Culture of Respect

1. Back to ISPI Culture of Respect A Muslim Perspective Javeed Akhter MD

2. Objectives. • Discuss multi-culturalism and pluralism. • Point out the differences between tolerance and pluralism. • Review the Muslim attitude toward pluralism. • Outline some common challenges facing a Muslim patient. • Suggest ways of creating a culture of respect for care receivers.

3. Multi-culturalism • In the first “Parliament of World Religions” held a little over a hundred years ago in Chicago almost all delegates were Christians and Jews. • There was only one Muslim delegate “Alexander Russel Webb” • and one Hindu delegate “Swami Vivekananda • The most recent parliament had scores of “faiths and traditions” represented

4. Multi-culturalism • Multi-culturalism is a historically new phenomenon in the US. • “The Harvard Pluralism Project” run by Diana Eck well known scholar lists many of new religions thriving in this nation of ours.

5. Plurality of Faiths

6. Pluralism • Multiplicity of cultures, faiths and traditions in the same public space makes understanding pluralism essential. Pluralism essential for civil society. Javeed Akhter.TAM2003.

7. Pluralism • “This realization of shared desires and needs is clear and apparent to those who live in multi-religious societies and to those that participate in interfaith dialogue • The acceptance of the idea that there is much truth in many faiths and traditions and one’s own personal faith is not the exclusive abode of all truth is pluralism.” Pluralism essential for civil society. Javeed Akhter.TAM2003.

8. Pluralism • Pluralism may be inter-religious as well as intra-religious. • Other than the Hajj pilgrimage, famous for its multi-racial multi-ethnic character, Muslim communities in the US are the most diverse.

9. The Challenges of Pluralism • Need to learn to respect values of others that may be incompatible or even in conflict with your own values. • Sometimes the values of the other group may be incompatible with the broad understanding of “global ethics”. • The state may contain religious and cultural minorities whose members may hold values incompatible with majority views and sometimes state laws. • Even though you may value pluralism the other person may not.

10. Pluralism Versus Tolerance • Tolerance presupposes that the followers of other traditions are largely if not entirely mislead and deserve compassion. • Tolerance privileges one’s own view over those of others.

11. Pluralism Versus Tolerance • Tolerance is inherently arrogant. • Pluralism is born out of humility and aversion to being judgmental. • Tolerance does not regard diversity as something positive.

12. Islam And Pluralism. www.ISPI-USA.org

13. Islam And Pluralism • Pluralism in the life of Prophet Muhammad: The Constitution (Covenant) of Madinah. • This Constitution set out many of the principles essential to the peaceful functioning of a pluralistic society.

14. Islam and Pluralism • It gave equality to all its citizens and accepted the coexistence of different religions in the community. • All religious, ethnic and tribal groups had equal protection, rights and dignity. • These groups (Three Jewish and two Arab tribes) would live by their own beliefs and judge themselves by their own laws.

15. Islam and Pluralism • Prophet Muhammad's inspiration for this pluralistic model was the Qur'an (Koran), which makes it incumbent upon Muslims to accept and respect all of the previous messengers without distinction and honor their communities.

16. The Koran (Qur’an) And Pluralism. “The Apostle believeth in what had been revealed to him from his Lord, As do men of faith. Each one of them believeth in Allah (God), His angels, His books and His Apostles. We make no distinction between any of the Apostles.” (Qur’an 2.285)

17. The Qur’an Celebrates Diversity. • “O humankind Allah (God)has created you male and female • And made you into diverse nations and tribes so that you may come to know each other. • Verily the most honored among you is he who is the most righteous.” (Qur’an 49.13)

18. The Qur’an Appears To Imply Diversity Is Part Of The Divine Design. • “To each of you (religions) God (Allah) has prescribed a law (shiratun) and a way (minhaj). • If God (Allah) had willed he would have made you a single people. • But God’s purpose is to test you in what he has given each of you. • So strive in the pursuit of virtue. (Qur’an 5.48)

19. Creating a Culture Of Respect.

20. What would Be Your Response To This Woman If She Walked Into Your Clinic? • What in the name is that? • Another oppressed Muslim woman. • She must be hot in there. • Different strokes for different folks. • That is cool! I am going to go out there and get myself a Hijab, Jilbab and Niqab.

