US doctor urges more 'halal care' for Muslims

Patients want halal food and respect for cross-gender divisions in health care, while research finds many healthcare professionals are unaware of Islamic medical ethics and law.

NEW YORK // Aasim Padela is a modern-day Renaissance man. The 30-year-old is not only an emergency doctor at the University of Michigan Medical Center, but also holds bachelor's degrees in classical Arabic and literature and in biomedical engineering.

Dr Padela, a Muslim who was born in New York to Pakistani parents, focuses on Islamic medical ethics and the medical challenges posed by Muslim and Arab populations in the United States.

Michigan has a large and long-standing Muslim community - the Detroit metropolitan area has the largest concentration of Arab-Americans in the US - but even there, he found many patients who, at the least, sensed a lack of sympathy to their needs or, at worst, discrimination.

He asked a focus group made of up 102 Muslims of Arab, South Asian and African-American origin what they would do if given US$100,000 (Dh367,000) to improve the health system. Their top three demands were: halal food, accommodation of cross-gender prohibitions, and heightened cultural sensitivity.

"Even in Michigan, there's a lot of perceived discrimination," Dr Padela said. "The focus group's desire for halal food was very interesting because they said it would make them more healthy while they were in hospital where they were presumably trying to get healthy."

Dr Padela does not suggest that the US have the kind of separate facilities that exist for male and female patients in Muslim countries, but he would like to see better physician-patient communication and greater awareness of Muslim needs.

He recounted two cases, in a recent paper for the Journal of Medical Ethics. In the first case, a female Muslim patient who wore the hijab complained about hospital staff who repeatedly uncovered her hair to put a thermometer in her ear. This could have been avoided by using an oral thermometer.

In the second case, a male Muslim patient was anxious during a physical exam by a female physician. But he could have been put at ease if the physician had simply worn a pair of gloves.

Dr Padela, who is spending this term as a fellow at the Islamic studies centre at Oxford University in England, said that given the variety of Muslim traditions and expressions, it was important not to make assumptions and he advised healthcare providers to offer an opportunity for discussion and negotiation.

"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?'" he wrote in his paper.

As well as giving an overview of Islamic medical ethics and law, his paper also explained the hierarchy of physicians to consult if a Muslim falls ill. "Preference is given to a Muslim physician of the same sex, followed by a non-Muslim of the same sex, then a Muslim physician of the opposite sex and lastly a non-Muslim of the opposite sex."

He explained that sex was given priority over religious creed because the concepts of seclusion and awrah, or the parts of the body that must be clothed, were less of a barrier in same-sex interactions.

Other recommendations in his paper included giving female patients gowns that covered more of their bodies, or allowing them to wear their own clothes, permitting chaperones during examinations, or keeping a door or window slightly open if a patient was in seclusion with a physician.

One of Dr Padela's research projects is Islamic interpretations of brain death and how it was construed in terms of life and death. "People in the West don't realise that Muslims don't have a Vatican," he said.

"You can have different verdicts about brain death from Saudi Arabia or Egypt and the challenge for the system here is who to use as an Islamic authority."

He believes that, with time, physicians in the US will know as much about Muslim needs as they do about Orthodox Jewish requirements, or the refusal of blood transfusions by Jehovah's Witnesses.