INTRODUCTION
Assessing cultural competence in the medical field brings about the examination that delves into the more thorough and conceptual origin of various religious beliefs providing deeper insights and understanding in connection with health-related dogma.
In health crises, many individuals try distinguished approaches to cope with their pain and suffering. Many turn to spirituality, often anchored in religious beliefs. The World Religion Database identifies 18 major religious categories globally, with scholars estimating approximately 2,400 distinct religions. A plethora of people believe that spirituality and healthcare are intertwined. Thus, at times, it is upon healthcare workers to be aware of how religion impacts patients’ happenings so that they can provide appropriate medical care. Many a time, varied religious and treatment beliefs can play quite a significant role in a patient’s life which can influence their care and treatments. Individuals may involve their religious teachings or scriptures when dealing with medical challenges.[1]
What are various religions and their way of addressing medical issues? And what if medical care hinders the spiritual teachings of the patient? How to bridge the gap between religious belief and medical care? The blog will explore the wide perspective in addition to the significance, understanding, and impact of religious beliefs in medical care.
HISTORICAL OVERVIEW
For almost millennia priests, healthcare providers or hakim[2], an Arabic term used during the Islamic era, were scholar’s literate in medicine, sciences, or Islamic philosophy. Monasteries or churches used to offer medical care for the sick as they became centres for preserving and developing medical knowledge alongside religious teachings. During the 17th-19th centuries advancement in science, they have led to the separation of medicine from religion. In today’s era, the relationship between religion and medicine is quite complex. Many patients try to integrate their religious faith with medical procedures and health professionals try their best to provide them with patient-centered care, respecting religious beliefs.
In the past 50 years the United States has made its religious laws and rules more stringent than before, the main objective is to safeguard the religious freedom of an individual. Therefore, health practitioners often deny giving treatment if the patient’s religious faith conflicts with medical procedures. For example, many doctors refuse to perform abortions on conscience grounds. However, withholding medical care for religious reasons can harm patients and can create forthcoming complications.[3]
Religious beliefs can play a significant role in a person’s healthcare choices. Including diet, medications, and worship routines. These beliefs may influence compatibility with certain therapy schedules.[4]
A MULTITUDE OF FAITHS OFFER DIVERSE SPIRITUAL PATHS
When there is a balance between the patient’s religious faith and providing care to that person the healthcare system becomes a more positive environment. Various religions have distinguished religious teachings on addressing medical challenges.
BUDDHISM
In Buddhism, there is a preference against using mind-altering medications near death. Healing is not approached through faith alone and Buddhists adhere to principles that prohibit aking a life.[5]
HINDUISM
Whereas in Hinduism, euthanasia is prohibited and termination of pregnancy is discouraged, because the life of the mother gets in danger which society disfavors. Circumcision is not a common practice in Hinduism. The religion promotes diverse paths to the divine, promoting tolerance. [6]
ISLAM
In Islam, autopsies are permitted strictly only in clinical situations. Acknowledgement and seeking mercy can happen before the patient. Female patients may prefer female physicians for certain medical procedures. Islam in common does not permit pregnancy termination, except in difficult situations like non-consensual sex, or if the life is in threat of the mother.[7]
CHRISTIANITY
Church doesn’t dictate individual healthcare choices in Christianity. They don’t look for quick health services. They favour very minimum clinical interruptions in pharmaceuticals, most importantly during conception, labour, or when the child is born, possibly requesting a midwife.[8]
JUDAISM
In Judaism, amputated limbs are laid to rest on holy ground. Products related to blood are permitted, and decisions related to feeding from tube to the child or providing life-sustaining measures may involve consultation with a Rabbi, the sick are exempt from fasting, and termination of pregnancy is allowed to protect the life of the mother, but contraception might not be permissible.[9]
IMPACT OF FAITH-BASED MEDICAL DECISIONS
Generally, when patients deny taking medications because their religious faiths or scriptures do not allow it, in a great sense, it poses a pernicious threat to their healthcare. Reliance on prayer and spiritual thinking can delay seeking medical care, resulting in the progression of illness that could have been treated earlier. In some faith communities, mental illness like depression is seen as a stigma or a spiritual failing, discouraging individuals from seeking professional mental healthcare.
Parents who refuse to vaccinate their children due to religious beliefs present a significant challenge for physicians and scientists who work to protect children from preventable and potentially fatal diseases like measles. Even healthcare professionals who abstain from certain vaccinations for religious reasons risk endangering individuals who are highly susceptible to severe illness or death from these diseases. Sometimes patients do not receive perfect medical care because of certain reasons. Example: Americans of Asian descent or black community not receiving proper medical care in the USA because of their ethnicity or race.[10]
In India, our constitution protects diverse religious faiths through Article 25, which ensures the right to freedom of religion. This can impact medical decisions, as individuals may refuse certain medical treatments based on their religious beliefs.[11]
Additionally, the highest court of India also known as the Supreme Court in the Aruna Shanbaug (2011) lawsuit recognized passive euthanasia allowing withdrawal of life support under strict guidelines. This decision often intersects religious beliefs of the sacred or pious life and the moral implications of ending life support treatment.[12]
BUILDING BRIDGES: PRACTICAL APPROACHES TO CULTURAL COMPETENCY
Cultural competency in healthcare is essential for providing the best care to varied patients and promoting workshops to educate health professionals about different cultures, beliefs, and practices. Care plans should be developed to respect and incorporate patients’ cultural beliefs and practices. The medical system should promote diversity in hiring to reflect the community served by healthcare facilities. Encourage continuous learning and adaptation to new cultural insights and practices.
