Letter to the Editor

There are approximately 2.8 million Muslims living in Britain and this number is expected to double by 2030. Many GP practices, especially those in urban areas, have a significant number of patients with Muslim backgrounds on their list. There is a common misconception within health professionals in the UK, including those of a Muslim background, that Islam is the only factor in shaping the identity of these diverse and multi-ethnic communities. Also, this identity manifests itself in distinct and fixed ways. This perception poses ethical challenges for GPs. While for some a religious identity is the overall arching framework by which they live their life, this is not the case for all.

The idea of writing this letter came after reading an article in InnovAiT titled ‘Challenges facing Muslim GPs and Muslim Patients’. I submitted my views in my eportfolio and later this was reviewed by my supervisor who encouraged me to write back to InnovAiT and express my opinion about that article that reinforced the use of Islam as a very influential and decisive factor in determining the identity of these groups.

In March 2007, The Sun wrote ‘Muslim GPs blab sex secrets’ about serious confidentiality breaches by some ‘Muslim GPs’ regarding ‘Muslim women’. Six months later, an article came in the Telegraph ‘if Muslim doctors are intolerant, let them go’. Discussing these allegations is beyond the scope of this article. However, the above examples highlight the use of terms like Muslim GPs and Muslim doctors. It is essential to realize, like any other faith group, that Muslims in the UK come from diverse communities and cultures. This includes a variety of ethnicities, languages, regions (both within the UK and internationally), social classes and religious sects. This means that it is unrealistic to describe ‘Muslims’ as a homogenous unit.

Professor Sami Zubaida gives a unique example of how misleading is the use of the adjective ‘Islamic’ when referring to different aspects of these cultures. One clear example is art. ‘In Europe, during the medieval centuries symbols of Christianity were heavily illustrated in painting: the crucifixion, the Madonna and child, the resurrection—all are central themes to centuries of European art. Yet, it is not ‘Christian’ art but Italian, renaissance, etc. On the other hand, ‘Islamic art’ has almost always avoided religious themes, and the portrayal of sacred figures being taboo. Calligraphy, mosaic decoration of miniatures, are the main example of Islamic art. But what is Islamic about them ?’ Similarly, there is ‘Islamic medicine’. It is more or less the same presumption that many GPs believe when dealing with patients of Muslim backgrounds. Even the term ‘Muslim community’ is misleading as the term implicitly refers to a monolithic group of people whose characteristics are uniformly shared through religious observance, belief systems and worldview. This categorization forces us to perceive an individual in a stereotypicalway. In addition, the use of terms like ‘Muslim patients’ and ‘Muslim GPs’ ultimately necessitates the use of other terms such as ‘Christian patients’, ‘Jewish GPs’, ‘Hindu doctors’, etc.

GPs should have an understanding of the social traditions and religious beliefs of the population they are serving. This awareness will have a positive impact on doctor — patient relationship. It is very important for GPs not to make assumptions when approaching a patient of Muslim backgrounds. Screening for alcohol consumption, taking sexual history and discussing sensitive issues like termination of pregnancy may pose a challenge for the doctor. However, asking questions appropriately and in a non-judgemental manner as well as signposting the patient is usually adequate to alleviate any anxieties on the patient's side. After all, these are general rules pertinent to good communication skills regardless of patient's faith, ethnic or social backgrounds.

GPs of Muslim backgrounds serving the community they belong to face a particular set of challenges. Patients may seek some religious advice about certain treatments or medical interventions from the doctor if they know that the doctor is also Muslim. In such situations, doctors should be very cautious about giving religious advice about a particular treatment or intervention. In some situations, especially when the patient is vulnerable because of the nature of their clinical problem, doctors with certain religious beliefs may unintentionally influence the outcome by giving a religious advice when asked by their patients. Doctors should always work within and refer to the GMC guidelines (Good Medical Practice 7,8,33 and 46, Personal belief and medical practice).