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Islam is the second largest religion in the world, consisting of 1.6 billion people. It was founded in 7th century C.E. by the prophet Muhammad based on revelations he received from God, and those revelations were compiled to create the religious text of Islam, the Quran. Islam means submission to the will of the one God, Allah, and the followers of the Islamic faith, or Muslims, are those who submit. There are Five Pillars of Islam. The first is witness, or shahadah, which is a devotion of the one God, Allah.
The second is prayer, or salah, which entails prayer being offered five times throughout the day. The third is giving, or zakah, which involves almsgiving and annual gifts to the poor. The fourth is fasting, or sawm, which occurs during the month of Ramadan from sunrise to sunset, and the last is pilgrimage, or Hajj, which is a pilgrimage to Mecca. These Five Pillars encompass the Islamic faith and they play a large role in the lives of Muslims.
Islam has become a very controversial religion around the world due to their beliefs and holy laws, also known as Sharia. One component of Islamic belief that has become very controversial due to its social implications is modesty. This belief is not only significant in the everyday life of a Muslim, but it becomes especially problematic regarding medical examinations and care for Muslims.
The Muslim belief of modesty represents their devotion to God. The Quran says “let them draw their head coverings over their bosoms.
And let them not display more of their charms to any but their [family]” (Quran 24:31). By following their belief of modesty and wearing the proper clothing, they are submitting to God. Both men and women must wear long sleeves and long bottoms to fully cover their arms and legs, and they may also wear a veil to cover their hair and neck. “There is an impression that women dress modestly compared to men; however, many men follow many of the same rules for modesty” (Attum and Shamoon, 2018), so this is not necessarily the case. Although the Quran offers insight on modesty, its interpretation can vary throughout Islam. This can be seen through some the different types of veils Muslim women wear. Some wear burkahs, which expose only their eyes, while others only cover their hair and neck with a hijab (Mujallad, 2016). Another component of modesty involves contact with the opposite gender. For Muslims, touching between two people of the opposite gender who aren’t related is forbidden (Andrews, 2006). Not only can two non-related members of opposite genders not touch, but they also can’t be alone in a room together. This is because adultery is prohibited, along with simply proximity to adultery. In Islamic faith, it is believed that when two people of opposite genders are alone together, there is a third being with them, Satan (Rabin, 2010). Based on their beliefs, Muslims’ have strict rules that they must follow in order to submit themselves to God, and in most cases for devout Muslims, they follow these rules in every aspect of their life. These interpretations and beliefs determine what is permissible by the Islamic faith not only in everyday life, but also concerning medical examinations.
Receiving proper medical care is crucial to a person’s health and can save someone’s life. Many people visit medical institutions for yearly visits to prevent or treat illnesses. Unfortunately for Muslims, it is difficult for them to receive the same medical care as others due to their beliefs. Islamic faith says that it is forbidden for Muslims to be touched by someone of the opposite gender who they are not related to. This is important to consider for medical examinations when a physician must touch a patient in order to properly examine or diagnose them. A simple solution for this is for a female physician to work with a female patient, and a male physician to work with a male patient. However, this is not always possible and can become problematic when there are only physicians of a certain gender on call and there is not the option to work with a physician of the same gender. When a Muslim does not have the option to be examined by a physician of the same gender, they may refuse the examination, which can lead to dangerous consequences for their health. This happened to one Muslim woman who fell and possibly suffered a spinal cord injury. Only a male physician could assist her so she refused a rectal exam. She refused the exam on the basis of her religion; however, not getting the exam could have led to dangerous consequences because her choice might cause the physician to miss “a serious injury that might have caused permanent paralysis” (Rabin, 2010). This is just one example of a Muslim refusing treatment due to their religious belief of modesty, and many other Muslims don’t get the care they need due to their devotion to their faith. One exception to this belief is that the Islamic faith says that a Muslim may touch a person of the opposite gender only in the case of an emergency. For childbirth, which is considered a life or death situation by Muslims, it is permissible for a male physician to deliver the child. Although this is an exception that is allowed by the Islamic faith, many devout Muslims still feel that they can never touch anyone of the opposite gender who they are not related to in order to be fully committed to their faith (Rabin, 2010).
