Acceptance or Refusal of Surgery Due to Religious or Cultural Reasons

Abstract

AbstractThe United States is witnessing an unprecedented increase in religious and cultural diversity. The highly rational, positivistic, and evidence-based practice of medicine inevitably clashes with practices of and normative claims made by members of these communities. While no comprehensive data exists on the prevalence of ethical conflicts featuring religious or cultural reasons for refusal or acceptance of surgery, studies suggest that these cases rarely end well. Health outcomes for patients suffer; surgeons fail to honor the core values of their profession leading to high levels of moral distress. This chapter uses two cases involving patients from different religious and cultural backgrounds—a Pentecostal African American woman and a young man from a faithful Islamic family—to uncover the normative assumptions of Western medicine, specifically the limitations of the conventional principle-based approach used in surgical ethics. In order to successfully cross the divide between the culture of medicine and religious conceptions of the body, health, illness, and healing, surgeons are invited to cultivate cultural and epistemic humility rather than attempt to understand every aspect of their patient’s religious beliefs or cultural norms. Clinical ethicists, community leaders, clergy, healthcare chaplains, and religious scholars are among those who may serve as cultural brokers in these challenging cases.KeywordsCultureReligionRefusal of treatmentCultural humilityCross-cultural medicine