21. The Correct Response. • What can I do to make sure she feels comfortable and has her dignity.

22. Our Client. • She refuses to shake the resident’s hand and makes little eye contact. • Her English is better than your Arabic but only marginally. • She hasn’t filled out the intake form. • You figure out one of the children has a fever and two other need immunizations. • She has no primary MD for the children.

23. Common Challenges & Dilemmas Facing Muslim Patients

24. Some Areas that Caregivers Need To Pay Attention To When Caring For A Muslim Patients • Stereotyping. • Modesty/Gender issues. • Language and customs.

25. Stereotyping Stereotyping. Modesty/Gender issues. Language and customs. The top three stereotypes of Muslims in the US are • Terrorists. • Male Chauvinists. • Arabs. • Black Activists. • Unkempt and smelly.

26. Stereotyping. The top three stereotypes of Muslims in the US are • Terrorists • Male Chauvinists • Arabs • Black Activists • Unkempt and smelly

27. Modesty. Stereotyping. Modesty/Gender issues. Language and customs. • Modesty in clothing is prescribed for both genders, so that the interaction between them is spiritual. • Diversity in interpretation of what is modest clothing. • The former Taleban regime and Saudi Arabia impose it. • Turkey, Morocco and now France prohibit it in many institutions. • Isn’t Jacques Chirac a Mullah Omar with a French accent? • Most Muslim countries allow personal choice.

28. Gender issues Stereotyping. Modesty/Gender issues. Language and customs. • Hand shake. • Female physicians and attendants. • Eye contact.

29. Language And Customs. Stereotyping. Modesty/Gender issues. Language and customs. • Use of phrases like “God willing” (Insha-Allah) • Easy to create misunderstandings because of lack of language. • Reluctance to say no outright because it would be considered rude

30. Lack Of Knowledge Of The System • Forms intimidating to fill out. • Most immigrants underutilize the system. • Concept of PCP and preventive care might be novel to her. Stereotyping. Modesty/Gender issues. Language and customs.

31. Your Challenges With This Client. • She is following her religion the best she understands. • In countries with large numbers of Muslims her appearance would be a common site albeit at the conservative end of the spectrum. • Her behavior would not raise any eye brows. • A female physician would probable take care of her family.

32. Creating A Culture Of Respect. UNESCO Document On Cultural Diversity

33. The UNESCO Universal Declaration on Cultural Diversity • Adopted by the 31st Session of the General Conference of UNESCO Paris, 2 NOVEMBER 2001 • http://unesdoc.unesco.org/images/0012/001271/127160m.pdf Koïchiro Matsuura, Director-General

34. The UNESCO Universal Declaration on Cultural Diversity • States to reaffirm their conviction that “intercultural dialogue” is the best guarantee of peace and to reject outright the theory of the inevitable “clash of cultures and civilizations”. • Consider cultural diversity as “the common heritage of humanity”, which is “as necessary for humankind as biodiversity is for nature”.

35. The UNESCO Universal Declaration on Cultural Diversity • Cultural diversity is the common heritage of humanity. • Cultural diversity should lead to cultural pluralism • Cultural diversity is an important factor in human growth. • The right to practice your own culture should be considered a basic human right.

36. The UNESCO Universal Declaration on Cultural Diversity • Create an enabling environment for cultural diversity. • Strive towards access for all to cultural diversity. • Cultural heritage as the wellspring of creativity • Cultural goods and services: commodities of a unique kind

37. Conspectus. • Creating culture of respect is essential to healing. • The first step is to make sure care seekers are not disrespected. • Work on creating a pluralistic non-judgmental mind-set in the work place.

38. Conspectus. • Increasing knowledge of the customs, faith and traditions of the other is the best antidote to stereotyping. • Guidelines for Health Care Providers Interacting with Muslim Patients and their Families , developed by The Metropolitan Chicago Healthcare Council. (www.ISPI-USA.org and Advocate web page) • Medical Ethics in Islam by Javeed Akhter (www.ISPI-USA.org)

39. Conspectus. • Taking a pledge of respect. • Lectures, videos and workshops. • Sensitivity training and role playing. • Anonymous feed-back from care receivers. • Rewards and penalties for behavior.

40. Conspectus. • Medical institutions are doing a good job and can set a trend for other work place environments. • Are you in touch with your own pluralistic self?