Bringing Innovation and Compassion to Patients with Drug Dependency: An Islamic Perspective
Yasir Akhtar, TN Heart Clinic, Knoxville, TN; Umar Shakur, Insight Chicago, Chicago, IL; Omar Hussain, Pulmonary Medicine Associates, Chicago, IL; Sara Alattar, Loyola University Medical Center, Chicago, IL; Kanwal Ahmed, UT Southwestern Medicine Center, Dallas, TX; and Akbar Ali. Ahsan Arozullah and Amin Kholwadia, Darul Qasim College, Chicago, IL
Patients with drug dependency are one of the most challenging populations to care for due to high rates of recurrence, poor treatment compliance and societal stigma. The healthcare system’s response has led to further marginalization of these patients while failing to provide a holistic cure.
We present two unique patient cases that demonstrate the application of Islamic principles to the care of this marginalized population. Our first case is a patient who overdosed and was left abandoned at the hospital entrance, unconscious with endocarditis. The discussions focused on if it was “worth it” to treat the patient based on whether people should be held responsible for their behaviors or sins. As Muslim healthcare providers, we applied an Islamic principle-based (usūlī) approach that requires us to provide for those who seek care, independent of a patient’s prior mistakes or sins. From this perspective, we were motivated to search for and successfully created a novel method of directly removing the heart valve infection, and subsequently the patient successfully returned home safely. We explore the religious roots of developing this novel treatment resulting in better outcomes at lower costs for treating infections of the heart.
Why do healthcare providers marginalize these patients? Is there a loss of hope for cure or is care based on pre-judgment that the outcome of care will be futile? A solely outcomes-based (utilitarian) focus does not provide healthcare providers with the means to create a positive approach to these patients. The very name of “addicts” carries negative connotations. We propose a proactive approach when caring for these patients by treating them with optimism and the same compassion we use to treat patients independent of their illness or behavior. Reorienting providers to their primary responsibility of providing care, independent of outcome only, and reclassifying these patients as “drug dependent” may be important first steps.
Origins of the Opioid Crisis: Consequences of Greed
We explore the historical development of pain scales, falsified data and pharmaceutical greed that contributed to and drove the opioid crisis of which our patients are victims.
We reintroduce the Islamic concept of “rahma” or compassion to ground the physician when treating patients. The principle-based (usūlī) approach dictates that a provider should treat each patient with compassion, even if they are considered “sinners.” We use the example from the life of the Prophet Muhammad (peace be upon him) who showed compassion even to the hypocrites in Medina, despite full knowledge of their ill intentions. Despite knowing that these people were “sinners,” they were not marginalized and were still included in the community. The ethics and value of the Muslim physician dictates that excellent care must be provided to all. This approach will ultimately avoid marginalization and “judgment” of others.
Our second case is a patient who injected drugs and had a confirmed infection on the heart valve while being 24 weeks pregnant. The status of the fetus was unknown due to ongoing infection. Local physicians would not perform the procedure, nor would the regional academic center hence the patient was transferred to our tertiary care center and was successfully treated.
Implementing Beneficial Interventions: Billing and Coding Challenges
Marginalization further exists in this patient subset since Current Procedural Terminology (CPT®) codes are not yet in place for performance of beneficial procedures and treatments. As these procedures are not reimbursed, physicians are reluctant to perform them. We explore the development of billing and coding strategies with emphasis on the ethical pitfalls and factors that drive their development in dictating value.
A Holistic View to Address Addiction
We explore the psychological and spiritual origins and challenges that exist in treating addiction with an aim to cure patients of addiction. Many hospitals have removed chaplaincy programs, one of the few sources of compassion and comfort to these patients.
Current approaches to addressing the epidemic typically focus on restricting supply, monitoring drugs, reducing demand, or increasing access to treatment like antidotes.
Genetics, environment, and early childhood trauma have all been implicated in increasing susceptibility to addiction. Yet, we have overlooked a crucial perspective: the spiritual dimension, and addressing the deeper spiritual crisis is often absent from the discussion.
