Religion vs infection control

February 15, 2008

Hospitals in the UK are grappling with non-compliance to hygiene on religious grounds:

Muslim medical students are refusing to obey hygiene rules brought in to stop the spread of deadly superbugs, because they say it is against their religion.

Women training in several hospitals in England have raised objections to removing their arm coverings in theatre and to rolling up their sleeves when washing their hands, because it is regarded as immodest in Islam.

(via Catron)



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  3. Religion of athletics
  4. Religion and vaccines
  5. Dying for your religion
  6. Clostridium difficile infection is spreading from the hospital to the community
  7. Canada’s NICU shortage


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{ 15 comments }

1 K. February 15, 2008 at 11:05 am

This is where I’d like to ask a question of someone with more theological training and/or exposure to everyday Muslim life.

I’m Catholic, and the obligation I take most seriously is fasting on Ash Wednesday and Good Friday. I had to work on Ash Wednesday, so I couldn’t fast. I don’t get a religious exemption for that, but I did feel that my low blood sugar would have endangered my ability to provide appropriate medical care.

Given that they claim to have significant proof that this type of handwashing will preserve health, the whole point of their training, how can they possibly put religious objections as more important? The closest I’ve been able to come is that I know several devout Chasidic Jewish men and women who, despite the tenets of their faith, allowed a surgeon of the opposite gender to operate on them intimately.

That a surgeon would not bare their arms to the elbow for scrubbing solely based on religion bothers me deeply. So I’m trying to understand. Is the evidence for this there? And is there no tenet of Islam that would permit this? I just don’t have the experience to begin to interpret this.

2 Anonymous February 15, 2008 at 11:47 am

The closest I’ve been able to come is that I know several devout Chasidic Jewish men and women who, despite the tenets of their faith, allowed a surgeon of the opposite gender to operate on them intimately.
I may be wrong here – I am Jewish, but secular – but I believe Jewish religion specifically specifies that rules can be violated when life or health is at stake.

3 IVF-MD February 15, 2008 at 11:56 am

When a resident states he can’t take call on a certain weekend for religious reasons the price is paid by his coworkers and he himself incurs a benefit by getting a weekend off. Not fair. However, when that same resident offers to make up the call or even make up above and beyond the deficiency, then HE shows good faith in paying the sacrifice for his privilege of exercising his religious practice as he wishes, while his colleagues actually benefit. This is a noble example of someone being true to his faith, by incurring the sacrifice himself. I would be more inclined to believe these students’ sincerity if they made a good faith effort to come up with a plan that would let them follow their faith, but have THEM incur the burden or cost rather than costing OTHERS — in terms of patients’ safety from deadly nosocomial infections. I offer a silly example, but if there were some magical protective covering that was clearly shown to be as hygienic as going sleeveless and they offered to buy those out of their own pockets, then that is noble. They are asserting their rights but very importantly, WITHOUT infringing on the rights of others. As believers of different religious, we have to live in this world together. Your right to practice your faith as you wish extends as far as you want it to UNTIL it crosses over into trespassing on the rights of others.

4 Anonymous February 15, 2008 at 4:05 pm

Do these people never bathe?

Perhaps the issue is that the wash-up area is not single-sex.

I’d think a curtain in the wash-up area would be a reasonable accommodation, not being required to wash-up is not.

5 K. February 15, 2008 at 5:25 pm

Just to follow up: thanks, anonymous 11:47. I was aware of that rule, just trying to provide an example of a conservative religious choice in which a law of modesty was superceded by health concerns. I’m still wondering if there’s a parallel sort of exemption for life/health that applies to Islam.

To anonymous 4:05: the article specifically references the operating room, not just the prep.

And in a tiny addendum to that article, a Muslim UK doctor organization suggests special arm-length disposable gloves, I believe, but does not offer to provide or pay for them.

6 Anonymous February 15, 2008 at 5:51 pm

This is ridiculous. Special curtains in the scrub area? You can’t just change the physical plant because some workers now (remember, they didn’t before) want accommodations on their terms in a facility whose purpose is medical treatment, not social gathering or worship. The welfare of the patients whose infection the washing is meant to prevent is the paramount concern.

Besides, one has to proceed from the wash sink into the OR with bare hands before drying and gowning.

Choose what you want to do. Work in the hospital and perform to the standards expected of everyone vis a vis infection control, or quit and go live and work somewhere where the safety requirements aren’t in conflict with your beliefs.

7 Anonymous February 15, 2008 at 6:05 pm

To the anon 11:47

In Judaism, all rules but 3 rules and regulations are suspended when someone’s life or health is at stake.

The 3 exceptions are murder, idolotry, and sex with animals. Anything else is fair game.

Um – how can medical student pass surgery rotation if they don’t scrub?

There comes a point in every medical students’ life when they must choose between career and lifestyle. If you are so devout that scrubbing in the surgery rotation is forbidden, you either need to become more liberal or get out of med school.

Once you graduate, you can decide to be a radiologist and never scrub again, but you have to get through med school first – we all did it.

8 Michael Rack, MD February 15, 2008 at 7:48 pm

Aren’t religious female Muslims supposed to be at home rather than out working or at medical school? If these female Muslims are so concerened that the site of a bare wrist might be too tempting to a male Muslim, why are they even out in the workplace?

