as the first cause of everything which happens in the mortal world, nothing is left to chance ... logic can be happily tossed out the window.”
STEPHEN KING, The Stand
No doubt, one has to respect the patient’s sentiments.
General Medical Council tells us about dos and don’ts regarding personal beliefs and Medical practice
http://www.gmc-uk.org/guidance/ethical_guidance/personal_beliefs.asp
“When people try to use religion to address the natural world, science pushes back on it, and religion has to accommodate the results. Beliefs can be permanent, but beliefs can also be flexible. Personally, if I find out my belief is wrong, I change my mind. I think that's a good way to live.”
LISA RANDALL, Discover Magazine July 2006
Finally
Do religious beliefs give ‘Comfort’ or adds ‘Stress’ to the patient / kith and kin?
Or
Do they cause Hindrance or Motivate?
Does religion influence patient’s health?
Listen to what Karl Marx said.
“Religion is the Opiate of the people”
Average user rating from: 2 user(s)
Reviewed by Dr. Prakash Vohra June 10, 2010
Reviewed by Anuj Mishra May 19, 2010
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Dr. Anuj Mishra
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... We all experience religious beliefs in our everyday practice. I come across female patients reciting from Holy Quran during an ultrasound scan. This is not distracting at all. We should expect it at every scan. My clinical practice and religious beliefs are not in conflict at anytime. I respect my patients' religious identity and faith and give him/her the space to be with the God. We must also never enforce our scientific reason onto the religious zealots as it may cause serious repercussions on us. For example, I had a patient with large acute liver abscess for drainage. This patient wished to undertake alternate treatment and I vehemently advised him against it telling him the complications if the abscess ruptures. He promised to return back if he does'nt improved. I saw him after a month when he had significantly improved and had made me a laughing stock in his community because I was non-Muslim. I respect my patients' religious belief and never interrupt him/her in his meditation or recitation. Nor should we try to change their beliefs! As Hitler had remarked - “This human world of ours would be inconceivable without the practical existence of a religious belief” Just do your job well and to the best of your abilities.....and leave the rest to God Almighty...... |
Dr. Sridhar V
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... Thank you so much Dr.Anuj Mishra for sharing your personal experience. If the medical condition is not serious ...it is OK . If it is serious ?? If the patient is refusing medical help due to own compulsions to what extent Doctor is liable ? If he listens to the patient ...that means he is abetting the greater danger befalling on the patient. Is it not ? If Doctor is not listening to the patient and goes ahead with the treatment....he is blamed that he is acting against the Sentiments of the patient. Indeed the doctor is " between the devil and deep sea " situation Many times doctors are put into difficult situations since the patient and relatives may seek (due to religious compulsions) 1.'Faith Healing' ( visiting Shrines) 2. visiting 'Babas or Swamjis' 3. Blind belief in ' Miracle cures' 4. Refusing 'Blood transfusion' since the religion forbids the same. 5. 'Alternative treatment' not proved scientifically.....ex Homoeopathy- Now British Medical Council has termed homoeopathy nothing but 'Witchcraft Practice' Reiki...( practioners of Reiki claim that they use 'Cosmic powers' to cure all complicated diseases' For being called as Doctor....all that one needs is to practice 'Reiki' for 2 to 5 hrs. Many more such examples abound. Is not religion the 'Most harmful creation' of Human being ? Is not it..... a COMPLICATED method of achieving dangerous psychological needs ? |
Alok Varshney
said:
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... To provide sanctity to one’s unreasonable beliefs, give it a garb of religion…. The easier way to deal with such misguided believers is to distance oneself from them. They are the ones who are seeking consultation, they are the ones who are not following our advice. As a professional it is our duty to help anyone who seeks help, but we don’t have to be responsible for the other person’s actions/ inactions. Its their life…. But somehow, every good doctor does get riled up in such a scenario when his expert advice for the betterment of the patient is overshadowed by erroneous beliefs. True, it is the patient who suffers from his own actions and beliefs, but there always lingers a twinge of guilt in a doctor’s heart- that perhaps he didn’t use his interpersonal skills in a better way to convince the patient…. |
Dr. Anuj Mishra
said:
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... We should not forget - When illness threatens the health, and possibly the life of an individual, that person is likely to come to the physician with both physical symptoms and spiritual issues in mind. In most instances, doctors are not aware of the religious beliefs and practices of their patients, knowing very well that these have the potential of playing a very important role in the doctor-patient relation. We are trained to diagnose and treat patient's illness, and are ill-equipped to deal with the spiritual practices of the patient. MOreover, physicians' ethics requires that he does not impose his beliefs on the patient. Adding further to the confusion, we have a myriad of religious beliefs and practices. At first glance, the most simple solution suggests that physicians avoid religious or spiritual content in the doctor-patient interaction. As with many issues, however, the simple solution may not be the best. The approach should be to explore the possibility that within the boundaries of medical ethics and empowered with sensitive listening skills, we may find ways to engage the spiritual beliefs of patients in the healing process. It is of utmost importance to respect the patients' religious beliefs and spirituality. And our excellence would show in how we can use it to our advantage to provide a clearer understanding of the pateints' illness and best treatment. |
Prashant Bhatt
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... Read with interest this article. With due regards..can I point out that the "Opiate of the masses" catchphrase is not the full quote of Marx The well-known phrase that religion is the "opiate of the people" is considered as the quintessence of the Marxist conception of the religious phenomenon by most of its supporters and its opponents. How far is this an accurate viewpoint? The expression appeared shortly afterwards in Marx’s article on the German philosopher Hegel’s Philosophy of Right (1844). An attentive reading of the paragraph where this phrase appears, reveals that it is more qualified and less one-sided than usually believed. Although obviously critical of religion, Marx takes into account the dual character of the phenomenon: "Religious distress is at the same time the expression of real distress and the protest against real distress. Religion is the sigh of the oppressed creature, the heart of a heartless world, just as it is the spirit of an unspiritual situation. It is the opiate of the people." Further reading:Marxism and Religion by Michael Lowy http://www.internationalviewpoint.org/article.php3?id_article=807 The key element of this method for the analysis of religion is to approach it as one of the many forms of ideology - i.e. of the spiritual production of a people, of the production of ideas, representations and consciousness, necessarily conditioned by material production and the corresponding social relations. |
Dr. Sridhar V
said:
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... Thank you Dr.Alok and Dr.Anuj for your insights It is true one should respect the sentiments ( be religious or otherwise) of a person and there is no doubt about this. Physician can never impose his beliefs but he can maintain a delicate balance being neutral, at the same time impressing the patient about the implications if the patient is not listening due to his beliefs.As Dr.Alok said patient alone responsible for his actions and beliefs. Dr.Prashant Thank you so much for the link you provided, very precise and informative. With due respects, I never misquoted Karl Marx.Neither anywhere I said that Marx is anti religion.Karl Marx's quote happened in the context to what was going on in the Church in 19th century. Not just in 19th century...this quote is even relevant in 21 st century too. Marx understands that when people are in distress ,they look towards religion which can provide solace just like people finding comfort in opium related medicines when they are in severe pain due to health condition.( I don't mean DRUGS -having different sinister meaning) Being humans, we are embedded in three aspects 1.Materialistic world 2.Spiritual world 3.Ethnicity based world. ( ref Age of the sag.org) and our life can not be separated from one of the above and we always look for comfort from one of the above in times of distress. |
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