Muslim Nurses Administering Haram Medications

[CaribMuslimah, RN]

may the peace, mercy, and blessings of god be upon all the muslims. blessed ramadan!

an issue that is tugging away at my conscious is: medication ingredients

all praise due to god, i recently accepted a position and will be working in a few days, god willing. in seeking the reward in the hereafter, i don't want to trade one good deed (working as a nurse) and use it to (even unintentionally) commit an evil deed (giving medications with forbidden substances, regardless of the patient's religion).

how do you other muslim nurses out there deal with this? haraam is haraam is haraam! is there such a thing as refusing to administer medication? is there a way to obtain the ingredients in all medications? when in doubt, should i just make du'aa'?

[CaribMuslimah, RN]

thank you. i do plan on volunteering for a few masajid (mosques). many do offer healh care services, but do so on a no-fee basis.

my goal is not to impose my religion on anyone, because there is no compulsion in the religion of islam, meaning i cannot force anyone to be a muslim. and i don't want to.

for everyone else, the point wasn't about whether or not i should give medication in general, or whether giving haram medications are acceptable. the question was and still is: how do muslim nurses deal with the dilemma.

for the most part, i agree with this statement. i will, however, disagree with your contention that nursing may "not be for you." i don't see where the op is trying to convert the masses to islam, i simply see that she is trying to ensure a safe place to practice with regards to her beliefs.

clearly the op has shown that they are interested in being a nurse and has gone to school to be a nurse. this person will need to go into an area where their beliefs don't conflict with patient care (or at least if they do conflict, to a very minimal extent). i am not very familiar with haram, but i would imagine that somewhere out there someone/something has a guide for medical personnel.

that being said, i wonder if the op has looked into something like being a parish nurse? many larger churches hire nurses to assist their parishioners. i am not sure if mosques do the same or not, but it would be worth looking into in my opinion.

it is really no different than being a strict jehovah's witnesses, christian, jew, etc, one just needs to find a job that "jives" with their beliefs. i'm a strict vegetarian, but i don't forbid my patients from eating meat or giving them heparin or ivig. i probably wouldn't accept certain meds/treatments for myself, but i don't let my beliefs affect patient care. the op is obviously different from me in that aspect, but that doesn't mean that she wouldn't make a good nurse.

there are a lot of jehovah's witnesses at my hospital, but most of them do not work in areas where blood is frequently administered. icu, er, or, transplant floors, etc, would not be a good match for them, and they don't tend to flock to these areas. if one is a strict muslim, i would suggest staying away from areas where lots of grafts are used such as burn units and ors. i think there's a niche for nearly every nurse out there. sometimes it just takes longer to find it.

[CareteamRN70]

I understand the dilemma, and several of my classmates and I have debated it in ethics class, but unfortunately I am afraid our answers would not apply to the OP. I would never knowingly administer a medicine or treatment to a patient that was prohibited to them by religion or cultural belief. If there was no alternative available, at that point I believe allowing the patient to make an informed (as in making sure they had all the information, teaching, and outcomes) decision probably with the help of their spiritual guidance (Rabbi, Priest, Imam, etc). On the other hand, If I was in the patient role I would not want needed medicines or treatments with held on the basis that the RN held beliefs that those meds or tx's were not allowed by their religion. I would like to believe that "if" I was a patient and my nurse was at conflict with my treatments that another nurse would be given those duties. I would still respect the original nurse for her beliefs, and be grateful to the 2nd nurse for actually helping me. I would never ask another to compromise their beliefs for me, just as i would not compromise my beliefs for them but in the end (and please take this with a grain of salt as i am still in school and maybe just don't know better yet) but I see the art of nursing being patient focused, seeing to their needs, being their advocate, giving them the best outcome choices possible. To the OP I hope you find the exact guidance you seek, and If you have embraced nursing as strongly as you have taken time to put thought into your current questions then I feel you will be (or are) a very conscientious nurse which in turn makes for a very good nurse.

[CaribMuslimah, RN]

again, i wasn't opening the floor for people to express their ill-founded views on my religious practices. once again, i was asking muslim nurses how they deal with the issue.

i am not asking my patients to suffer...that would be against my religion. i am not going to compromise my patient's care.

the fact is, life is all about choices. i base my choices on the foundation of my religion, and i am entitled to do just that. i am entitled to work as a nurse as a muslim, and i am doing just that.

i wasn't asking for (non-muslims especially) to issue fatwa on haram medications. i was asking a question to get a general idea about a particular issue.

well, there is no way of looking up all the ingredients in all the meds you give every shift for every patient. so, you probably need to choose somewhere to work where patients take their own meds, or you don't dispense meds. that's if you decide it is immoral for you to do so. you need to talk to you clergy about it for guidance. they can probably help you more than this board regarding what is right or wrong for you to do...whatever you decide you can't compromise patient care or disregard a doctor's order regardless of your religious beliefs. (!!!) for example, i don't believe in abortion. so i didn't apply at planned parenthood. i am a strict vegan, so i wouldn't work as an employee health nurse at a slaughterhouse. but i administer drugs that have animal products--it's unavoidable, unfortunately. i figure i do the best i can myself with being a strict (ethical) vegetarian. but i can't "not give heparin" or whatever, because it has animal products in it. well, i could decide that, but then i would have to not work in a hospital setting. and, if that's what i determined, then that's what i would do: not work there. you can't have everything....and patient care and everyone around you can't suffer (administering all your meds) because of your religious beliefs. don't mean to sound course, just my take on things. good luck with whatever you decide!