Methods to enhance multicultural competence in individuals and systems encompass: Involving family in the healthcare decisions of patients, promoting healthcare with cultural values, making a surrounding where healers can adapt, bringing useful services for patients, and hiring diverse teams.[13]
Acts like National Health Policy 2017: emphasize the need for culturally sensitive healthcare services, ensuring that healthcare providers are there to help patients coming from different backgrounds.[14] And Transplantation of Human Organs Act, 1994: Regulates donation and transplantation, considering religious beliefs about the sanctity of the body. Education and awareness programs can help reconcile the faith with the benefits of organ donation in India.[15]
Creating an environment that allows for traditional healing practices that acknowledge the importance of cultural heritage and provide patients with comfort and familiarity. Interpreter services are vital for overcoming language barriers, ensuring accurate communication, and preventing misunderstandings. Recruiting minority staff enhances cultural representation, within the healthcare workforce, fostering trust and improving patient-provider relationships.
CONCLUSION
In conclusion, enhancing cultural competence in healthcare is essential for bridging the gap between medical care and patient’s religious beliefs. By involving families in healthcare decisions, integrating culture-specific values, providing cultural awareness training, accommodating traditional healing practices, offering interpreter services, and recruiting minority staff, the healthcare systems can foster trust and improve patient outcomes. Acknowledging and respecting patients’ diverse spiritual and cultural backgrounds creates more empathetic and safe patient care surroundings.
With the development of science around the world. Religious beliefs persist in the conscience of almost everyone. Thus, in hospitals, the practitioners should take care of the beliefs of patients and should look after them with care. Doctors should try their best not to hurt his/her beliefs. While simultaneously being able to practice their profession without any serious hindrance.
Author(s) Name: Shristi D Kumar (Institute of Law Nirma University)
References-
[1] ‘Religion and healthcare: The importance of cultural sensitivity’, (AdventHealth University, 29 December 2020) <https://www.ahu.edu/blog/religion-and-healthcare-the-importance-of-cultural-sensitivity> accessed: 9 July 2024
[2] ‘Definition of HAKIM’ (Merriam-Webster: America’s Most Trusted Dictionary)< www.merriam-webster.com/dictionary/hakim> accessed: 10 July 2024.
[3] ‘The complex relationship between Religion and malpractice’ (Fronzutolaw, 20 January 2024) <https://www.fronzutolaw.com/articles/the-complex-relationship-between-religion-and-medical-malpractice/> accessed 9 July 2024
[4] Diana L Swihart, Siva Naga S. Yarrarapu, Romaine L. Martin, ‘Cultural religious competence in clinical practice’ (PubMed Central, January 2024) <https://pubmed.ncbi.nlm.nih.gov/29630268/> accessed 10 July 2024
[5] Thanh M, Leigh PD, ‘Sutra of the Medicine Buddha’ (Buddhanet’s Book Library, 2001) <https://www.buddhanet.net/pdf_file/medbudsutra.pdf > accessed 10 July 2024
[6] Sarma D, ‘Hindu bioethics?’ (J Law MedEthics,2008)<https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1748-720X.2008.00236.x> accessed 10 July 2024
[7] Inhorn MC, ‘Serour GI. Islam, medicine, and Arab-Muslim refugee health in America after 9/11. Lancet.’(Pubmed, September 2011) <https://pubmed.ncbi.nlm.nih.gov/21890058/> accessed 10 July 2024
[8] ‘Church Manual’ (General Conference of Seventh-day Adventists, 1951) accessed 10 July 2024
[9] Noble A, Engelhardt K, Newsome-Wicks M, Woloski-Wruble AC, ‘Cultural competence and ethnic attitudes of midwives concerning Jewish couples’ (J Obstet Gynecol Neonatal Nurs, September 2009) <https://gemini.google.com/app/858c6cb9bbcecaf1?hl=en-IN > accessed 10 July 2024
[10] ‘The complex relationship between Religion and malpractice, (Fronzutolaw, 20 January 2024) <https://www.fronzutolaw.com/articles/the-complex-relationship-between-religion-and-medical-malpractice/> accessed 10 July 2024
[11] ‘Article 25: Freedom of Conscience and Free Profession, Practice and Propagation of Religion’,(Constitution of India, March 2023) <https://www.constitutionofindia.net/articles/article-25-freedom-of-conscience-and-free-profession-practice-and-propagation-of-religion/> accessed 10 July 2024
[12] Aruna Ramchandra Shanbaug v. Union of India & Ors, AIR 2011 SC
[13] Diana L Swihart, Siva Naga S. Yarrarapu, Romaine L. Martin, ‘Cultural religious competence in clinical practice’ (PubMed Central, January 2024) <https://pubmed.ncbi.nlm.nih.gov/29630268/> accessed 10 July 2024
[14] ‘National Health Policy 2017, Ministry of Health and Family Welfare, 2024 (India)
[15] Sunil Shroff, ‘Legal and Ethical Aspects of Organ Donation and Transplantation’ (PubMed Central, 2009) <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2779960/ > accessed 10 July 2024
