Towards Religious Competency for Health Professionals

Written by: Eleanor Lippmann, MPH
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.