Religious Premeds Plan to Have Faithful Bedside Manner

[cbayer]

http://www.usnews.com/education/best-graduate-schools/top-medical-schools/articles/2012/04/16/religious-premeds-plan-to-have-faithful-bedside-manner

New research shows doctors told not to wear their faith on their white coat sleeves are less effective.

By MENACHEM WECKER
April 16, 2012



When Hasan Siddiqi saw a patient wearing a head scarf, the fourth year medical student at University of Michigan—Ann Arbor wished her "Assalamu alaikum." After returning the Arabic greeting, the patient—who, it turned out, attended the same mosque as Siddiqi—asked him about everything from the availability of halal food at the hospital to the proper times and direction to pray.

"That put her more at ease that there was someone at least familiar in this very strange environment," says Siddiqi, a former president of Michigan's Muslim Medical Students' Association. "There was something extra that I had to offer, because I understood some of the rituals and the religious context."

Doctors need to be cautious about bringing up religion in a hospital room, just as one does at the dinner table, Siddiqi says. But, he adds, connecting with patients on a variety of levels—including faith—can help physicians see their patients as people rather than as algorithms and can better appreciate the larger context of their ailments.

Connecting with patients on a faith level is something that researchers at the Pritzker School of Medicine at University of Chicago have also found to be important, though often ignored."We can talk to people about their sexual practices, but not about their own spirituality," Daniel Sulmasy, co-director of Chicago's Program on Medicine and Religion, recently told The Chicago Tribune. "In prehistoric times, the role of the healer and the priest were one and the same. We don't want to go back to that. But we've encountered a situation in that they are so radically separated that physicians think religion has no role."

more at link

[LeftishBrit]

1. I suspect that it's more a matter of culture than faith, though the two often go together

In any case, cultural communication between doctor and patient, including that based on a common religion, is fine; but this should not be taken as license for medical practitioners to seek to convert patients, or to deny them certain medical treatments on the basis of their religion.

[cbayer]

2. Agree and I don't think this article argues for conversion or denial of treatment.

[ashling]

3. I had a student in my college govt. class

who was super religious and was studying to become a nurse. She was extremely homophobic and wanted to become a nurse for hospice care for AIDS patients. Not hard to guess what her intentions were there.

[cbayer]

4. What? That sounds insane.

[ashling]

5. Pray away the gay

[cbayer]

6. Ahh, I get it.

Just what someone with a serious, terminal illness needs.



I hope she never saw her dreams come true.

[darkstar3]

7. So where's the link to the research?

We all know that scientific reporting is ridiculously inaccurate, and has been for decades. Where is the link to the research? I read the article, and I didn't find it.

[rug]

8. Here.

Sulmasy DP. "Spirituality, religion, and clinical care." Chest. 2009;135:1634-1642.
PDF

Curlin FA. "Spirituality and lifestyle: what clinicians need to know." South. Med. J.. 2006;99:1170-1171.
PDF

Sulmasy DP. "Spiritual issues in the care of dying patients: ". . . it's okay between me and god"." JAMA. 2006;296:1385-1392.
PDF

Curlin FA, Hall DE. "Strangers or friends? A proposal for a new spirituality-in-medicine ethic." J Gen Intern Med. 2005;20:370-374.
PDF

Hall DE, Curlin F. "Can physicians' care be neutral regarding religion?" Acad Med. 2004;79:677-679.
PDF

Curlin FA, Moschovis PP. "Is religious devotion relevant to the doctor-patient relationship?" J Fam Pract. 2004;53:632-636.
PDF

Hall DE, Curlin F, Koenig HG. "When clinical medicine collides with religion." Lancet. 2003;362 Suppl:s28-29.
PDF

Sulmasy DP. "A biopsychosocial-spiritual model for the care of patients at the end of life." Gerontologist. 2002;42 Spec No 3:24-33.

Note: All articles are the sole copyright of the respective publishers. Materials are provided for educational use only. Downloading of materials constitutes an agreement that the materials are for personal use only.

https://pmr.uchicago.edu/content/how-should-clinicians-address-spiritual-concerns-patients

[darkstar3]

12. Those aren't research.

I followed your link, and I opened every PDF there. What did I find? Articles written for various publications that contain no data, no experimentation, and no analysis of data or experimentation. They were opinion pieces written for an audience of clinical physicians interested in pondering questions of faith. They might as well be editorials.

Where is the research? Where is the experimentation and the explanation of method? Where are the results, and the repetition? Where is the actual scientific research regarding faith and treatment?

All I see here are opinions.

[cbayer]

14. What I said before I edited is consistent with your take on this, darkstar.

I think this is more an analysis piece and the subtitle about research is just sloppy. I also don't see any true research. They may have done it at U of C, but it's not reported in this article.

OTOH, I think the topic is worth a discussion and is most likely based more on surveys than research.

