Religous Practices Observance

[uglyEMT]

Hey all. I know the thread title sounds like a joke or something but I have some serious questions about devout religous observances pratices in our field. Not talking about holidays but in practices.

Im trying to find out what, if any, observanes should we follow. A question was posed to me by a rookie and I didn't have an answer so I figured I can come here and you guys and gals could help.

The question posed was as follows:

If we have a devout Islamic patient such as in traditional garb ie Burqa or similiar is it allowed to remove or cut it to gain access for patient care?

I took a course on religious practices and traditions and tolerance but it never touched on this aspect. So I did a little research on my own and found out the practice is for modesty in public and it is concidered an "offense" to the husband or father for another man to "see" the women or her body. I also believe, from my understanding, that a women could be concidered an adulteress if another man sees her body. So I am stumped, would we be breaking some moral, ethical, religous code by removing the clothing? Im thinking something along the lines of a trauma here where in any other instance we would cut clothing without hesitation. I guess even medical calls too, say to gain access to the arm for a BP or the wrist for a pulse. Lung sounds?

I tried looking through my protocols and about the only thing I found was a sentence stating to try and maintain the wishes of the patient and/or family whenever practical. I went a little farther and checked with a local ED Doc and he told me, nothing in writing just verbal, that usually for Orthodox Jewish people an autopsy wont be preformed due to religous observance and also the body would be released as soon as possible so as to be buried by the next sundown. He also stated there are special observances for Muslims as well but he would have to look them up.

So I figured I would ask you all the question and see your replies. I know some have worked in theater in the Middle East and would probably have a good handle on this situation, I may be wrong though.

Thanks Everyone For Your Help

[tniuqs]

The Arabic word burka / 'برقع' refers to a face cover with eye openings. It does not mean the whole black dress called the abaya.

Are you asking what is politically correct if or is there is a tangible reason not to visualize an injury ? For that matter

Medically:

If it needs to come off to evaluate, then it comes off or would you rather explain to a judge or deal a wrongful death suit instead why you did not "expose" as in all of our training.

Use your right hand (PC) as the right is for eating and the left for wiping ones ass in muslumville. It sure would suck to be right brain dominate ..

Most realistically, once again in the western world are so bloody concerned with what is politically correct to the point of impairing our logic. I believe the entire concept is degrading to women and and means of control, in North America culture (Yes an open society) attempts to de-humanize is unacceptable but once again our western values Christian values are discarded like trash.

cheers

From the infidel

Edited February 15, 2011 by tniuqs

[mobey]

The only time I have had any consideration for religion/beliefs is during a code when the daughter asked to place a cross in her mothers hand. I allowed it.

Other than that, I have asked a motorcyclist if I may cut his jacket since it was hell's angels issued. He said he preffered if I didn't, but as we fought to get it off the old fashioned way, he submitted to the scissors.

I do not believe I would ever "not expose" unless I was placing myself in danger. Ie: cutting gang-colours, and getting stabbed for it!

Though, not really a problem in podunk Ab.

So the question

So I am stumped, would we be breaking some moral, ethical, religous code by removing the clothing?

Quite possibly.

However, it would be the patients morals/ethics/religious etc etc. Therefore, I do what has too be done.

Keep in mind however, that a A&O pt can refuse anything.

[DwayneEMTP]

I think that these are really good questions. It is a tough thing to understand when what we consider a 'devout' Catholic looks silly in comparison to the weight another culture may give to their religion.

I had a badly hurt Afg National at Bagram Air base overseas. He'd fallen through the 14' ceiling of a new hospital they were building, at least I think that's what it was. On the way through he hit his shoulder and L face on the exposed edge of unfinished ductwork. Sliced him like a scalpel and then he fell the entire distance directly on his ass. When we arrived there was blood and vomit everywhere, truly it was a mess. There were 15-20 other Afg men around yelling at him and...well. not really sure what they were doing as we didn't share a language. I jerked out my pocked knife and started cutting his clothes off (Yeah, I know I'm supposed to use shears...sue me) at which point two of the men pushed forward and spread their hands over his groin yelling, what I assumed was that I couldn't expose his penis before the crowd. I thought about it for about....ok, I didn't really think about it at all as his pants were soaked with blood, called security and management to move everyone outside and stripped him naked for my exam. Before moving him outside I covered him from about his navel to his knees.

