I'm going to probably open a can of worms here, but I want your opinion

[dspring]

I was just at a seminar a couple of weeks ago, and the person at one of the lectures commented that they are no longer make a heparin from beef, and it is all pork heparin. This triggered something in my mind, and mad me think if this is the case, can you actually give Heparin to someone of the Jewish, of Muslim faith. Since both faiths from what I understand forbid the use of pork. One nurse I used to work with had told me in the past if I ever come in as a patient you have to use the beef based Heparin. The more I have thought about this the more it really bothers me. I want to here your opinions.

D

[SmilingBluEyes]

There ARE alternatives to porcine insulin. And to not tell a person, knowing their potential or real objections to this to me, is highly unethical.

[LydiaNN]

I don't see an ethical alternative to telling the patient that the heparin is derived from porcine. Many of them may not consider it a concern, though:

http://www.memag.com/memag/article/articleDetail.jsp?id=158977:

"That was thought to cause a potential problem for Jewish, Muslim, and Seventh-day Adventist patients at this institution," says Doha Hamza, the coordinator of Muslim volunteers at the spiritual care service department at Stanford (CA) University Medical Center. "We investigated the issue with an imam and a Muslim doctor who concurred that the use of porcine heparin is lawful because of the chemical modification the product undergoes and the urgent need involved. Also the amount is so small, it doesn't fit the definition of consumption." Similar solutions might be found for insulin products derived from pork and porcine heart valves.

[Marie_LPN, RN, LPN, RN]

Many might not consider it a corncern, yet it's hard for them to decide if it is or not when someone chooses to withhold the information.

[Luv2BAnurse]

I am bothered by the little "heh" at the end of your post. Do you think you are pulling some clever joke over on someone by denying them information they should have? If you know the patient is Muslim or Jew, you need to tell them what you are giving them.

Not informing them out of ignorance is one thing, but knowingly violating one of their deeply held beliefs is quite another and I would hope you would rethink your actions.

I knew it was bound to happen sooner or later. Someone took something I typed totally out of context. I am not one of the nurses that knows the origins of every single medications that I give. I don't deem myself clever, but thank God, someone here is going to set me straight. Please forgive my "heh" as it was simply meant as an ending to my statement that I would give a med after I got it from Pharmacy- which the unspoken words were "I had NO idea where heparin came from except from a pharmacy". heh.

[JeanettePNP, MSN, RN, NP]

I still believe that it's the patient's job to disclose their religious views and to ask what's in the drug before they take it, if it's important to them. I don't see how it's an ethical violation for a nurse not to disclose information that she was not told is significant. If the patient noted their religious requirements in their chart and their wishes were not honored, that's an ethical violation. With everything that nurses have to do/remember, I don't expect them to keep my religious preferences in mind unless I explicitly tell them. There are many different customs/rulings/practices even within Judaism or Islam and a nurse can't be expected to keep track of them all. I don't see why you'd want to even go there as a nurse - do you want to be blamed now for inadvertantly causing a patient to violate a religious stricture that they didn't inform you of? As a protection for you, the standard should be that the onus is on the patient to inform the healthcare provider of their religious needs.

[Luv2BAnurse]

I agree.

A little disturbing to know that some know its origin, yet keep it to themselves ("heh"). I can only hope what goes around doesn't come around in some form or another.

I didn't know the origin until this thread. Sorry I "heh'ed". Honestly. I am not like that.

[LydiaNN]

I still believe that it's the patient's job to disclose their religious views and to ask what's in the drug before they take it, if it's important to them. I don't see how it's an ethical violation for a nurse not to disclose information that she was not told is significant. If the patient noted their religious requirements in their chart and their wishes were not honored, that's an ethical violation. With everything that nurses have to do/remember, I don't expect them to keep my religious preferences in mind unless I explicitly tell them. There are many different customs/rulings/practices even within Judaism or Islam and a nurse can't be expected to keep track of them all. I don't see why you'd want to even go there as a nurse - do you want to be blamed now for inadvertantly causing a patient to violate a religious stricture that they didn't inform you of? As a protection for you, the standard should be that the onus is on the patient to inform the healthcare provider of their religious needs.

The one time I was hospitalized, I was asked my religious affiliation. Ditto for my Mom, husband and son. I/they have never not been asked. I doubt anyone who responded was working on the assumption that religious affiliation was unknown, because in that case, of course you're not responsible for informing the patient of heparin's origin.

[nickola]

My family does not eat pork due to religious beliefs- & they would prefer to be informed. My in-laws abstain from all beef and pork products, and would really be upset if they weren't properly informed. They recently declined taking a supplement that had bovine testes extract in it. I think more care is taken if a person says they're "allergic" to something, but religious beliefs are important and it's not up to US to decide what's okay or what WE perceive as "right" for anyone- whether it be blood transfusions, meds, etc. Patients should be permitted to make informed decisions. My mother now says she is allergic to pork to avoid any misunderstanding- it seems to work better than saying it's for religious reasons, which I find disturbing- but that's a whole 'nother can of worms!!!

[firstyearstudent]

I wonder why posters consider the animal origin of a drug to be significant only to religious people. I'm an atheist and a vegetarian (for ethical reasons) and I'd certainly like to know if my drugs were animal derived and if there were alternatives.

Ooops! I see Student Girl already made this point.

[lauriearcher]

I would think you might want to know where Heparin comes from, as it is a VERY common drug given. And no, I dont believe it "comes" from the pharmacy.

[nickola]

"Saving a life is always preferable to its loss, even if it requires breaking a minor commandment."

well, some patients I've had, such as Christian Scientists may not agree w/the above statement; not sure what a "minor" commandment is either....

[JeanettePNP, MSN, RN, NP]

OK, then should there be a policy that "all patients should be informed of the origin of all drugs"? Or only the most common ones? Or only if the patient is known to belong to a religion that has a ban on pork products? Or only if the patient asks for that information? Since it can get very complicated as to exactly what ingredients a patient might be averse to and for what reason, I think the most sensible approach is to leave it up to the patient to make staff aware of what strictures s/he has, due to religious, philosophical or any other reasons.