“Muslims want an Islamic NHS,” from The Sun:
MUSLIMS should get special treatment within the NHS [National Health Service], a top medic claimed last night.
Prof Aziz Sheikh called for “faith-based health services”. He wants same-sex doctors, information to ensure treatments do not contain alcohol or pork, extra prayer rooms and circumcision for baby boys on the NHS.
The professor, from Edinburgh University, said in the British Medical Journal: “Muslims have the poorest overall health profile but there are few faith-centred initiatives aiming to improve health outcomes for our largest minority faith community.
“Many Muslims, to maintain modesty, prefer to see a same-sex clinician but such choice is typically unavailable. Male infant circumcision should be available throughout the NHS and more access is needed to prayer facilities.”
But Prof Aneez Esmail, of Manchester University, said: “It’s not practical. Members of the same religion are not all the same and their needs may be different. Going down this path risks stereotyping.”
It is also right that we should not force Muslim and Jewish people to use poorly regulated male circumcision services. But that does not mean that the NHS should provide them “” having an accredited list of doctors who have been trained to carry out the procedure may be the service that the NHS can and should provide. However, we obviously cannot nor should we meet everyone’s demands for special services based on their religious identity: it would not be practical. In some cases there are practices which may be morally and ethically unacceptable “” for example, female circumcision and the refusal to accept blood transfusions in life saving situations.
The latter example underscores Esmail’s central argument in favor of treating patients as individuals: Imagine a doctor’s liability in proceeding based on assumptions in an emergency situation that a particular patient would refuse a certain treatment.
We cannot assume that religious identity is homogeneous. Members of the same religion are not all the same and their needs may be different. There are many sects within Islam, for example, that place differing emphasis on many of the core tenets of the religion, and they do not all translate into the same requirements for faith based services.
The way forward is not a crude categorisation of people into even more tightly defined groups. We already monitor peoples’ ethnicity, not because we believe that this is how people want to categorise themselves but because we recognise that racism is prevalent in our society and that it affects certain groups disproportionately. Monitoring ethnicity allows us to assess the effectiveness of our services and challenge inequality. It is not
about assuming that the Asian patient has a core set of beliefs about illness because of fixed ethnic traits.
In an ideal world doctors would ask patients about ethnic identity not because it is an abstract concept used for monitoring but because patients may see it as an important part of their self. They would ask about a patient’s beliefs not so that they can be categorised but because it might be important for the patient in their illness. As Kleinman and Benson say, the key task for the clinician would be to routinely ask patients what matters most to them in the experience of illness and treatment. The main thrust is to “focus on the patient as an individual, not a stereotype.” The needs of people for whom faith is important are best met by drawing on our tradition of pluralism and the emphasis on tolerance and respect.