|
What to do when religion meets EMS
By Art Hsieh
|
Editor's note: A group of women in one of the country's largest Orthodox Jewish communities is proposing to join up with Hatzolah as emergency medical technicians to respond in cases of labor or gynecological emergencies. Editorial Advisor Art Hsieh points out that, as evidenced by this story, America’s right of religious expression can cause conundrums in emergency medicine. |
Our nation holds several values near and dear to our collective hearts — freedom of speech, freedom to assemble, and freedom of religious expression. The last one can cause conundrums in medicine, especially in emergency care situations. As this article points out, the conflict between a religious viewpoint of the sexes and the needs of a woman in labor can be difficult to resolve. I suspect that it'll be some time before there is any movement.
Religion is a belief system. Whether Christian, Jewish, Muslim, Hindu, there is the requirement that you must have faith in its teachings and ideals. Almost by definition, there is no scientific evidence for the faith to rest on. And there doesn't have to be, which is the wonder and criticism of faith. Over my career I have encountered several situations where there was some conflict between the care I was providing and the belief system of the patient or family. I'd love to tell you that each was resolved without fuss, but that would not be true. If I wasn't comfortable about the end result, I was pretty sure that the patient sure wasn't. This is especially true in situations where children are involved.
Here are some suggestions to consider if you ever find yourself in a similar situation:
1) Be tolerant. You may subscribe to a certain faith, or you may be agnostic or atheist. Regardless, the patient in front of you deserves your respect of their belief system, even if it conflicts with yours. Your role is as a caregiver, in a situation that demands careful consideration of all of the environmental factors.
2) If your patient is critically ill or injured, your duty is to tend to the patient. You may need the assistance of law enforcement to secure the scene while you extricate the patient. Carefully and completely document the reasons why you initiated care and transport over any objections. Caveat: a patient who is awake, alert, and can clearly demonstrate decision-making capacity who is objecting to your care for religious reasons will be a significant legal challenge to manage. You may need to contact your medical command and enlist the help of clergy to convince the patient to consent to care.
3) If the patient is not critical but requires further medical care, prepare to spend time and effort in convincing the patient and/or family. Remember that rational; science-based thinking may not be convincing to someone who is basing his or her decision on faith-based practices. Again, a member of that faith's clergy may be of assistance in these situations.
4) If the patient is a minor and the parents are refusing care, be careful! The obligation of the state to protect children will run headlong into the right of a family to express its religious views. You will need to clearly understand the laws of your state in terms of child abuse and neglect in order to steer a reasonable decision-making process. In more extreme cases you may need an emergency court order to initiate care.
Jordan Roscoe McCoy Tuesday, November 29, 2011 6:56:12 PM And if it is a religious system you are uneducated about, please do reach out to a clergy member or diversity training liaison for assistance. Don't acciddntally trample over cultural and religious observances with the best of intentions. 
Richard Hallman Wednesday, November 30, 2011 2:34:13 PM Try and learn the makeup of culture and religion in your service area. Learning the customs associated with medical care in your coverage area can be the difference between a headache and an easy call. Some religions are extremely sensitive to cross-gender care, example is Islamic women and male caregivers. 
Aline Kloeppel Wednesday, November 30, 2011 6:20:05 PM @Richard - My old district had so many different cultures and religions that there was no way to be sure you knew everyone of them. We had Christian, Islam, Jewish, Hindu, Buddist, Pagan, Athiest....you name it. I would do my best to accomodate their religious beliefs. I would attend on Islamic women even if they didn't need a paramedic. If an Islamic man needed ALS and they objected to a woman, I would try to have a male fire medic attened but I would still be in the back. There have been times that the only way to get an ALS patient to go was if the EMT attended due to religious beliefs. I dictated from the front and we documented the living H*ll out of it. We also notified the supervisor and/or med-control prior ttransport. But, sometimes, there's only so much you can do...then it's up to your negotiation skills and the patient's willingness to accep care. 
Robert J. Busch Friday, December 02, 2011 12:23:49 PM In L A yrs ago (before AIDS was diagnosed) in certain areas we were transporting homsexuals to hospital and were fully gowned up due to an unknown health issue. The Nurses told us all the personal protective equipment made our patiens uncomfortable. What about those with duty to act are we not uncomfortabe too.
What level of tolerance allows people to agree to disagree yet care for lifes material essentials? As Always do unto others as you would have done unto you (One of those rules we used to live by & I still try)! Keep up the good work.
Robert ( 
Heather Kahl Sunday, December 11, 2011 10:32:28 AM Excellent article! I was thinking back twenty-some-odd years ago, when I went through EMT & Medic training that there was NO education included about religious beliefs and practices. It was something we learned on the fly, and honestly, in rural southwest Pennsylvania, there wasn't a whole heckuva lot of religious diversity to have to deal with. I am finishing my associate's degree in Health Information Management now, and, in the nursing-level classes I've had to take, the texts nowadays do teach about the cultural and religious differences and how to approach and honor them. It's interesting to see the responses of some of the younger generations. Apparently, most EMS education still doesn't address these issues. 
Brian Schlener Tuesday, February 07, 2012 12:41:17 PM If they refuse treatment, and are oriented, that's their choice.
If they are crazy and refuse treatment for their innocent kid because of dumb religious beliefs, MC will be contacted, but ultimately, the courts can say I abducted all they want.. he's stable and that's all that matters. 
