TSR Med Students' Society Part VI

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    (Original post by Bunicornaces)
    How did you reach the conclusion that the doctor praying with the patient somehow equates his personal beliefs coming into how he treats the patient?
    Then what else is it?

    Once again, I do not understand what the fuss is all about. I don't understand why prayers should make anyone uncomfortable, but if it did, it's as easy as saying, "please don't pray for/with me". Reasons do not even have to be given. I do not think it is in any way inappropriate.
    Having been a patient in a similar situation (who is religious too, might I add), I completely disagree. It's not as easy as that at all - especially given what I was being treated for at the time. With the greatest respect, you sound rather naive about how patients could see things.
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    (Original post by usycool1)
    Then what else is it?



    Having been a patient in a similar situation (who is religious too, might I add), I completely disagree. It's not as easy as that at all - especially given what I was being treated for at the time. With the greatest respect, you sound rather naive about how patients could see things.
    Are you under the impression that having religious beliefs hinders a doctor from appropriately administering medical treatment? You claim to be religious, and I assume you're a medical student, or a doctor. Does sharing your religious beliefs with a patient, if you believe that it would help them feel better, whether physically or psychologically, impact on your ability to make succinct medical decisions? I'm not naive about anything, except clearly in your head. My point was and still remains, there is absolutely nothing wrong or inappropriate with what the doctor did. As adults living in a civilised nation, where free speech is not restrained and celebrated (at least used to be), if someone suggests something that you are not in support of, rather than moan about being uncomfortable to others, simply politely tell them that you do not wish to partake in whatever activity they suggest.
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    (Original post by Bunicornaces)
    Are you under the impression that having religious beliefs hinders a doctor from appropriately administering medical treatment?
    No, and I do not recall myself saying that. This is not the argument that I or many others are trying to make at all.

    You claim to be religious, and I assume you're a medical student, or a doctor. Does sharing your religious beliefs with a patient, if you believe that it would help them feel better, whether physically or psychologically, impact on your ability to make succinct medical decisions?
    You assume correctly, but no. Again this isn't the point we are trying to argue one bit.

    I'm not naive about anything, except clearly in your head. My point was and still remains, there is absolutely nothing wrong or inappropriate with what the doctor did.
    You seem to think it's easy for patients, but it really isn't. It opened up a whole range of questions in my head when the same happened to me. Why is he offering to pray for me? Am I now a lost cause? Is there nothing more that can be done to help me medically?

    As adults living in a civilised nation, where free speech is not restrained and celebrated (at least used to be), if someone suggests something that you are not in support of, rather than moan about being uncomfortable to others, simply politely tell them that you do not wish to partake in whatever activity they suggest.
    Patients will be anxious enough as it is, and many feel as though they should say things to please their doctor. It's like asking "Do you smoke?", for example - there will be some patients who will feel ashamed or too scared to admit to their doctor that they do. It's a similar case here, but almost worse I'd argue because of how much more personal religious beliefs are. Will the doctor still treat me to the best of my abilities if I 'offend' their religious beliefs by saying no? Of course, the answer will almost certainly be yes but it won't be to an anxious patient at the time. It really won't be as simple as you think it would be.

    I don't get this free speech argument here. Can I use my freedom of speech to belittle a patient's beliefs then?
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    (Original post by usycool1)

    I don't get this free speech argument here. Can I use my freedom of speech to belittle a patient's beliefs then?
    Maybe read the comment again in order to get the free speech argument. How does praying with someone compare to belittling a patient's belief. These are completely 2 different things. But still, belittling a person's beliefs may be offensive to that person, but is still free speech. Non-offensive speech does not need protection. Look, Mr/Mrs/Ms usycool, this is a battle of opinions. You think that what the doctor did is inappropriate, I think that it is not. In my honest and non-biased opinion, I am right and you are wrong. I won't be replying to any more of your comments, I have things to do. Have a nice day.
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    (Original post by Bunicornaces)
    Have a nice day.
    You too!
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    (Original post by Bunicornaces)
    Are you under the impression that having religious beliefs hinders a doctor from appropriately administering medical treatment?
    Straw man. No one said this.

    Does sharing your religious beliefs with a patient, if you believe that it would help them feel better, whether physically or psychologically, impact on your ability to make succinct medical decisions?
    If you know the patient has specific religious beliefs that mirror your own, then sure. To go out and assume they want your religious intervention when this isn't apparent (as per the second case) is inappropriate.

    My point was and still remains, there is absolutely nothing wrong or inappropriate with what the doctor did.
    I do believe that using superstition to treat patients is inappropriate. Look at how OP worded it; it's not merely a comforting action. It's about 'praying away disease'. Medicine should be evidence based...
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    (Original post by MJK91)
    Straw man. No one said this.



    If you know the patient has specific religious beliefs that mirror your own, then sure. To go out and assume they want your religious intervention when this isn't apparent (as per the second case) is inappropriate.



