The physician-patient interaction is both professional and social. The bedside visit fulfills the brotherhood
obligation of visiting the sick. The human relationship with the patient comes before the professional technical relationship.
It involves 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, 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, nasiihat
for the patient, and reminding the patient about 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 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 about the patients and avoid evil or obscene words. They must observe the rules of lowering the gaze, and
seclusion. Caregivers must have an attitude of humbleness. 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 dua for the patients because qadar
can only be changed by dua. They can make
ruqya for the patients by reciting the two mu’awadhatain
or any other verses of the Qur’an.
must seek permission 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 basmalah. Everything should be predicated with the formula inshallah, if Allah wishes. 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 awrat as much
as possible. However, the rules of covering are relaxed because of the necessity, dharurat,
of medical examination and treatment. The benefit of medical care takes precedence over preventing the harm inherent in uncovering
awrat. When it is necessary to uncover 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 awrat is uncovered. They should
seek permission from the patient before they uncover their 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; learning clinical
skills by examining other students; and the 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. 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 ‘awrat
or touch a patient. The conditions that are accepted as constituting dharuurat
are: skills and availability. The preference between a Muslim of opposite gender vs non-Muslim of same gender depends on the
Dealing with the family
Visits by the family fulfill the social obligation of joining the kindred and should be
encouraged. The family are honored guests of the hospital with all the shari’at
rights of a guest. The caregiver must provide psychological support to family because they are also victims of the
illness because they are 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.