The path to addiction often begins with an intention to escape from the pressures of reality. Islam offers profound and practical guidance on how to manage life’s problems instead of fleeing from them. The teachings of Islam encourage self-awareness, personal responsibility, preservation of a healthy mind, and a deep connection with the Creator, which can serve as a foundation for healing and recovery.
We present two unique patient cases that demonstrate the application of Islamic principles to the care of this marginalized population. Our first case is a patient who overdosed and was left abandoned at the hospital entrance, unconscious with endocarditis. The discussions focused on if it was “worth it” to treat the patient based on whether people should be held responsible for their behaviors or sins. As Muslim healthcare providers, we applied an Islamic principle-based (usūlī) approach that requires us to provide for those who seek care, independent of a patient’s prior mistakes or sins. From this perspective, we were motivated to search for and successfully created a novel method of directly removing the heart valve infection, and subsequently the patient successfully returned home safely. We explore the religious roots of developing this novel treatment resulting in better outcomes at lower costs for treating infections of the heart.
Why do healthcare providers marginalize these patients? Is there a loss of hope for cure or is care based on pre-judgment that the outcome of care will be futile? A solely outcomes-based (utilitarian) focus does not provide healthcare providers with the means to create a positive approach to these patients. The very name of “addicts” carries negative connotations. We propose a proactive approach when caring for these patients by treating them with optimism and the same compassion we use to treat patients independent of their illness or behavior. Reorienting providers to their primary responsibility of providing care, independent of outcome only, and reclassifying these patients as “drug dependent” may be important first steps.
Origins of the Opioid Crisis: Consequences of Greed
We explore the historical development of pain scales, falsified data and pharmaceutical greed that contributed to and drove the opioid crisis of which our patients are victims.
We reintroduce the Islamic concept of “rahma” or compassion to ground the physician when treating patients. The principle-based (usūlī) approach dictates that a provider should treat each patient with compassion, even if they are considered “sinners.” We use the example from the life of the Prophet Muhammad (peace be upon him) who showed compassion even to the hypocrites in Medina, despite full knowledge of their ill intentions. Despite knowing that these people were “sinners,” they were not marginalized and were still included in the community. The ethics and value of the Muslim physician dictates that excellent care must be provided to all. This approach will ultimately avoid marginalization and “judgment” of others.
Our second case is a patient who injected drugs and had a confirmed infection on the heart valve while being 24 weeks pregnant. The status of the fetus was unknown due to ongoing infection. Local physicians would not perform the procedure, nor would the regional academic center hence the patient was transferred to our tertiary care center and was successfully treated.
Implementing Beneficial Interventions: Billing and Coding Challenges
Marginalization further exists in this patient subset since Current Procedural Terminology (CPT®) codes are not yet in place for performance of beneficial procedures and treatments. As these procedures are not reimbursed, physicians are reluctant to perform them. We explore the development of billing and coding strategies with emphasis on the ethical pitfalls and factors that drive their development in dictating value.
A Holistic View to Address Addiction
We explore the psychological and spiritual origins and challenges that exist in treating addiction with an aim to cure patients of addiction. Many hospitals have removed chaplaincy programs, one of the few sources of compassion and comfort to these patients.
Current approaches to addressing the epidemic typically focus on restricting supply, monitoring drugs, reducing demand, or increasing access to treatment like antidotes.
Genetics, environment, and early childhood trauma have all been implicated in increasing susceptibility to addiction. Yet, we have overlooked a crucial perspective: the spiritual dimension, and addressing the deeper spiritual crisis is often absent from the discussion.
The path to addiction often begins with an intention to escape from the pressures of reality. Islam offers profound and practical guidance on how to manage life’s problems instead of fleeing from them. The teachings of Islam encourage self-awareness, personal responsibility, preservation of a healthy mind, and a deep connection with the Creator, which can serve as a foundation for healing and recovery.