    I do believe that using superstition to treat patients is inappropriate. Look at how OP worded it; it's not merely a comforting action. It's about 'praying away disease'. Medicine should be evidence based...
    Maybe I misread it, but there was apparently nothing more that could be done, and if the doctor praying with the patient or the doctor reinforcing the patient's beliefs is comforting for the patient, I don't see how that is a bad thing.

    I think we have to remind ourselves that it is beyond the medical condition that makes a patient a patient. Showing compassion isn't just limited to demonstrating empathy. If there is some deeper connection over shared values, that's a good thing.
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    (Original post by Newtothis83)
    Maybe I misread it, but there was apparently nothing more that could be done, and if the doctor praying with the patient or the doctor reinforcing the patient's beliefs is comforting for the patient, I don't see how that is a bad thing.

    I think we have to remind ourselves that it is beyond the medical condition that makes a patient a patient. Showing compassion isn't just limited to demonstrating empathy. If there is some deeper connection over shared values, that's a good thing.
    If there's nothing to be done and the patient requests your religious input then I don't see a problem. If you introduce it to them, that for me is out of order – who are we to say that religious intervention will come across as empathetic rather than disrespectful to that individual? The second case was the consultant specifically talking to someone who did not state their beliefs. That's odd behaviour; I certainly wouldn't want a religious doctor praying for me in hospital – I'd want them to treat me, even if that's evidence-based palliative care as opposed to prayer.
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    A doctor patient relationship shouldn't be a religious one. If it turns out that one's religion plays a role in the interaction between the two, surely a patient led discussion or even prayer should be the way forward. Patients should initiate and lead what is such a controversial topic. Doctors, being in a position of trust, should never play this role. If that's what the doctor did, then there shouldn't be anything wrong. If otherwise, then I would look into the predicament further and advise the student to bring it up with someone at a more senior position.
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    If it was unsolicited then it's wrong. If not, then what is stopping me from offering to pray to the flying spaghetti monster, handing out acupuncture pamphlets, or recommending homeopathy, to patients that have shown no interest in any of the three, because it is my personal belief that they will help the patient? I know they are all far more outrageous than simply offering to pray for a patient, but if you allow this to happen then it sets the precedent.

    I imagine that all four 'treatments' have an equal chance of working anyway, about equal to that of a sugar pill. Did the consultant consider he could be doing harm, should the patient(s) decide their meds aren't working/attribute their improvement to prayer instead of medicine, and decide to go with faith healing alone?

    This has nothing to do with freedom of speech. You're free to be a street preacher on the weekends. It's about being professional. You can dress as a clown in your free time if you'd like, but if you walk into an office with a strict dress code as one then don't start crying about your human rights being quashed when you get fired. Same goes here - medicine is evidence-based and that is what you are being paid to practice.

    Obviously there is some leeway here because you are there to look after both the patient's physical and psychological needs. If the patient was terminal, and very clearly religious, clutching rosary beads - fine. That's just showing some compassion. But it is worrying that the patient was asking for 'any other options'. Was it clear that they were not referring to another medical treatment? And prescribing a gospel...wouldn't be too out of place on this sketch: https://www.youtube.com/watch?v=HMGIbOGu8q0

    Although would be a lot less funny if the patient were vulnerable and being pushed towards religion by someone they should be able to trust.

    ^my opinion
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    Thread got serious.
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    http://www.thestudentroom.co.uk/show....php?t=4251132 She got reinstated in the end but it just goes to show some patients take it very seriously.
    http://www.dailymail.co.uk/news/arti...colleague.html (ignore the source)
    http://www.telegraph.co.uk/news/2016...lim-loses-app/ This is the nurse I was thinking about.

    If it in instigated by the patient, then thats one thing. But on a PTWR, with someone the consultant has never met, then it is completely inappropriate to bring it up. There is certainly precedent for facing disciplinary actions over such matters (though I wonder if a consultant would have this swept under the carpet a bit more than a nurse can).
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    Just going to leave the GMC Good Medical Practice here...

    37. You must be aware of how your behaviour may influence others within and outside the team.

    54. You must not express your personal beliefs (including political, religious and moral beliefs) to patients in ways that exploit their vulnerability or are likely to cause them distress.
    Also the GMC Personal Beliefs and Medical Practice:

    30. During a consultation, you should keep the discussion relevant to the patient’s care and treatment. If you disclose any personal information to a patient, including talking to a patient about personal beliefs, you must be very careful not to breach the professional boundary§ that exists between you. These boundaries are essential to maintaining a relationship of trust between a doctor and a patient.

    31. You may talk about your own personal beliefs only if a patient asks you directly about them, or indicates they would welcome such a discussion. You must not impose your beliefs and values on patients, or cause distress by the inappropriate or insensitive expression of them
    Also the equivalent BMA guidance:

    Summary point: doctors should not share their private moral views with patients unless explicitly invited to do so.

    Although the BMA recognises the importance of frankness and openness with patients, this does not extend to doctors offering unsolicited opinions about their own moral views. Although all doctors have private moral views, they should not share them unless explicitly asked by patients to do so.

