Aasim Padela, M.D., M.Sc.
University of MichiganDr. Padela is an emergency medicine physician who holds bachelor degrees in Biomedical Engineering and Classical Arabic & Literature, attended medical school at Weill Cornell Medical College, and completed his residency at the University of Rochester. His current research focus on cultural accommodations for, healthcare disparities of, and ethical challenges for Muslim and Arab American populations. He is a fellow at the Institute for Social Policy & Understanding, an American Muslim think-tank, working on a project relating to cultural barriers to clinical care for Muslim Americans, collaborating with Dar-ul-Qasim, an Islamic educational institution to probe the frontiers of Islamic bioethics, and conducting CBPR work in Greater Detroit on Arab and Muslim health. His other work focuses on the “culture” of clinical accommodation of patient values in the ED. Of note, he has spent time professionally in Turkey, Qatar, and Egypt.
Padela states that doctors need to accommodate religions. But of course this is all about pushing Islam on non-Muslims. (These will just be the beginning of the Islamic demands.)
From the University of Michigan Health System website.
Padela’s paper, “Muslim Patients And Cross-Gender Interactions In Medicine: An Islamic Bioethical Perspective,” provides a series of practice recommendations to help physicians better accommodate Islamic religious ethics. Practice recommendations include:
Dress Code: Understanding that a patient whose religion requires modesty may not feel comfortable changing into an examination gown. Padela offers a number of alternatives.
Seclusion: Having a chaperone or leaving a door slightly ajar during internal examinations would meet the requirements of Islamic law.
Gender Relations: For patients who follow Islamic ethics concerning cross-gender interaction—when all else is equal—physicians of the same religion and gender are preferred, followed by a non-Muslim of the same gender whenever possible.
Also jumping on the I will bow to Islam bandwagon is the Journal of Medical Ethics, which published the following article.
Law, ethics and medicine
Muslim patients and cross-gender interactions in medicine: an Islamic bioethical perspective
Aasim I Padela, Pablo Rodriguez del Pozo
The manner in which Islamic beliefs and values inform Muslim healthcare behaviours is relatively under-investigated. In an effort to explore the impact of Islam on the relationship between patients and providers, we present an Islamic bioethical perspective on cross-gender relations in the patient-doctor relationship. We will begin with a clinical scenario highlighting three areas of gender interaction that bear clinical relevance: dress code, seclusion of members of the opposite sex and physical contact. Next, we provide a brief overview of the foundations of Islamic law and ethical deliberation and then proceed to develop ethicolegal guidelines pertaining to gender relations within the medical context. At the end of this reflection, we offer some practice recommendations that are attuned to the cultural sensitivities of Muslim patient populations.
The excerpt above was all the JME website showed unless you are a member, or are willing to pay a fee. But there was also an option to to sign up for a free 30 day trial. So I signed up, and now we see the journal completly bowing down to Islam, as the article provides a sales pitch for Islam. Even quoting the Koran and ahadith.
Case vignette
A 35-year-old female presents to an urgent care clinic complaining of leg pain after a fall. The nursing documentation notes that the patient has refused to put on a gown and is accompanied by a male relative. When you enter the examination room you notice a well-appearing African-American female wearing a ḥijāb (a Muslim religious head covering). As you put out your hand to introduce yourself she states ‘Are there any woman doctors around?’
The attempted handshake of members of the opposite sex does not go over big in the Islamic world. I am sure the doctors will eventually comply to that as well.
Islam, Muslims and healthcare disparities
Islam is a monotheistic faith that holds Muhammad ibn ʿAbdullāh of 7th-century Mecca to be the final prophet from among a long line starting with Adam and including Abraham, Noah, Moses and Jesus. It is a cumulative tradition spanning 14 centuries that Muslims have developed and adapted in diverse ways to varied times, places and contexts. Muslims across time and place refer to a singular universe of meaning: that by submitting to God inwardly, one can attain true peace within oneself, manifest it outwardly in this life, and will find everlasting peace in the hereafter. From this follow the five pillars of Islam, which represent the obligatory external manifestations of faith, the many beliefs comprising a Muslim’s internal faith (Īmān), and teachings related to righteous and moral character (Iḥsān and/or Akhlāq).
Doctors, did you guys ever treat a rape victim? If so it must have been horrible, but here you are supporting a religion/ideology that OKs rape. Of course that is not mentioned, or the fact that the Islamic version of Jesus is not the Jesus of Christianity.
There are over 1.57 billion Muslims in the world, with nearly 7 million in the USA, that can be divided into two main branches: Sunnī and Shīʿīte.10–13 These two groups share beliefs, religious practices and legal structures, but vary on issues related to religious authority and prophetic succession. The majority of Muslims are Sunnī, while between 10 to 20% are Shīʿīte.
Why not mention the fact that the two groups hate, and kill each other? Oh I forgot, the EMJ is only giving us part of the story.
SNIP
Yet, Muslims as a group may suffer from healthcare inequity and inequality for several reasons.
