Religion in Medicine Volume I

RELIGION

In

MEDICINE

Volume I

(Religion in Practical Medicine)

by

John B. Dawson B.M., B.Ch., M.A. (Oxon). F.R.C.P. (Edin).

Associate Professor — Department of Medicine

Eastern Virginia Medical School

Norfolk, Virginia, U.S.A.

Copyright © 2011 by John B. Dawson.

Library of Congress Control Number:   2011916749

ISBN:       Hardcover       978-1-4653-6831-7

                 Softcover         978-1-4653-6830-0

                 eBook               978-1-4653-6832-4

All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the copyright owner.

Any people depicted in stock imagery provided by Getty Images are models, and such images are being used for illustrative purposes only.

Certain stock imagery © Getty Images.

Rev. date: 07/26/2019

Xlibris

1-888-795-4274

www.Xlibris.com

534274

This book

is

dedicated

to my

most memorable

parents.

CONTENTS

Volume I

Presents the content of my original volume upon this approach to religion in medicine.

Prologue

Introduction

On Asklepios (GK)—Aesculapius (Latin) and Asclepius (Mod)

The Hippocratic Oath

The Established Anglican, Scottish and Nonconformist Patient

An Addendum After a Death

The Roman Catholic Patient

The 95 Theses of Dr. Martin Luther

The Seventh Day Adventist Patient

The Jews and Judaism Patient

The Jehovah’s Witnesses Patient

Summary—Part I

Comments

About The Author

PROLOGUE

This booklet has been written during the metamorphosis of a medical student trained in the United Kingdom, to a physician practicing in the world at large, leading to a coordinator of an Introduction to Clinical Skills course in the eastern USA.

The activator was my realization that to interview and examine patients successfully one must be able to communicate (a much overworked word) to the best of one’s ability. To this end all general information from all four corners of the compass will sooner or later be required to establish the basis of an individual patient contact, and that a very important component of all information is that related to a man’s religion.

The religious subjects mentioned in the text appear to some readers to be disproportionately allocated between religions. This is deliberate because this is not a book on religions but rather one which attempts to suggest an approach to religion for those within medicine especially; and for all those who read this tract in general.

It begins with examples of how I was first made to realize that I was both uninformed and clumsy in matters religious, and how much unnecessary unhappiness and unintended distress such ignorance could cause. (The Roman Catholic, the Orthodox Jew and the Jehovah’s Witness).

I then go into some of the doctrinal tenets of the Protestant ethic to satisfy my own particular needs, and to improve upon some of the general fundamental ignorance that many everyday well-meaning Protestants, such as myself, often demonstrate (the Established Anglican, etc.).

The next portion (the Adventist) goes on to show a practical way of encapsulating knowledge which can be useful to you in routine everyday experience, and leads on to a rather extensive description of the Baha’i. This latter is intended to be an example of the type of information database you should have to mind in order to discuss rather more fully a particular belief with one of its adherents.

If you as a reader can be convinced that this gradual evolution to a more sensitive medical practitioner is not only practical, but is a most interesting human and enjoyable experience; you will find in the process that, as one of the able followers of Anon has stated, The comparative study of religion will tend to make you comparatively religious.

John B. Dawson

Eastern Virginia 1978

INTRODUCTION

It is a sad fact in the modern medico-religious field that the magical appeal of the powerful therapeutic tools recently vested in the hands of the modern doctor have shifted the balance of power from the cleric to the doctor within their combined role as family advisors. The failure for some doctors to realize this—to remain in ignorance of many religious beliefs—and to maintain a purposeless isolation from their clerical brethren, condemns the family unit to an existence devoid of comforting advice.

Similarly, a patient in a modern hospital all too easily becomes a case, a number, or therapeutic problem; and his/her personality, and to a greater extent, his/her religion is forgotten. It is tragic to die as a case of leukemia in Bed 6.

In many cases John Citizen does not know what his religion is, and may be quite embarrassed if asked to put a name to it. But in other cases a patient’s religion is vital to him, and it is for these individuals that modern medical training and practice makes no allowance. Students are never encouraged to take the trouble to understand religious beliefs other than their own, or to appreciate when, where, why and how they are liable to affect routine medical practice.

Usually, the maximum interest taken in a patient’s religion within a ward is that the nurse in charge becomes the curator of this item of knowledge, notes it on a chart, and puts a hieroglyphic cipher somewhere near the patient’s bed to which she can refer as she passes by or in an emergency. Anglicans in England, and Presbyterians in Scotland will find the medical system geared for their religious requirements, but if a devout Roman Catholic, an Orthodox Jew, a Mohammedan, or a member of some other religion, represented in the country by a numerical minority, wish to continue with their routine religious devotions in the hospital, life may become quite complicated for them.