[CaribMuslimah, RN]

thank you very much for your thoughtfulness. i do believe that our work as nurses is absolutely patient-oriented, but i won't do something just because it falls within what is normal in the field of nursing if it falls out of the realm of islam. and i have that right.

i do not plan on witholding patient medication. i don't think i ever said that.

god willing, there are other nurses (even lvns) who can administer the rx's and have no moral dilemmas about which medications they can and cannot distribute.

as far as asking others to compromise for my beliefs...we all make compromises. i'm not asking the facility to be turned into an islamic center. i'm in a secular country and i get it.

i put lots of thought into all my actions, and i became a nurse by the will and grace of god. i love to care for people, and it's second nature to me. many of you here who are crying foul might actually be ones who would appreciate my services if you can get over your own personal issues. if you were my patients, chances are you wouldn't even know i was grappling with moral and religious dilemmas.

i understand the dilemma, and several of my classmates and i have debated it in ethics class, but unfortunately i am afraid our answers would not apply to the op. i would never knowingly administer a medicine or treatment to a patient that was prohibited to them by religion or cultural belief. if there was no alternative available, at that point i believe allowing the patient to make an informed (as in making sure they had all the information, teaching, and outcomes) decision probably with the help of their spiritual guidance (rabbi, priest, imam, etc). on the other hand, if i was in the patient role i would not want needed medicines or treatments with held on the basis that the rn held beliefs that those meds or tx's were not allowed by their religion. i would like to believe that "if" i was a patient and my nurse was at conflict with my treatments that another nurse would be given those duties. i would still respect the original nurse for her beliefs, and be grateful to the 2nd nurse for actually helping me. i would never ask another to compromise their beliefs for me, just as i would not compromise my beliefs for them but in the end (and please take this with a grain of salt as i am still in school and maybe just don't know better yet) but i see the art of nursing being patient focused, seeing to their needs, being their advocate, giving them the best outcome choices possible. to the op i hope you find the exact guidance you seek, and if you have embraced nursing as strongly as you have taken time to put thought into your current questions then i feel you will be (or are) a very conscientious nurse which in turn makes for a very good nurse.

[SuesquatchRN, BSN, RN]

This article is germane to the discussion in a sideways way. The physician certainly asked the patient what he wanted.

http://health.nytimes.com/health/guides/disease/aortic-stenosis/news-and-features.html

I have to say that I am surprised at the judgmental nature of many of these posts. The OP asked a simple question of others of her faith and many have taken the opportunity to express extremely negative opinions of her religious beliefs. I find the question fascinating.

We are taught, as nurses, to respect cultures and belief systems that differ from our own. Why can we not extend the same courtesy to our sisters and brothers in nursing?

[SolaireSolstice, BSN, RN]

Perhaps because we were also taught as nurses to leave our personal opinions at the door of the patient's room.

However, this isn't about that is it? My understanding is although this nurse may not be able, due to her beliefs, administer some medications, she can find someone else to do it, or maybe find an alternate place to practice as a nurse that won't have this issue.

[CaribMuslimah, RN]

i see where you're going with that article, and my first instinct is: i do know that us muslims are expected to use alternatives if they exist, so the pig valve would have been out of the question. but, the best and safest answer is, "allah knows best."

it's sad, but i'm far from surprised at many of the posts. unfortunately, most of the ill-treatment i have experienced in the field come not from my patients, but from nurses. i live in the south, and sometimes i get nervous about what the patient would say when they see me. more often then not--the patient would mind their manners and nurses flaunt their ignorance.

so many are responding that they are willing to lay aside their personal beliefs for another... are you really? what happens if i end up your patient? are you just going to smile to my face and talk behind my back? does that make you feel better? do you think it makes everything okay?

either way, thank you so much suesquatchrn for your help. i actually have decided to do some research on islam and mental health (my previous research was also in mental health), and i think i may be able to network with other muslim health care workers for some advise. but please, as you find more information, please please post. i love to learn.

thank you again

this article is germane to the discussion in a sideways way. the physician certainly asked the patient what he wanted.

http://health.nytimes.com/health/guides/disease/aortic-stenosis/news-and-features.html

i have to say that i am surprised at the judgmental nature of many of these posts. the op asked a simple question of others of her faith and many have taken the opportunity to express extremely negative opinions of her religious beliefs. i find the question fascinating.

we are taught, as nurses, to respect cultures and belief systems that differ from our own. why can we not extend the same courtesy to our sisters and brothers in nursing?