So, I don't know what the right answer is. But as he was unable to advocate for himself I had to assume that he wouldn't want me allow him to die to keep a couple of people from seeing his dick, right? I'm not sure if I had the legal obligation of implied consent in Afg, ak would probably know, but I certainly had the moral obligation in my opinion. He will get over his embarrassment.

But, it's easy to say, "He will get over being embarrassed, but he won't get over being dead!" But what about the woman that will not get over it, when it will never be forgotten by her or her community? When she wouldn't simply have been embarassed, but for all intents and purposes had been raped? I don't have an answer for you here brother, and I hope I never have to make such a decision.

I do believe that they take some responsibility by moving to a country with our standards. If I moved to Afghanistan I have to accept the fact that if I'm seriously injured that there is every chance that I will die due to lack of medical care if I'm out in the villages. If you come here and are seriously injured I believe that you have to accept some responsibility that you may be disrobed in front of strangers of both sexes.

Tough questions man... Speaking of which? What the hells up with you and your lack of posting lately? Getting to good for us?

Dwayne

[tniuqs]

Not trying to be argumentative Dwayne ...

But

The question was about a female.

This is not in the sandbox.

ps and sue me too, I use a Blackie Collins "Rescue One" because shears just don't chew off parkas and safety harnesses, BA carriers or bunker gear.

Maybe the observers were freaking because they did not want you to circumcise the patient ?

[tniuqs]

Ie: cutting gang-colours, and getting stabbed for it!

Though, not really a problem in podunk.

Dude I have cut 3 sets of colours now ..

Indian Posse stabbing at a Fire (screw em).

H.A no issue at an MBA and Tiny and Grizz bought my partner both dinner in FMM. oh YES they did.

Grim Reapers Deadmonton Chapter back in the day (GSW) .. no issue either the cops used it in evidence.

[fiznat]

We have a Hindu temple nearby that we respond to every once in a while. They have it set up with a curtain down the middle of the room- all the women on one side and all the men on the other side. They tried to tell us that only my partner (a female) could go in and see the female patient, and also that we had to remove our shoes. Mind you, this was for an unresponsive patient. We were as respectful as possible, but we told them that both of us need to see the patient and that we would not be removing our shoes. After explaining (for longer than I would have liked) that this was important, and "proving" that our shoes were "clean," they allowed us to do what we needed.

Edited February 15, 2011 by fiznat

[Richard B the EMT]

Taking into account that this is more what is my understanding, and might not reflect actuality, try to have a family member of the Muslim woman accompany her, like her husband, brother, sister, or mother. From general EMS training, for a female patient, if possible, have a female tech ride with the patient (I've had NYPD lady officers ride for that reason).

In all cases, try to provide cover to the groin area of all patients, and the breasts for women.

In "Superman: The Movie", when checking out a rather chesty lady (who was faking injuries from a car crash, to stall a convoy of truck mounted ICBMs, so that Lex Luthor could tamper with them), the security detachment (commanded by Larry "J.R.Ewing" Hagman) formed a circle around her, then was ordered to face outward as a visual shield. Hey, it worked, if only in a movie "for instance". (The movie played on TV this past weekend).

I've had instances where I realized, after starting patient evaluations and treatments, that I was in houses where they didn't wear shoes inside, due to religious observances. I would continue the evals and treatments, while apologizing for not removing my boots, as I was under the opinion that such evals and treatments took temporary priority. I never had anyone complain, as most understood where I was coming from.

As for the woman wanted us to remove the boots, because they's stain her new carpet, while we tried to access her asthmatic child...

[Bieber]

As with all scenarios regarding respect for the individual patients' sensitivities, I'll make reasonable accommodations for my patients, but ultimately I have a job to do and that comes before their personal and emotional comfort.

[tniuqs]

As for the woman wanted us to remove the boots, because they's stain her new carpet, while we tried to access her asthmatic child...

The movie analogy .. no comment except hollywood but the last statement speaks very clearly for itself.

Most serious this PC for the plethora of religious denominations / groups / cults (presently minorities) I believe our "tolerance" and fear of offending others sensitivities will change the face of North American Culture, just my 2 cents.

Anyone listen to Russell Peters ?

Look to what is happening in Europe especially France where the burka has been banned, look to Quebec where the carrying of a Sikh ceremonial "non knife" has been banned in the Legislature .. I mean really rules are rules (they define a nation) why in our counties do we make exceptions to the rules ?

Point being if one needs to evaluate a human for medical reasons, yes the psychological well being is important part (although not a lot die because of this ) of the picture but not the meat and potatoes if you follow.