Question time: Are some Muslim women’s dress codes incompatible with surgery? A doctor responds to the Sun newspaper.
Last week’s exclusive in the Sun newspaper reported how an NHS consultant was suspended after revealing that a female Muslim surgeon had been in breach of theatre safety standards when she refused to remove her blood stained hijab. Was the surgeon violating the code of ethics and professional standards by observing her faith whilst practicing her specialty? Should her colleagues have been afraid of being penalized for breaching equality and diversity rules as claimed in the article? Should Muslim women be more willing to compromise their religious observation for patient safety or does this point to surgery being an unsuitable specialty for Muslim female doctors?
A recent article[1] in the British Medical Journal reported that women are under represented in surgical specialties even though most doctors in training are women. The article mentions that 3% of medical students are Muslim, many of whom are women who choose to wear the hijab. One of the factors that may deter them from pursuing a career in surgery or anaesthetics could be their inability to observe this religious requirement. A Department of Health Equality Impact Assessment, in 2010, looking at Uniforms and Workwear[2] found that some staff had had such difficulty with existing dress code provisions that they could no longer continue in their jobs.
The Royal College of Surgeons (RCS) is keen to increase the number of women in surgery and more specifically to ensure that flexibility in hospital trust dress policies can accommodate a religious dress code without breaching health and safety regulations. There has also been concern that without making the necessary provisions for flexible dress policies, NHS trusts could be in breach of UK law on equality and diversity.
The Department of Health subsequently worked with the Muslim Spiritual Care Provision in the NHS, which is hosted by the Muslim Council of Britain (MCB), to consider these concerns. The outcome was that the Department of Health has allowed local health trusts flexibility on their dress policies. There is, however, no clear national policy on theatre hijabs, only that NHS Trusts may negotiate what their provisions are such that these are in keeping with surgical and patient safety standards.
The British Islamic Medical Association (BIMA) is working on developing a national guideline on theatre hijabs[3] . Current provision for Muslim female surgeons observing the hijab include trusts advising their surgeons to bring their own theatre dedicated headscarves washed at 60oC or orthopedic hoods. There is neither standardized policy nor are all trusts aware of the Department of Health’s guidance.
The article in the Sun points to the potential mistrust that can develop within surgical teams when there is lack of awareness of national policy and flexibility in theatre dress codes. The resulting vulnerability amongst Muslim female surgeons, who are unaware of their being able to observe their religious requirements, may deter them from pursuing such careers. The article highlights a need for trusts to be more aware of the Department of Health’s guidance and for surgical teams to be adequately informed of such dress codes being not only within the remit of their profession but symbolizing the inclusiveness that the medical profession can offer. Enabling Muslim women to feel welcomed and comfortable within the theatre setting would mean more suitably skilled women would feel able to continue training within surgical specialties.
Dr Mehrunisha Suleman, DPhil student, University of Oxford
Ms Faatimah Esmail, ST5 Surgical Registrar
[1]http://careers.bmj.com/careers/advice/view-article.html?id=20016322 (last accessed 14th March 2016)
[2]http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/en/publicationsandstatistics/publications/publicationspolicyandguidance/DH_114751(last accessed 14th March 2016)
[3]https://www.facebook.com/BritishIMA/?fref=nf (Statement 8th March 2016)