[CaribMuslimah, RN]

maybe you were taught as a nurse to set aside your beliefs. if they taught that in my nursing school, i overlooked it, didn't hear it, and am glad that i don't follow that point-of-view. i don't believe that's a great approach on life in general, and for the practice of nursing in particular. every action has a reason behind it. but that's neither here nor there...

i'm not leaving my job, but thank you for the suggestion. the facility is not set up like typical hospital units, and i may not actually have to administer (most) medications to the patients. maybe...

perhaps because we were also taught as nurses to leave our personal opinions at the door of the patient's room.

however, this isn't about that is it? my understanding is although this nurse may not be able, due to her beliefs, administer some medications, she can find someone else to do it, or maybe find an alternate place to practice as a nurse that won't have this issue.

[SuesquatchRN, BSN, RN]

Perhaps because we were also taught as nurses to leave our personal opinions at the door of the patient's room.

However, this isn't about that is it? My understanding is although this nurse may not be able, due to her beliefs, administer some medications, she can find someone else to do it, or maybe find an alternate place to practice as a nurse that won't have this issue.

Where were we taught that? We have been taught not to be judgmental and, if we can not transcend our feelings on the issue, to hand off care to someone else if possible.

Certainly med surg is out for the OP because the omnipresent heparin is a deal-breaker. As you said, she needs to find an area in which she can practice without compromising her soul. She therefore asked persons of her faith, or at least respectful of her faith, to provide input so that she can resolve her conflict. Instead she has mostly gotten grief.

[CaribMuslimah, RN]

you miss the point. i don't know how to make this any more clear: i am not forcing my beliefs on my patients. i am trying to find a way to make sure the patient is treated within the leagal and ethical framework outlined by my board of nursing while not compromising my religious beliefs. *whew* i'm exhausted from making that point over, and over, and over.

i never said non-muslims don't face difficult situations. in fact, it wouldn't be proper for me to go in circles and respond to the rest of your comment. you don't get what i was asking. the question wasn't intended for you. i don't mind non-muslims answering, but answer with respect, common sense, and understanding. your issue seems to be with the fact that i am muslim, not with anything else, because nothing you said had to do with my question.

geez. critical thinking was beat into my head during nursing school. reading questions carefully was an integral part of nclex.

so if i believe that the true cure contains haraam, then i can give you heparin or pork insulin because i'm looking out for the patient? i'm sure you'd throw an absolute fit if i forced my beliefs on you, why should you get to force your beliefs on me if i'm your patient?

just because i'm not muslim doesn't mean i don't face situations where i have to put my beliefs aside for the patient. there's a lot of days at work where i'm doing things that i'd come back and haunt my family if they allowed done to me. would you want a christian scientist as your nurse, refusing to give you any medical care because that's their belief? i'm ok with blood transfusions, should jw's be forced to undergo them because i think it's ok and i'm their nurse that day? perhaps if you aren't able to put your beliefs aside for the good of the patient, then nursing is not for you. because it is not about you or your beliefs, it's about the patient's beliefs.

[CaribMuslimah, RN]

that's what i was trying to say, and maybe they will listen to you since they don't have an issue with your religion.

btw ppl, islam itself is not on trial here. my beliefs are not on trial here. the question was simple: how do you deal? thank you once again sesquatchrn. yes, i realize med-surg is out of the question; i believe there are alternatives out there in the facility i will be working...i just don't know for sure as yet. so i pray.

nb: i have read elsewhere (on muslim websites) that there are many muslims who won't join this site because of the attitudes of so many on this board. at present, i don't plan on leaving just because many of you have an issue with me and what i do. i am a nurse. my goal is to care for my patient, not to convert them to islam or to enforce islam on them (ie, i'm trying to find a way for my patients to get their medication). silly that any of you would think otherwise.

where were we taught that? we have been taught not to be judgmental and, if we can not transcend our feelings on the issue, to hand off care to someone else if possible.

certainly med surg is out for the op because the omnipresent heparin is a deal-breaker. as you said, she needs to find an area in which she can practice without compromising her soul. she therefore asked persons of her faith, or at least respectful of her faith, to provide input so that she can resolve her conflict. instead she has mostly gotten grief.

[SolaireSolstice, BSN, RN]

Where were we taught that? We have been taught not to be judgmental and, if we can not transcend our feelings on the issue, to hand off care to someone else if possible.

Certainly med surg is out for the OP because the omnipresent heparin is a deal-breaker. As you said, she needs to find an area in which she can practice without compromising her soul. She therefore asked persons of her faith, or at least respectful of her faith, to provide input so that she can resolve her conflict. Instead she has mostly gotten grief.

In that part in not to be judgemental. The commitment to nursing in that we are there for the patient, not for ourselves. I was actually quoting one of my instructors when I put the "leaving our personal opnions at the door". This is more than a personal opinion issue, it is a true conflict of faith verses practice. I was trying to say, and may have said poorly, exactly what you are saying. Just like previous examples given about Johovah's Witnesses not being able to transfuse blood. The OP is looking for a resolution to the conflict. The alternatives I gave were valid. It's great that the OP feels supported by the facility. I'm sad the OP does not feel supported by this community. I personally support the OP in her search to find resolution to this conflict.