Nurses usually find themselves taking care of patients from varied cultural backgrounds. Each patient expects their cultural biases to be taken into consideration when receiving patient care. The role of the nurses is to try to understand the patients’ needs and meet them. The nurse should understand the patients’ requests regarding their cultural beliefs. If the choices the patients make may have harmful repercussions, then the nurse must make this known to the patient and both of them should try to come to an agreement that will ensure the wellbeing of the patient. This discussion highlights the teachings of Islam and about nursing ethics and the care of patients. Nurses are expected to provide medical care to Muslims while respecting their beliefs. Muslims use various texts from the Koran and Islamic law to justify their opinions on various issues regarding patient care. They are obliged to do the will of God even when receiving patient care.
Is the philosophy of science adequate for nursing epistemology?
The effective care of patients is supported by research in nursing. Such research includes how patients respond to emotional, biological, psychological, and social manifestations of illness. In order to understand this, nurses must use a number of scientific methods. They therefore use interpretive and sociological methods in order to understand their patients. The philosophy of empiricism should be applied to patient care. This philosophy gives understanding to events and circumstances in caring for the patient and this knowledge can be used in research and practice. It helps the nurse to understand the needs of a patient from a scientific perspective and therefore give the best patient care that the patient needs. Phenomenology enables the nurses to understand the experiences of the patients through observation, interviews or, stories. For instance, the nurses may want to know how a patient feels after a certain operation has been done (Risjord, Moloney, and Dunbar, 2001).
According to Polifroni and Welch (1999) nursing epistemology can not advance under the philosophy of science. Nursing science requires the development of an exclusive epistemology. Common knowledge and new knowledge in the field of nursing need to be properly examined.
There are several areas in which the cultural beliefs of patients may affect the patient care that they receive. Different cultures have varying perceptions about disease, health, death and suffering. Patients may also have some restrictions regarding gender, privacy, and age. In addition, patients have different views about nurses and some types of therapies administered to them. Some patients may also want to include their families in making critical decisions. All these must be taken into consideration by the nurses in order to give good patient care to their clients. The nurse should ensure that there is proper communication with the client in order to understand his/her needs. If there is a communication barrier, the services of an interpreter can be used. The nurses also need to take into consideration how their behavior might be interpreted by the patients. For instance, body language, posture, and tone of voice say a lot to the patient.
Muslims consider the nursing profession as a gift of mercy from God to the people. They believe that it is God who teaches people the knowledge about medicine. Therefore, doctors are expected to treat this profession as a charitable act, source of income as well as an act of worship. Access to patient care is a basic right in Islam. The Muslim law upholds the protection and preservation of life (Maqsood, 1995).
There are some rules that are applicable in the practice of nursing in Islam. Firstly, the rule of necessity overruling prohibition allows the permitting of certain forbidden conventions if there is a necessity. For example, Muslim patients do not prefer to be examined by nurses of the same gender, but if one is not available the patient will have to be examined by a nurse of the opposite sex. Another rule is that harm should be prevented at all costs. In addition, if two harms cannot be avoided, the lesser of the two should be allowed. Another one states that the interest of the public should supersede that of an individual. For instance, if a patient makes a choice that can affect other patients, it should be denied (Maqsood, 1995).
Muslim patients are supposed to be treated respectfully and in line with their religious beliefs and philosophies. Nurses should take care not to inadvertently violate the rights and beliefs of Muslim patients, for instance, by giving them food prepared with pork products; because pork is forbidden in Islam. Meat served the Muslim patients should also be slaughtered according to Islamic regulations. If such food is not available, the relatives of the patient should be allowed to bring proper food from home that has been prepared according to Islam. The Muslim patients also need privacy and the doctors should respect that. For instance, Muslim women do not allow the exposure of their bodies and may request to wear a gown during medical examinations. The patients should also be granted the time and place to perform their prayers. Religious leaders should also be allowed to visit them and perform prayers together. Islamic law also advises that patients should be treated by specialists of the same sex. However, if the doctor is of the opposite sex, another person of the patient’s sex should be present. If a patient dies, the family should be allowed to take care of the body according to Islamic law. HIV patients should not be discriminated against but should be cared for compassionately, though Islamic law associates the disease with promiscuous lifestyles and drug use (Sheikh & Gatrad, 2008). In order to give such specialized care to the patients, the nurses need to have adequate knowledge by using the philosophies of empiricism and phenomenology.
Muslims are against autopsy. They base this on the teaching that the dead might feel pain. Tampering with the body desecrates it. Therefore, human beings should be treated with care, whether dead or alive. They believe that the body belongs to God and therefore should be left alone. Muslims also consider post-mortems as time-wasting since they prefer to bury their dead as soon as possible so as to reunite them with the creator. The Islamic law also does not allow the movement of the body from place to place because it may incur physical damage. The law prefers the burial of the body at the place of death. Therefore, the movement of the body to a laboratory for a postmortem is not pleasing to Muslims. However, if the law demands an autopsy because of suspicious causes of death then it is allowed. Thus, the rule of necessity overruling necessity prevails (Gatrad, 1994).
