Intended for healthcare professionals

Rapid response to:


Lessons for doctors from Jewish philosophy

BMJ 2006; 332 doi: (Published 02 February 2006) Cite this as: BMJ 2006;332:311

Rapid Response:

Keep all religions out of it. Lesson for the doctors is to improve their communication skills

It is imprecise to suggest that a religious philosophy will always
provide lessons for personal growth of doctors and spirituality alone will
enable doctors to take interest in patients as people. Religious beliefs
will not always enable a doctor to relate what he knows and how he can
help others relate to what he knows. For example because of the inherited
problems that is mostly complicated by individual interpretations of
religion in the Middle East a particular religious faith does not enable a
doctor to relate any better to a patient from a different religion. The
religious philosophy is open for personal interpretation hence leading to
misunderstanding and divisiveness. Individuals interpret religious
doctrine in ways that reflect their own personality and past experiences
as it is obvious in the first year medical student, Naomi Lear’s situation
(4th February BMJ 2006;332:311). Naomi is proposing that doctors should
take lessons from her religion to be “whole people” if they are to help
their patients as whole people, I think this a simplistic view that is
based on lack of experience of the wider world and perhaps it suggests how
hard medical students have to work in there first year at McGill
university with out appropriate mentoring. The view of religious or
cultural enrichment reminds me of what you can read in the Yiddish
translation of Shakespeare which carries on it “Translated and improved”.

A religious idealist may claim that lessons should be taken only from
Islam in treating mentally unwell individuals because historically they
have held the whole society responsible for the “kindly care” of the
insane, their hospitals had psychiatric divisions in Baghdad (750) and
Cairo (873); they also built special insane asylums in Damascus (800),
Aleppo (1270), and the Muslim-ruled Spanish city of Grenada. There is
undoubtedly a degree of subjectivity in the interpretation of this
historical narration and if you look at the state of psychiatric services
in Moslem countries, they are far from being ideal.

In prehistoric times, disease was believed to be caused by evil
spirits or forces. The concept of disease as a result of divine
intervention to test or punish the guilty or ungodly is well entrenched in
Judeo-Christian religion as reflected in the Book of Job and the exorcisms
practiced by Jesus in the New Testament. What are now understood to be
mental disorders were believed to result from possession by evil spirits
or demons that could be cast out by exorcistic rites or destroyed by
killing the possessed persons. Alternatively, one could be cured or
cleaned of illness by supplication, sacrifice, prayer, or ritualistic
appeasement of the gods. Belief in the power of prayer and other religious
and spiritual rituals to invoke divine intervention to alter the forces of
disease remains a component of most religious belief systems.

Differences in gender, education, language, race, ethnicity,
nationality, value system, religion and other significant cultural
differences between a patient and a doctor can impair communication and
may lead to misunderstandings unless the doctor is well trained in all
aspects of communication skills.

Through out history religious individuals have assumed the role of
healers with opposing overall outcomes. For example, the existence of many
traditional healers/ shamans in the native Canadian communities has not
particularly resulted in improving the health of the young or the older
members of these communities. Conversion to Christianity under the
influence of the settlers has not been much more helpful. We continue to
read about and see the health problems in these communities.

Many people, not excluding medical students, when they are under
stress, feel desperate or regretful, may return to religion as a source of
comfort and as a social resource.

I agree with Stephen J Goldie, medical student, University of Glasgow
(studentBMJ 2004;12:1-44 February ISSN 0966-6494), that his intention to
practice equal and non-judgmental medicine without religious beliefs
should not be disparaged. In order to be able to practice equal and
judgmental medicine requires ongoing training in communication skills.
Good communicators usually understand their patients very well by
attempting to understand their culture, belief and way of life. It is
extremely important that good communicating doctors are also aware of
their own religious beliefs, culture and moral modes operands, which at
times can have negative influence on the doctor patient relationship and
their communication. Erich Fromm (1900–1980), a Psychoanalyst, who
emphasized that culture and social setting influence an individual's
dynamics as much as instincts do. Through years of studying, he identified
the constructive and destructive roles that religion may play in
individual lives. Therefore there is less value in taking lessons from any
particular religious philosophy but rather understand the dynamics of your
patients’ and your own set of values and other relevant cultural

Competing interests:

Competing interests: No competing interests

09 February 2006
Mariwan Husni
Consultant Psychiatrist
Northwick Park hospital, Harrow HA1 3UJ