The physician-patient interaction is both professional and social. The bedside visit fulfills the brotherhood
obligation of visiting the sick. The human relation with the patient comes before the professional technical relation. It
is reassurance, psychological and social support, show of fraternal love, and sharing. A psychologically satisfied patient
is more likely to be cooperative in taking medication, eating, or drinking. The following are recommended during a visit:
greeting the patient; prayer/supplication, dua, for the patient; good encouraging
words; asking about the patient’s feelings; doing good/pleasing things for the patient; making the patient happy, and
encouraging the patient to be patient; discouraging the patient from wishing for
death; advice, nasiihat, for the patient; reminding the patient about remembering
God, dhikr. Caregivers should seek permission, idhn,
before getting to the patient. They should not engage in secret conversations that do not involve the patient.
ETIQUETTE OF THE PATIENT
The patient should express gratitude to the caregivers even if there is
no physical improvement. Patient complaints should be for drawing attention to problems that need attention and not criticizing
caregivers. The patient should be patient because illness is expiation for sins, kaffaarat,
and Allah rewards those who surrender and persevere. The patient should make prayer/supplication, dua, for himself, caregivers, visitors, and others because the supplication, dua,
of the patient has a special position with Allah. When a patient sneezes he should praise
Allah and the mouth to avoid spread of infections. It is obligatory for the attendants to respond to the sneezer. The patient
should try his best to eat and drink although the appetite may be low. The caregivers can not force the patient to eat. They
should try their best to provide the favorite food of the patient. The believing
patient should never lose hope from Allah. He should never wish for death. The patient should try his best to avoid
anger directed at himself or others. Getting angry is a sign of losing patience.
ETIQUETTE OF THE CARE-GIVER
The caregiver should respect the rights of the patient regarding advance directives on treatment, privacy,
access to information, informed consent, and protection from nosocomial infections. Caregivers must be clean and dress appropriately
to look serious, organized and disciplined. They must be cheerful, lenient, merciful, and kind. They must enjoin the good,
have good thoughts, husn al dhann, about the patients and avoid evil or obscene
words. They must observe the rules of lowering the gaze, ghadh al basar, and being
secluded in a closed place, khalwat. Caregivers must have an attitude of humbleness,
tawadhu'u, They cannot be emotionally-detached in the mistaken impression that
they are being professional. They must be loving and empathetic and show mercifulness but the emotional involvement must not
go to the extreme of being so engrossed that rational professional judgment is impaired. They must make supplication, dua, for the patients because pre-determination, qadar, can only be changed by prayer, dua. They can recite some formulas asking
for cure, ruqya, for the patients by using the two surahs of the Qur’an called
al mu’awadhatain or any other verses of the Qur’an. They must
seek permission, isti' dhaan, when approaching or examining patients.
Medical care must be professional, competent, and considerate. Medical decisions should consider the
balance of benefits and risks. The general position of the Law is to give priority to minimizing risk over maximizing benefit.
Any procedures carried out must be explained very well to the patient in advance. The caregiver must never promise cure or
improvement. Every action of the caregiver must be preceded by saying in the name of God, basmalah.
Everything should be predicated with the formula if God wishes, inshallah. The
caregivers must listen to the felt needs and problems of the patients. They should ask about both medical and non-medical
problems. Supportive care such as nursing care, cleanliness, physical comfort, nutrition, treatment of fever and pain are
as important as the medical procedures themselves and are all what can be offered in terminal illness. Caregivers must reassure
the patients not to give up hope. Measures should be taken to prevent nosocomial infections.
ETIQUETTE OF INTERACTION BETWEEN GENDERS
Both the caregiver and patient must cover nakedness, awrat,
as much as possible. However, the rules of covering are relaxed because of the necessity, dharurat,
of medical examination and treatment. The benefit, maslahat, of medical care takes
precedence over preventing the harm inherent in uncovering nakedness, awrat. When
it is necessary to uncover nakedness, awrat, no more than what is absolutely necessary
should be uncovered. To avoid any doubts, patients of the opposite gender should be examined and treated in the presence of
others of the same gender. The caregivers should be sensitive to the psychological stress of patients, including children,
when their nakedness, awrat, is uncovered. They should seek permission from the
patient before they uncover their nakedness, awrat. Caregivers who have never been
patients may not realize the depth of the embarrassment of being naked in front of others.
Medical co-education involves intense interaction between genders: Teacher-student, student-student,
and teacher-teacher. Interacting with colleagues of the opposite gender raises special problems. Norms of dress, speaking,
and general conduct; class-room etiquette; social interaction; laboratory experiments on fellow students; Clinical skills
laboratory: learning clinical skills by examining other students; Operation theatre. Medical personnel of opposite genders
should wear gender-specific garments during surgical operations because Islam frowns on any attempt to look like the opposite
gender. Legal, shari’at, guidelines on interaction with patients of the opposite
gender should be followed. Taking history, physical examination, diagnostic procedures, and operations should preferably be
by a physician of the same gender. In conditions of necessity a physician of the opposite gender can be used and may have
to look at the nakedness, ‘awrat, or touch a patient. The conditions that
are accepted as constituting necessity, dharuurat, are: skills and availability.
The preference between a Muslim of opposite gender vs non-Muslim of same gender depends on the local situation.
DEALING WITH THE FAMILY
Visits by the family fulfill the social obligation of joining the kindred and should be
encouraged. The family members are honored guests of the hospital with all the legal, shari’at,
rights of a guest. The caregiver must provide psychological support to family because
they are also victims of the illness because they anxious and worried. They need reassurance about the condition of the patient
within the limits allowed by the rules of confidentiality. The family can be involved in some aspects of supportive care so
that they feel they are helping and are involved. They should however not be allowed to interrupt medical procedures. Caregivers
must be careful not to be involved in family conflicts that arise from the stresses of illness.