It is every patient’s right to have his/her religious ideas respected by members of our profession, and ignorance of the various creeds is no excuse for a student, houseman-resident or attending consultant-chief to disregard them. It is essential for the compleat medical practitioner to have a basic understanding of the attitude adopted by differing religions to subjects such as: euthanasia, contraception, suicide, dietary rituals, sexual and marital relations, artificial insemination, abortion, and sterilization. Similarly, it is important that he/she should understand the concept of the sacredness of the body while in this world; its relation to post-mortem examination and cremation, and the leaving of bones, arteries, eyes and bodies for medical purposes.

Active acknowledgments of the religion of a devout patient is of great importance in the doctor-patient relationship, in the arranging of medical therapies, and in the discussion of case history detail. Wherever a doctor is working he/she should have a knowledge of the fundamental beliefs of the main professed religions within his/her district. For the British doctor practising within the confines of the British Isles, this means that a thorough working knowledge of the tenets of the established churches of England and Scotland, namely the Anglican in England and Presbyterian in Scotland, the Nonconformist, the Roman Catholic and the Jewish faith is the least to be expected. In addition, all doctors should be fully aware of the theoretical foundations of religious beliefs which may produce friction and difficulty from a purely medical standpoint. To help in this approach mention is made of a few of the salient points within several representative religions, together with a short list of books presenting the major and minor points of their different doctrines. Such selected literature should enable anyone interested to find answers to most problems in this field as they present, whilst at the same time increasing your knowledge should you, as reader, become engrossed in the subject. For example, the following are highly relevant to routine medical practice, and yet many in the profession will not have given a moment’s thought even to this short list

1. The attitude of Jehovah’s witnesses to blood transfusion.

2. The position of vaccination to a Christian Scientist.

3. The significance of shaving off a Sikh’s hair in preparation for cranial surgery.

4. The Muslim doctrine related to the eating of pork, eggs and meat, and the difficulty in arranging a diet during the feast of a Ramahdan.

5. The part of the Sabbath (Saturday) in the religious week of the Seventh Day Adventist.

6. The flat refusal of a woman in Purdah to allow a male doctor to perform a vaginal examination.

To increase your interest and knowledge in these matters, jot down the varying beliefs upon general subjects such as: The significance of birth; Baptism, or its equivalent—total immersion—infant dedication; Circumcision; Death, with or without cremation; The various episcopal and liturgical structures (best learnt by taking part in routine daily services within the many religions).

Similarly, annotate the differing attitudes within the Christian brotherhood towards: The Bible, both New and Old Testaments; The Holy Trinity versus Unitarian Concepts; The Holy Communion, The Virgin Mother; Saints; The First and Second Coming of Christ; Doomsday and Armageddon; Con-and Trans-substantiation; The Seventh Day; Temperance; Murder; Adultery.

Any patient practising a religion which is understandably unfamiliar, such as Shintoism in East London, will easily forgive a doctor’s ignorance. However, what he will not forgive is the lack of appreciation that he has a religion, and the fact that little effort is made to adapt routine ward procedure and medical treatment within the standard modern hospital so that they will not interfere with his/her important religious observances.

I wish to illustrate my point with a few examples, and then to examine each of the three major religions found in the British Isles from the point of view of their relationship to medicine.

A young Roman Catholic woman, a patient in the ward, was given fish on Thursday. No trouble so far, but on the following day, Friday, she was offered a choice of meat or meat. This necessitated an explanation that she could not eat meat—thank you—and so she had to go with out her meal. If her houseman-resident had had an understanding of the religious observances of the time with which this patient was obliged to comply, he could have easily prescribed a dietary routine of meatless Fridays and by so doing avoided a lot of mental distress, embarrassment and physical self-denial.

The next example was told to me by a friend who was studying for a doctorate in Indian history. While he was travelling through Northern India collecting material for his thesis, he obtained the services of a very devout young Brahmin student who was to act as his guide, and to assist in dialect translation. My friend soon noticed that whenever this young man wished to cook a meal he disappeared. It transpired that he had been ordered by his doctor to eat eggs for a heart lesion, a complaint which had forced him to leave the university, and to which he desperately wanted to return. His wish to return to his studies made him obey his doctor’s orders, while his religion forbad him to eat eggs, fish or meat. He was forced into an impossible situation of mental conflict, and had resolved this, in part, by eating outside the circle of his fellow faithfuls. Consider whether the prescribing of eggs for this young man, with all that it meant in terms of mental distress, without any consideration of some form of alternative substitute, was good therapy for a degree of heart disease, that had already forced him to leave his University.