Not only do Muslims refuse examinations regarding pre-existing conditions, they also refuse preventative examinations, such as for breast or cervical cancer. “Research has shown that many devout Muslim women delay accessing health care and may have very advanced disease[s] by the time they seek medical help” (Rabin, 2010). This is because Muslim women find medical visits to be distressing (Stainsby, 1997), most likely due to worrying about betraying their faith. There are very few studies measuring the mammography rates for American Muslims. However, in those few studies it was found that for almost all the reported rates, the mammography rate of American Muslims was lower than the recorded national rate (Padela, Murrar, Adviento, Liao, Hosseinian, Peek and Curlin, Journal of Immigrant and Minority Health, 661). Another study showed that Muslim women have low rates of screening procedures, especially those for cervical cancer (English, 2007). In a focus-group discussing modesty, many said that “because strict rules about dress, manner, and behavior are so important, ‘bodily exposure’ precluded [Muslim] women from obtaining breast health exams” (Andrews, 2006). In the Muslim culture preventative healthcare is not essential, so many Muslims feel that it is not a valid enough reason to expose one’s body (Andrews, 2006). As was mentioned before, for Muslims, betraying the belief of modesty is only permissible in the case of an emergency, and preventative healthcare does not meet those standards. The examples used regarding breast and cervical cancer only pertain to women, but Muslim men experience the same issues and are “reluctant to be cared for by female physicians” (Rabin, 2010). By refusing to get the medical care they need, and not taking preemptive measures to prevent diseases, Muslims are putting their lives in danger.
The beliefs of Muslims can be validated based on their faith, but with those beliefs come problems that aren’t easily solved. While the reasons behind their decisions make sense to them, they often don’t make sense to those of other faiths. This causes conflicts between Muslims and other groups of people, in this case physicians. Muslim modesty may cause Muslims to refuse medical treatment. A physician’s job is to do whatever is in their power to help their patients. When a patient refuses treatment because of religious beliefs, they are limiting a physician’s ability to help them and preventing them from doing their job. Physicians can only do so much for the patient when they refuse treatment, such as making sure to fully explain the need for the treatment or attempting to find an alternative treatment, one they may not refuse; however, the one thing a physician cannot do is force a treatment on a patient. Patients have the right to refuse medical treatments or exams for any reason, such as religious reasons. “There are well-publicized and long-standing laws protecting a competent patient’s right to refuse any recommended treatment of physical examination” (English 2007). This is one of the problems the Islamic belief of modesty causes. If a lifesaving treatment goes against the Islamic faith and a Muslim refuses the treatment, it causes everyone around them to become helpless: physicians, nurses, friends and family members who may be in support of the treatment. By refusing a treatment they are choosing to possibly die rather than betray their faith. These laws that allow people to refuse treatment protects the First Amendment, which allows citizens of the United States of America free speech, press, assembly, and religion; however, it does not protect the life of the patient. While it is understandable that people would want freedom, such as the freedoms given in the First Amendment, I can’t understand why people would use that freedom to choose death over life. This example may be an extreme situation, but Muslims choosing not to get mammograms for breast cancer or screenings for cervical cancer are also choosing death over life. They are choosing the possibility that they may die of breast cancer that could have been prevented or treated. The Islamic faith says that life is sacred, which then opens a variety of questions that are difficult to answer. If Muslims believe life is sacred, then how validate refusing treatment that can help them live? These two beliefs contradict each other and leave many questions unanswered, causing a conflict in their faith.
Muslims are firm in their beliefs, and the best way to help them receive the care they need is not by forcing them to change their beliefs. Perhaps one day they will be more open to accepting certain treatments or exams, but we can’t sit around waiting for that day to come, especially not knowing if it ever will. Instead, the way we can help Muslims today is to improve the healthcare and treatment for Muslims. The most important change would be making Muslim’s feel more comfortable during their medical visits. Since a large reason Muslims don’t receive treatment is because they get stressed about going to a medical appointment, healthcare workers should try to make their Muslim patients feel more relaxed during their visit. This would mostly entail medical workers having a better understanding of the Islamic faith so that they can understand Muslims’ needs and better cater towards those needs. Having a better understanding of, and being more sympathetic to, Muslims’ needs, will allow physicians, nurses, and other medical staff to be more prepared for when a Muslim patient comes in and refuses to undress. Medical personnel will know how to handle the situation in order to accommodate the patient. Seeing how devoted Muslims can be to their faith is inspiring, and they should not be forced to choose between committing themselves to Islam or receiving proper medical care. Unfortunately, the current medical system causes this choice to be a reality that Muslims have to face every day. Hopefully the day will come when they won’t have to sacrifice their health for their religion, and vice versa, because medical professionals will be better equipped to care for them and their beliefs.
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