Robert Wood Johnson Foundation Clinical Scholars Program, Department of General Internal Medicine, University of Michigan, Ann Arbor, MI 48109-5604, USA.
J Med Ethics. 2011 Jan;37(1):40-4. doi: 10.1136/jme.2010.037614. Epub 2010 Nov 1.
As physicians encounter an increasingly diverse patient population, socioeconomic circumstances, religious values and cultural practices may present barriers to the delivery of quality care. Increasing cultural competence is often cited as a way to reduce healthcare disparities arising from value and cultural differences between patients and providers. Cultural competence entails not only a knowledge base of cultural practices of disparate patient populations, but also an attitude of adapting one's practice style to meet patient needs and values. Gender roles, relationship dynamics and boundaries are culture specific, and are frequently shaped by religious teachings. Consequently, religion may be conceptualised as a cultural repertoire, or dynamic tool-kit, by which members of a faith adapt and negotiate their identity in multicultural societies. The manner in which Islamic beliefs and values inform Muslim healthcare behaviours is relatively under-investigated. In an effort to explore the impact of Islam on the relationship between patients and providers, we present an Islamic bioethical perspective on cross-gender relations in the patient-doctor relationship. We will begin with a clinical scenario highlighting three areas of gender interaction that bear clinical relevance: dress code, seclusion of members of the opposite sex and physical contact. Next, we provide a brief overview of the foundations of Islamic law and ethical deliberation and then proceed to develop ethicolegal guidelines pertaining to gender relations within the medical context. At the end of this reflection, we offer some practice recommendations that are attuned to the cultural sensitivities of Muslim patient populations.
随着医生遇到越来越多样化的患者群体，社会经济状况、宗教价值观和文化习俗可能会成为提供优质护理的障碍。提高文化能力通常被认为是减少因患者和提供者之间的价值观和文化差异而导致的医疗保健差距的一种方法。文化能力不仅需要具备不同患者群体文化习俗的知识基础，还需要有一种调整实践风格以满足患者需求和价值观的态度。性别角色、关系动态和界限是特定于文化的，并且经常受到宗教教义的影响。因此，宗教可以被概念化为一种文化手段，或者是动态工具包，信仰的成员可以通过这种手段来适应和协商他们在多元文化社会中的身份。伊斯兰教信仰和价值观对穆斯林医疗行为的影响相对较少受到关注。为了探讨伊斯兰教对医患关系的影响，我们提出了一种关于医患关系中跨性别关系的伊斯兰生物伦理观点。我们将从一个突出性别互动三个临床相关领域的临床场景开始：着装规范、异性成员的隔离和身体接触。接下来，我们将简要概述伊斯兰教法和伦理思考的基础，然后着手制定与医疗背景下性别关系相关的伦理法律准则。在这次反思结束时，我们提供了一些适应穆斯林患者群体文化敏感性的实践建议。