The third example is that of a gynecological consultant whom I overheard discussing the menstrual history of an Orthodox Jewish woman. In the process he was discussing the possibility of coitus immediately after the menstrual flow had finished. The mere mentioning of such a situation meant that he had no idea of Jewish custom in these matters. If he had instead said something on the lines of of course you will have had no coital trouble until after Mikvah (the proper bath of immersion taken seven days after the cessation of menstrual flow), her opinion of him would have increased one hundred fold, and she would have realized that she was dealing with someone who was more than a mere pill-pusher.

The fourth example occurs in a major teaching hospital, when as a senior student you find yourself on an obstetric rotation. For the first time in your student career you are really going to be responsible for doing something important on your own, even if you are supported by a midwife, a student colleague or with an emergency backup Flying Squad from the big hospital nearby.

My OB career began badly; my first babe was a stillborn, my second an anencephalic, and the third was a Down’s syndrome. Somewhere I was beginning to feel that obstetrics was not my forte. However, my next delivery was a pair of twins to a young mum and I celebrated with a fellow student at the local pub with a glass of ale and a dish of jellied eels.

Nowhere, had my overworked obstetric instructors mentioned that I might ask the mother about her religion, and no instructions were offered for the babe to be. Should it be baptized by me if it is in extremis to prevent it from being in limbo or hell, should I say a significant prayer at its arrival to welcome it into the world, regardless of my own personal beliefs? Is the dying or dead mite to be cremated, to be wrapped in a plain white shroud, or to become hospital detritus to avoid further pain for the mother, in the case of the anencephalic. Will the child require a minimal ritual circumcision . . . and lots more?

Nowadays, you may keep the delivered babe below the placenta for a short time to get a little extra haemoglobin, and then when you have checked the placenta for completeness and that all the membranes are accounted for, thereby removing the possibility of retained products, what to do with the cord? Is the cord needed for paternity or genetic testing, will the Red Cross need it for stem cells in a sterile and good condition?

In England in the 1950s, one had to deliver at least 30 babes to qualify for the General Medical Council’s requirement towards your medical licence. At St. Bartholomew’s Hospital in London we also delivered babes in the district. This meant that you pedaled your bicycle with a bag of required instruments to a home in the East End of London. Here, you met a midwife, and between you, you delivered the babe with mother on clean newspaper on the cleaned concrete floor, burned the placenta in the living room grate, and drank a tot of gin, all around, with Dad.

Today, as a visiting student to a Third World country, you may not be bothered with medical niceties, but your spiritual consideration may become all-important.

The fifth and last example is that of a Sikh from their East London community, who presented at the emergency room of a major London hospital with a sizable depressed fracture of his skull. In order to repair his cranium we had to completely shave his head; this being in contradiction to the most important K—the unshorn hair and beard of the five Ks of his faith (See Sikhism in Part II).

I, at the time, had an on inkling of what we had done, and explained to him, as he became conscious, as to what had happened and why, and that we understood the significance. He was so impressed, that after his discharge, he presented himself at the emergency room once a month with a beautiful silk square for me, until I left for Edinburgh.

It thus becomes evident that to remove from a male member of this theocratic warrior class any of the four other impressive physical exhibitions of the five Ks, even for medical reasons, is, to him, a very significant fact. They must be carefully preserved for him until he is in a position to accept them once more.

Similar external symbols are the important outward manifestations of many religious faiths, such as the rosary and the devotional locket worn by devout Catholics, and these should not be unthinkingly tampered with. In passing, and on a less spiritual plane, the removal of a Western woman’s wedding ring from her finger, for medical reasons is, to many a woman, a very significant deed. An intelligent realization of the situation is once again a guide towards taking the necessary respectful and sympathetic action.

Small points, some may say, but it is just such small points that mean everything to the faithful.

ON ASKLEPIOS (GK)—AESCULAPIUS (LATIN) AND ASCLEPIUS (MOD)

The Healer

To the readers, some of you are members of the medical profession, who should recognize Aesculapius—‘the healer’, because many of you upon graduation swore: I swear by Apollo Physician and Aesculapius and Hygieia and Panacea and all the gods and goddesses, making them my witnesses, that I will fulfill according to my ability and judgment this oath and this covenant: . . .

Aesculapius was the son of Apollo and the nymph Coronis, who died in childbirth, but his father did a Caesarean upon her on the burial