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Physician says understanding
religion
is a key to health care
 Dr.
Farhat Moazam, chair and professor at the
Centre of Biomedical Ethics and Culture
in Karachi, Pakistan, spoke Oct. 24, 2007,
at University of Missouri-Columbia.
Moazam, whose center is
affiliated with Sindh Institute of Urology
and Transplantation, spoke about her experiences
as a doctor and ethnologist working with
kidney patients in Pakistan.
One difference Moazam noted
between the United States and Pakistan is
that in the U.S. medicine is practiced using
a very secular premise and language. This
has a tendency to ignore spiritual aspects
of health care and decision-making, she
said.
"Birth, death, disease,
pain, suffering - the majority of us learn
to work with these issues and make sense
of these issues through reason," she
said. "… and our spiritual resources
are extremely important to us (as well)."
Doctors helping to make decisions about
patients' health care would be well served
to have an understanding of their shared
traditions and religious beliefs, she said.
Moazam, who was trained
in both the U.S. and Pakistan, said physicians
in both countries rely on the same science
and technology, yet have different awareness
of religious traditions and cultural beliefs.
Pakistan's population is made up of Muslims,
Protestant Christians, Catholics, Hindus
and Zoroastrians. Still, she said, there
are "shared values that cut across
social strata and education - a common history
and (being) culturally similar. A big unifying
force is the values of Islam," whose
believers make up 95 percent of the country.
 In
Pakistan, there is a "centrality of
religion and extended family in one's life,"
Moazam said. "It is a collectivist
culture. Family is the social unit."
The system is also hierarchal in structure,
she said, where "roles are very clear,
based on gender and age." A physician
is often treated as an elder of the family,
with the influence and respect accorded
to that position.
A focus of Islam is obligation
to kin, Moazam said, which often is expressed
in making medical decisions, such as organ
donations. In Pakistan, only relatives can
donate organs to a patient. "It is
the obligation of the doctor to treat the
patient and for the family member to donate
(an organ) to save (a relative's life),"
she said. "Therapeutic distance' (for
doctors) doesn't work in Pakistan."
Doctors - recognizing the
religious and familial traditions that inform
patients' decisions - can work with those
beliefs to make the best health-care choices
for patients (as well as those who may be
marginalized in decision-making by those
beliefs), Moazam said.
Doctors in the U.S. and
Pakistan can learn from each other - especially
as medical practitioners increasingly have
global experiences and populations around
the world become more diverse.
"If we can have
intelligible discourse on that … we
have made a good beginning," she said.
 Sponsored
by the MU Center on Religion & the Professions.
For more information, call (573) 882-2770
or e-mail whiteab@missouri.edu.
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