[darkstar3]

21. I think the topic is fraught with complications,

but more importantly, I find it annoying when people refer to things like "research" and "studies" that "show" things, when really all they have is a minor correlation or no research at all. The article stepped on a pet peeve of mine, is all, and I think it's well explained in this comic.

[cbayer]

22. LOL!

It's also a pet peeve of mine, as you might know. And my biggest gripe is that people will embrace it without even looking for the actual *study* and analyzing it for themselves.

This happens at all levels. Probably the most dangerous place it happens is with pharmaceutical reps, who are trained to present *data* in a totally skewed way and who often correctly assume that those they are selling to won't take the time to actually analyze the studies and data (even though they are fully equipped to do so).

Surveys are particularly useless, imo.

[darkstar3]

25. What do you know? Common ground...:)

[cbayer]

28. Who'd a thunk it?

[rug]

15. You may want to search further.

http://www.ncbi.nlm.nih.gov/pubmed/12415138

[darkstar3]

19. And that has what to do with the OP?

[rug]

23. That's one of the places this is coming from.

https://pmr.uchicago.edu/

[darkstar3]

26. That was clear in the OP. The place is of little interest to me.

The science and the rigor involved, on the other hand, are.

[cbayer]

9. Never mind, see above.

Not sure why the snark, though.

[Humanist_Activist]

10. Frankly, if I were a doctor(or nurse), I would be a religious chameleon...

whatever makes the patient comfortable, I wouldn't care. It would be for their benefit, not your own, after all. Of course, this is assuming they even bring it up.

[cbayer]

11. And in reality, I think that is what a lot of medical professionals do.

And if they can't do it, they try to find someone who can provide what the patient is asking for.

[Humanist_Activist]

13. Yeah, a lot of hospitals have visiting clergy for this sort of thing. n/t

[cbayer]

16. In the hospitals I have worked in, we had rosters in which we tried to make sure we could get

someone from pretty much any religious (and non-religious) community.

The hardest for me were always the Jehovah's Witnesses. What they wanted was in such conflict with what I was trained to do. Always a very difficult situation.

That's when ethics committees come in to play as well. They probably have some of the most interesting and intense conversations in the hospital setting.

[Humanist_Activist]

17. Ethics should center around doing the least amount of harm to a patient, either mental or physical..

to help them get better while always complying with the patient's wishes(if they are at age of majority). I can see where Jehovah's Witnesses can be difficult though, Christian Scientists would be even more hair pulling, assuming any ever show up.

[cbayer]

18. You rarely see the Christian Scientists, but they are also very difficult.

I agree about what how ethics should operate in a hospital setting. It's the patient's (or family's) wishes that often complicate things, and religion often comes into play

[Humanist_Activist]

20. I can see that, generally if its the patient's wishes, and they aren't a minor...

it should be complied with, if the family, for whatever reason, objects to something, and that objection will adversely affect the health and wellbeing of someone who can't consent, the family should be ignored.

[cbayer]

24. The absolute hardest decisions were Jehovah's Witnesses who were

critically ill and had no medical directive, particularly if there were members of the family who were not Witnesses.

Then the whole issue of liability comes in as well. What a freaking nightmare. Somebody is going to sue you no matter what you do or don't do. In the end, we generally erred on the side of action versus no action.

But even honoring a competent adult's wishes can be so complicated. What if they are depressed?

I love this stuff, but it is some of the hardest work I have ever done.

[darkstar3]

27. And you see, this is where I think federally recognized standards of care would help a lot.

I think it should be universally accepted that a doctor's job is to save the life and wellbeing of the patient in his/her care. A lot of people feel like that's a bridge too far, and I just don't understand the way their brains work.

[Humanist_Activist]

29. I would prefer the standards be written up by medical professionals, not Congress though...

and they shouldn't be a law written in stone. A federal level medical ethics board that advises would be best.

[cbayer]

31. The AMA already has the mechanism to put this in place, as do the specialty societies.

The standards are really already out there, it's just that no one is required to use them. They are generally presented as guidelines, giving the medical professionals sufficient wiggle room to make decisions with their patient.

But there should be only so far outside the lines you can draw, if you know what I mean. Right now, there are far too few consequences for practice that does go far outside the lines. There are also far too many penalties for not doing enough because of a totally broken medical liability system.

How in the world did we get so off topic!

Anyway, gotta go. Talk to you another time, I hope.

[cbayer]

30. But you may be defining the wellbeing of a patient too narrowly.

A Jehovah's Witness that believes that they will be forever banned from entrance to the Kingdom if they receive blood products will not experience any wellbeing if you utilize national standards of care regardless of what they want.

As to standards of care, I am pretty pessimistic that we will ever see that until we have a single payer system. When we do have a national health system, we will most assuredly have clear standards of care. We can't afford not to.