Muslims may have different healthcare-seeking behaviours stemming from Islamic conceptions of disease and cure, and Islamic rulings about permissible therapeutics may contribute to different health outcomes. Furthermore post 9/11 discrimination and abuse may lead to increased psychological distress and mistrust of the healthcare system, which in turn may affect poor health outcomes. Lastly, Muslims may be treated differently due to stereotyping or lack of familiarity with their cultural practices and values. Thus, enhancing the knowledge-base of providers towards Muslim health behaviours and values, will better equip them to serve this population based on nuanced understandings, thereby enhancing patient trust and satisfaction.
Of course the article would not be complete, without playing the Muslim victim card.
Islamic medical ethics and Islamic law
Writing on Islamic medical ethics consists of two dominant genres. The first is Adab; literature which aims to promote virtues and righteous conduct couched within Islamic terms. Ethicolegal writings comprise the second type and aim to expound the legal permissibility of medical interactions, procedures and therapeutics.
The Islamic ethicolegal structure or Sharīʿah, has two dimensions. The first is as a corpus of legal rulings, precedents and statutes, and the second as the moral code of Islam. Since the Sharīʿah is not codified or used by modern states as the single source of law, it is better conceptualised as ‘the collective ethical subconscious’ of the Muslim community. Muslim patients and practitioners alike may refer to the Sharīʿah when discussing therapeutic options, or seek assistance of Islamic legal experts when facing complex moral challenges around healthcare decisions. Similarly Muslim bioethicists may refer to the Sharīʿah when debating ethical constructs.
Right there is the main problem. Sharia does not belong in America.
The Islamic sales pitch continues.
Usūl al-Fiqh and the sources of law
A full discussion on the sources and mechanics of Islamic ethicolegal reasoning is beyond the scope of this paper. A brief overview, however, will aid the reader by introducing the framework for our subsequent discussion. The sources of Islamic fiqh are both material and formal. The former include the Qur’ān, held to be the literally revealed word of God through the angel Gabriel to the Prophet Muhammad, and the Sunnah, which represents the sayings, actions and silent affirmations of the Prophet Muhammad. Since he represents a life lived in accord with the ethicolegal code of Islam, he is both the normative case and the explainer of the code. The Sunnah is accessed through collections of ḥadīth, which are single statements or behaviours of the Prophet. The two formal sources that are agreed upon by the four major schools of law in Sunnī Islam (Hanafī, Shāfiʿī, Mālikī and Hanbalī are ijmā and qiyās. Ijmāʿrefers to consensus agreement about the assessment of an act or practice, while qiyās involves reasoning by analogy.
Of course Dr. Islam does not tells us what else the schools agree upon. Which can be seen HERE.
Gender relations in Islam
The overarching Islamic ethic pertaining to cross-gender interaction is maintaining modesty. The Prophet stated: ‘Every dīn (religion/way of life) has an innate character, the character of Islam is modesty (Muwatta Imam Malik)’ and ‘Īmān (faith) has over 70 branches, and modesty is a branch of Īmān (Sahih Muslim)’.
Dress code
The Qur’ān tells both men and women to ‘lower their gaze and guard their modesty’ and further addresses women to ‘not display their beauty and ornaments except what (must ordinarily) appear thereof; that they should draw their veils over their bosoms (Al-Nur, 24:30–31).’
Sorry, I have a hard time taking people seriously if they will not look me in the eyes, and not all eye contact with members of the opposite sex is about sex. There is a thing called “respect” in the modern world. Islam is stuck in the past.
Seclusion
Protection of dignity is one of the main objectives of Islamic law. Growing from this objective arise the regulations of khalwah. Khalwah is defined as the situation where a ‘man and a woman are both located in a closed place alone and where sexual intercourse between them can occur’. This situation is prohibited between non-mahram adult members of opposite sexes in order to prevent the accusation, and committal of, illicit relations. This prohibition stems from Prophetic traditions stating that when a non-mahram male and a female are alone ‘Satan’ is the ‘third among them’ and his stating that ‘a man must not remain alone in the company of a woman’ (Sahih al-Bukhari).
Right, because if there is eye contact between members of the opposite sex at a hospital a massive orgy will break out. Get real, this is all about pushing Islam.
Physical contact between the sexes
The Qur’ān exhorts ‘Nor come nigh to adultery: for it is a shameful (deed) and an evil, opening the road (to other evils)’ (17:32), and thus Islamic law not only prohibits adultery but also strictly regulates physical contact since the verse bars ‘proximity’ to adultery. The general rule is that non-maḥram members of the opposite sex may not have any physical contact in order to block the means to impermissible relations.
Hey Doc, why not tell us what is permissible? Here, I’ll do it for you.