9 Supremacy Claus February 16, 2008 at 9:28 am

In the US, a rule may interfere with religious practice if it serves a purpose and does not single out a religion. The Supreme Court upheld the law against hallucinogenic mushroom use, even in an Indian religious practice.

For opposing argument, see this loud dissent by a Commie, criminal lover Justice, to a decision allowing the military to impose uniform standards on a military psychologist wishing to wear a skull cap.

http://www.law.cornell.edu/supct/html/historics/USSC_CR_0475_0503_ZD.html

10 Anonymous February 16, 2008 at 5:13 pm

Actually, there is no specific tenet in Islam (in the Qur’an) that mandates a woman (or man) has to be completely covered to his/her wrists.

As a devout Muslim female in the medical profession, I routinely wash up to my elbows when I scrub in.

Religion is a personal matter, so ultimately, it is up to these women to choose how to interpret religion, BUT for health’s sake and for working in the hospital setting, I don’t really buy their arguments.

Islam is not a rigid, unyielding religion, and definitely allows “exceptions” in matters of health!

On a side note, I certainly hope Michael Rack MD was being VERY sarcastic with his comments, as many devout/religious Muslim females are happily working in the medical profession.

11 Supremacy Claus February 16, 2008 at 8:26 pm

Left wing Brit officials spinelessly, cravenly kowtow to hate filled internal traitors in the name of extreme PC. They deserve their terror attacks.

http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2008/02/15/nterror115.xml

If Brit Commie Care recruits terror doctors to replace their own English surgeons, demanding a raise to ridiculously low $90K a year, they deserve their terror attacks.

If they accommodate religious extremists, and suffer adverse patient outcomes, these PC twits deserve to be sued into oblivion. To deter their accommodationist delusions.

All PC is case, trumped up, phony pretext to generate lawyer enrichment. In the US, any judge permitting any tort or civil rights claim from these extremists to intimidate any institution should be immediately removed by the administrative judge of the jurisdiction. Any administrative judge failing to remove these PC traitors from the bench, should face defunding of the entire court. All traitor lover judges should be shunned, boycotted by all service and product providers, and driven from their communities.

12 Anonymous February 16, 2008 at 9:51 pm

Doctors have to put their patients first and that means washing properly.

If they can’t or won’t do that, they they should not enter the medical profession. It is that simple. It doesn’t matter what the reason is. Religion is not an adequate reason to put patients at risk. It doesn’t matter whether it is sincere religious belief, mere custom, or a misunderstanding. Science is science and germs are real and have no religion.

The same is true to a degree with being able to work at any time. A doctor cannot abandon their patients. While we can make arrangements for coverage that suit our preferences/requirements/needs most of the time, we don’t own other people and cant’ force them to accommodate us all the time, and besides, they may be ill or otherwise unavailable. An absolute rigid prohibition on working certain days or times that one would no be willing to alter when patient care requires it is a disabling disqualification for the medical profession. It doesn’t matter why–religion, preference, whatever.

13 Anonymous February 17, 2008 at 2:51 pm

While I agree with you anon 9:51 a question. How come some PCP’s can just have a prerecorded message saying “go to the ER” afterhours? I’ve seen this more than infrequently.

14 Anonymous February 17, 2008 at 8:04 pm

Because that is the arrangement that they have with the patients in the practice that they have created. They have chosen to not handle unstable patients in their current practice. Even so, in order to be qualified to run a practice, they had to acquire the skills to handle unstable patients. They could only learn that by doing it, which means working, for least a part of their career at all sorts of hours.

Even in their current practice, they still have an obligation to not abandon their patients. If a patient who is not stable comes into their office, they have an obligation to attend to that person until someone else assumes the care. If they have a religious prohibition against, say, working after sundown on Fridays, and the sun sets on Friday and the patient still isn’t in an ER due to transportation or other similar problems, then they are obligated to remain in attendance.

Also, the way that a doctor structures his practice at any particular time is not guranteed to continue. What if there is a natural disaster and he is the Johnny on the Spot and the usual array or protective mechanism that keep him living an ordered controlled life collapse–well then he has to do what he must do for his patients, and not compromise their health and safety for his idiosyncratic notions whatever their origins.

The PCP with that phone message is limiting his role as a physician, but can assume the full mantle if circumstances dictate. The same must apply to handwashing. One might, say, go into psychiatry where it is not such a big deal on a daily basis. But before they can limit their role by specialization they must master the basic clinical skills by doing–and do that without putting patients at risk. Then, even if it isn’t a daily routine, they still must be prepared when clinical care demanads it to examine patients more fully and do so with full safety for the patients–meaning touch them with properly washed hands

15 Michael Rack, MD February 17, 2008 at 9:35 pm

“On a side note, I certainly hope Michael Rack MD was being VERY sarcastic with his comments, as many devout/religious Muslim females are happily working in the medical profession.”
No, I wasn’t being sarcastic. However, I do apologize for lumping all Muslim branches together, as there are many branches of Islam (just as there of Christianity). Anon 5:13, I would imagine that the branches of Islam that demand that women keep their wrists covered are the same branches that want women to remain at home (just as the more fundamentalist branches of Christianity want women in the home). If I am wrong about this, please let me know.

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