    In 2008, a nurse was suspended on the basis of failing to demonstrate a professional commitment to equality and diversity, after offering to pray for a patient, who reported the comment. She was re-instated but it was made clear that offering prayers is only acceptable when patients ask for them.

    The issue was discussed at the BMA's 2009 annual meeting, which recognised that the NHS is committed to providing spiritual care but that the initiative for it must rest with the patient.
    It's important to be objective when discussing sensitive things like religion (in terms of us in this thread). In my interpretation of the guidance, and given the precedent set by previous FtP proceedings, the most appropriate actions are clear.
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    I have been asked before by patients if I'm religious, and I must say I find it an intensely awkward conversation, usually because the ones asking are the sort to think that my wishy-washy brand of CofE-ness is "not true Christianity" and lead to more discussions I'm not comfortable with when trying to maintain a professional therapeutic relationship. Occasionally, usually in a palliative care setting, I'll ask a patient or their relatives if they have a religion, and offer the services of the chaplaincy (very impressed by the RC priest who turned up at my request in resus at 2am in habit and sandals to help a family!) but that's as far as I'd go.
    #4

    (Original post by Beska)
    *Snip*
    Very informative reply.
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    (Original post by Beska)
    Just going to leave the GMC Good Medical Practice here...



    Also the GMC Personal Beliefs and Medical Practice:


    Also the equivalent BMA guidance:



    It's important to be objective when discussing sensitive things like religion (in terms of us in this thread). In my interpretation of the guidance, and given the precedent set by previous FtP proceedings, the most appropriate actions are clear.
    PRSOM. A great reply, as always.
    #4

    (Original post by Bunicornaces)
    What is your aim if you were to report it? Did he force anyone to pray with him? Did he forcefully pray for anyone? If it made you feel uncomfortable, you could have very easily excused yourself. I'm pretty sure he didn't ask you to be part of the prayers did he? The patients in question wanted the prayers. The senior doctor in question did ask if they would like him to pray with them. I don't see what the fuss is about.
    Appreciate your opinions as much as everyone else.

    My aim would be to end that particular practice. I have no desire for that individual doctor to lose their position, to face FtP proceedings, to be run through the press etc. - I could tell they are an excellent doctor - but that part of their consultation should stop.

    It did appear to be a forced prayer - what initially seemed like "I will add you to my list to pray for" actually turned out to be a touchy-feely almost papal blessing. It's nice to know what you're agreeing to before it happens.

    I was not asked to be part of the prayers but neither could I easily escape the confines of the side room without walking through people or being exceptionally rude to someone that was kind enough to teach me.

    Everything said, if you're a non-believer, this could be interpreted as harmless words to an imaginary friend that can't harm anyone. It's when it becomes "I won't have the original treatment" or "I will say I'm religious so the doctor likes me more" that we're in a grey area.
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    (Original post by Anonymous)
    Appreciate your opinions as much as everyone else.

    My aim would be to end that particular practice. I have no desire for that individual doctor to lose their position, to face FtP proceedings, to be run through the press etc. - I could tell they are an excellent doctor - but that part of their consultation should stop.

    It did appear to be a forced prayer - what initially seemed like "I will add you to my list to pray for" actually turned out to be a touchy-feely almost papal blessing. It's nice to know what you're agreeing to before it happens.

    I was not asked to be part of the prayers but neither could I easily escape the confines of the side room without walking through people or being exceptionally rude to someone that was kind enough to teach me.

    Everything said, if you're a non-believer, this could be interpreted as harmless words to an imaginary friend that can't harm anyone. It's when it becomes "I won't have the original treatment" or "I will say I'm religious so the doctor likes me more" that we're in a grey area.
    Going back to your original dilemma, I think it's definitely worth having a quiet word with the senior, or if you don't feel comfortable doing so then someone else who knows both of you. If nothing else, this individual is potentially opening themselves to FTP issues that they might not have grasped, as from the sound of things they are not aware that the situation is inappropriate (are they from a different culture and recently new to the NHS?).
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    (Original post by Bunicornaces)
    So what?
    So what do you think? :rolleyes:

    He's a doctor in a hospital, it's not an appropriate venue to seek out converts to whichever faith/religion/sect you subscribe to.

    Out of curiosity, would you feel the same way if the consultant happened to be a Muslim offering to recite a Muslim prayer or telling the patient to go home and read the Qur'an and let Allah into his life?
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    (Original post by Democracy)
    So what do you think? :rolleyes:

    He's a doctor in a hospital, it's not an appropriate venue to seek out converts to whichever faith/religion/sect you subscribe to.

    Out of curiosity, would you feel the same way if the consultant happened to be a Muslim offering to recite a Muslim prayer or telling the patient to go home and read the Qur'an and let Allah into his life?
    This is exactly what I've been wondering. If it was as you suggest, I imagine we'd be hearing about this from the Daily Mail instead.
 
 
 
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