Koran verse 33:50
YUSUFALI: O Prophet! We have made lawful to thee thy wives to whom thou hast paid their dowers; and those whom thy right hand possesses out of the prisoners of war whom Allah has assigned to thee; and daughters of thy paternal uncles and aunts, and daughters of thy maternal uncles and aunts, who migrated (from Makka) with thee; and any believing woman who dedicates her soul to the Prophet if the Prophet wishes to wed her;- this only for thee, and not for the Believers (at large); We know what We have appointed for them as to their wives and the captives whom their right hands possess;- in order that there should be no difficulty for thee. And Allah is Oft-Forgiving, Most Merciful.
Sex slaves…..not too ethical in Western Civilization, huh Doc?
Here is how the medical field is supposed to change to accomodate Islam.
Practice recommendations
As we make our recommendations below it is important to note that these are formed from our own experiences and reflect our opinions. Our focus is on Muslim sensitivities which are variably interpreted and practiced thus cannot be generalised to all Muslim patients. As providers we have to be cautious not to stereotype patients but on the other hand must create the space for patients to relay concerns, preferences and values. Thus for patients who appear to be Muslim one could easily offer the comment ‘I know some people are very anxious about being examined or taken care of by someone who is not of their gender, do you have any concerns you want to share with me?’ This could be followed up by asking ‘Is there anything you want me to do differently or be cautious about during the physical exam?’ These types of questions are significant in that they tell the patient that the provider has some knowledge of cross-gender boundaries, is willing to engage in a discussion about these, and is primarily concerned about the welfare of the patient. Our last caveat is that our recommendations below should not be interpreted as fully developed policy recommendations. There may be other more effective-methods to reach the same goals.
In other words ask the Muslim patients if they do not want to be treated by a kuffar doctor. It is more than OK when a Muslim discriminates against non-Muslims.
Dress code
It is standard practice to ask a patient to change into an examining gown in the hospital and clinic. While this facilitates physical examination, and protects the patient’s clothing from staining, the gown may insult a patient’s sense of modesty. A more limited scope of this practice, in addition to effective communication explaining the need for gowning, is advocated. Alternatively, some hospitals offer patient gowns that are more covering and may allow patients the option to wear their own clothes in the hospital. Such practices may be effective strategies as well. When the patient gown is a necessity, hospital staff could offer to keep the curtains drawn, or the door closed, so that patients could be saved from onlookers. Another effective intervention is a ‘knock, wait, enter’ policy by which staff knock, wait for permission and then enter patient rooms. This would be especially helpful for Muslim women who wear the ḥijāb, as they may feel the need to cover their hair before someone enters the room, and in general benefits others who feel the need for more privacy during hospital stays.
Lastly, it must be stressed that the clinician uncover only that part of the body that needs to be examined, and cover those that are not part of the exam or have been examined already. Paramount here is effectively communicating the need to examine the body before proceeding to do so.
Once again, the Doctor is out to seduce the Muslim patient. I don’t think so. What is next guys, how about the hosptial removes all sign of Christianity? Would that make you happy?
Seclusion
Many patients may feel anxious when in seclusion with the physician for a variety of reasons. This concern is more prominent during internal examinations. Standard practice calls for chaperones when conducting these sensitive examinations. However this practice may not adequately address prohibitions against seclusion within the Islamic and orthodox Jewish faiths. Here one must strike a balance between the need for privacy and the prohibition against seclusion (if patients observe this practice). An ideal situation would be to have a chaperone, preferably of the same gender as the patient, present or in close proximity, who could potentially hear or see what occurs during the patient-provider encounter. Such a potential disrupts seclusion. Simply keeping the door slightly ajar or having a door with a window slit would meet the requirements of Islamic law.
Jews are not on a worldwide movement looking to subjugate everyone under a barbaric set of religious laws, so don’t bring them into your Sharia push. Muslims are, and Islam should not be catered to.
Physical contact
Physical contact outside of the medical examination can be interpreted in different ways subject to cultural norms. A provider holding the hand of a patient who just lost a family member may be viewed as a boundary crossing by some and compassionate by others. Effective communication and paying attention to non-verbal clues may guide clinicians in caring for the patient. Physical contact outside of the examination should always be approached with caution. During the physical exam one can employ innovative strategies that may reduce the trepidation of some patients. Two personal cases are illustrative. In the first case a female Muslim patient who wore the ḥijāb complained about hospital staff repeatedly uncovered her hair to place a thermometer in her ear. This situation could have been easily remedied by using an oral thermometer. In the second a Muslim male became anxious during physical examination by a female provider. By simply donning gloves the provider put the patient at ease.
How about letting the doctor treat the illness, and not Islam? Works for me.
Case resolution
‘Unfortunately there are no female physicians around right now, is there some way I can make you feel more comfortable?’ you ask. The patient tells you that she is a practicing Muslim and feels uncomfortable with a male examining her and disrobing into a gown. After some discussion you both agree on a compromise. You will obtain the history and a female nurse practitioner will perform the physical examination under your direct observation, with you never being in the room alone with the patient. Ultimately the patient is discharged home with crutches, an ankle stirrup air cast and anti-inflammatory medication for her ankle sprain.
Ultimately, this will would be another victory for Islam. Which is another loss for America.
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