Copy editors: Jennifer Kolker, MPH, Co-Principal Investigator, Pennsylvania Public Health Training Center; Kurt Holliday, Communications Specialist, Pennsylvania Public Health Training Center
An elderly Hindu woman presents at a city health clinic with
her teenage granddaughter acting as an interpreter. The teenager explains that her grandmother
has been sad and reclusive for the past couple of months because she has pain
in her hands. She has been unable to do
her normal activities like working in her garden and cooking for her
family. The doctor examines the elderly
woman and finds that she is suffering from severe arthritis in her hands. He offers to give her a prescription to treat
the pain so that she can return to doing the things that she loves. When the teenager translates this
information, the elderly woman just shakes her head and slumps in her chair.
The teenager explains
to the doctor that in Hinduism, there is a central belief in the doctrine of
karma, the law of cause and effect. Every thought, word, and action accumulates karma, which can affect
current and future lives, including health and well-being. Her grandmother believes that the pain in her
hands is a natural consequence for something she has done in a past life. Rather than treat the pain, she sees this as
an opportunity to progress spiritually. How
can the doctor respect her choice while also giving her the highest quality of
care?
Understanding the reasoning behind a patient’s medical
decisions is critical in clinical practice, for both better prevention and
treatment. The Co-PI of the PA Public
Health Training Center, Jennifer Kolker, explains, "So just like we ask
somebody about their marital status, or we ask about sexual activity, or we ask
about employment, we should be able to ask questions about whether or not they
are member of a faith, how adherent to a faith they are and are there things
about their faith that a clinician might need to know in treating them?"
To better understand the intersection of religion and
health, providers may need to consider the following questions:
- How much does a particular
religion inform the patient’s health decisions?
- What are the long-term
effects of this patient turning down treatment?
- In this particular
religion, is there a more effective way to communicate information about
treatment?
- Who, in this religious
community, may be a good resource for health practitioners to contact if
they are having trouble giving care to a patient?
While this particular scenario features Hindus, a similar
scenario could be described for Catholics, Jews, Buddhists – people of many
different faiths. And while it would be
impossible for providers to be competent in every religion, it is their responsibility
to ask the right questions in order to effectively treat their patients.