Nurses should have knowledge about some prohibitions in Islam. Transplantation of body organs is prohibited by some Muslims while others support it. Those who support it see it as an act of generosity. Donation of body organs should be done willfully and should not endanger the life of the donor. The donor and recipient must first give their consent before a transplant takes place. Islam prohibits the selling of body parts; therefore the donor should not ask for any money in exchange for the organs. Donation of some organs is prohibited because it can contravene the purity of marriage, for instance ovaries, sperms, embryos, and testicles. Donation of some organs after death is also allowed if it is written in the donor’s will. Blood transfusion either between Muslims or between Muslims and non-Muslims is allowed (Veatch, 2000).
Muslims believe that God created human beings perfectly and that they should not be altered. Therefore, they are against genetic manipulation. Human beings should not try to influence the hereditary characteristics of other human beings. They believe that each life is unique and therefore should not be distorted. Gene therapy is useful in restoring health but Islamic principles should not be contravened. Parental integrity should not be destroyed during the process, therefore during genetic transplantation doctors should use cells whose genes cannot be passed on to someone else (Atighetchi, 2007).
Fertility drugs are accepted in Islam. Contraception methods are also allowed, but those that may lead to abortion are forbidden. However, sterilization is prohibited unless it is done to safeguard the life of a patient, for instance, if the procedure will stop the spread of a genetic disease to another generation. It is also allowed if getting another pregnancy might harm the mother or if other contraception methods are harmful to her. Sterilization should be done willfully without force. A couple that cannot get a child of their own is allowed by Islamic law to adopt one (Omran, 1992).
Muslims are against Vitro fertilization and artificial insemination. They only allow assisted conception if the sperm used belongs to that woman’s husband. They support the birth of children only in marriage. They base this on the ideology that blood ties should be respected. Once the husband dies, that marks the end of the marriage; therefore, extracting sperm from the deceased to make the widow pregnant is forbidden (Khan, 2003).
The fetus has the right to live and inherit in Islam. When someone procures an abortion in Islam, she is forced to pay a money ransom. A pregnant woman on a death sentence waits till she delivers before she can be executed. Muslims believe that a fetus gains a soul forty days after conception. Therefore, termination of a pregnancy is prohibited after this period unless the pregnancy endangers the life of the mother.
In Islam ending another person’s or own life is prohibited. Islamic law forbids killing because life is sacred. Mercy killing is also not allowed. In Islam, hastening the death of patients by denying them food is not acceptable (Brockopp, 2003).
Irreversibly unconscious patients who have lost brain stem reflexes should be considered dead. After this, Muslims accept the life support therapy to be discontinued. However, the diagnosis should be made by three different doctors. The nurses should pass on the message about the death of a patient with all honesty and should be sure about it (Potts, Byme and Nilges, 2001).
Muslims accept the discontinuing of treatment to patients with severe conditions that can not be healed. They do this on the basis of relieving the patient from unnecessary pain. Some Muslims are against the use of non-natural means to prolong the life of a patient, unless they are sure that the procedure will lead to recovery. This is in line with the principle that the doctor is supposed to preserve the process of living and not dying. Medical treatment and feeding can go on but they should let the patient die peacefully without further attempting to prolong life artificially. The doctor should also not attempt to hasten the dying process (Gatrad and Sheikh, 2001).
People should seek treatment when they fall sick because the Muslims believe that God cannot send an illness without a cure. But if the treatment may cause harm, then it should be avoided. This philosophy is important as it protects patients from unqualified nurses.
According to Islam, nurses are entitled to a fee from the patients but should treat the poor for free if they do not have the money for treatment. This is done on the basis that giving the poor pleases God and that the profession of nursing is a calling from God to help man. Nurses are also not supposed to have dishonest practices like asking for commissions or overcharging the patients. In addition, the nurse should not reveal the patients’ secrets.
During war time, the nurses are supposed to offer treatment to all the casualties without discrimination regardless of whether they are from the enemy or ally side. This is in line with the teaching of the Koran that we should always be good even if others wrong us. Since the nursing profession is considered to be an act of God’s mercy, doctors are supposed to help everyone because the mercy of God is accessible by both the good and the evil. Nurses are not supposed to be influenced by any enmity but should always aim at showing mercy to everyone.
The nurses are also supposed to be fully qualified to avoid endangering the lives of the patients. The Koran says that the doctors who practice the profession without enough qualifications will be held responsible by God. The nurses are also supposed to give patients the best treatment without neglecting their duties so that even if the patient does not get well, he/she will not be blamed for it.
From the above discussion, it is evident that Islamic philosophies play a great part in the patient care that nurses deliver. Nurses are supposed to use scientific methods to determine the experiences and preferences of the patients in order to give them the best possible care. The philosophies of empiricism and phenomenology, among others should be applied. Matters related with health care are treated with a lot of care by Muslims lest they make decisions that may go against God’s will. It is paramount that nurses have enough knowledge about the care that should be given to Muslim patients in order not to violate their beliefs during treatment.
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