Answered by Ustadh Salman Younas
Question: I am a female medical student, and have some questions regarding my future job as a Muslim.
1. It is a part of the uniform policy at the hospitals to wear a short-sleeved coat. How should one deal with this dress policy?
2. How should one deal with male patients?
3. Should one strive to choose a specialty in which the contact with patients is minimal to avoid these circumstances?
Answer: assalamu `alaykum
1. If you are unable to get a dispensation for this, you would be permitted to wear a uniform that does not cover your forearms, since there are followable positions within our tradition that do not deem the forearms to be a part of female nakedness (`awra). [al-Mawsili, Ikhtiyar (1:152-53 ed. Arna’ut)]
2. The basis when it comes to medical treatment is that a patient from one gender should be treated by a practitioner from the same gender. However, scholars have always recognized that this is not always possible, and they provided general guidelines on when it would be permissible to treat someone of the opposite gender and how medical practitioners should interact with patients of the opposite sex.
It would be permissible for a woman to treat a male patient in the following situations:
-where other male doctors are not easily available, which includes the scenario where such doctors refuse or are unable to examine a patient, or where one is unable to make a referral to a male doctor for any valid reason.
-where the female doctor is more qualified and skilled in the required field that the patient requires an examination in.
-where the male patient is required to be seen on an emergency basis requiring immediate attention.
-where attempts at gender-selectiveness would pose a hardship to the medical professional in terms of being a determent to her career and reputation.
-in educational and training contexts.
These are some general considerations that are not meant to be all-inclusive and the specific ways they may play out for a given practitioner may differ from that of another. You are expected to exercise your best judgment as to what course of action you do take in light of your knowledge of your practice and situation. However, as you can see, there is significant leeway on the permissibility of doctors treating patients of the opposite gender.
As for the actual treatment of male patients, there are three things generally prohibited between unrelated members of the opposite sex that are relevant to this discussion: (a) physical contact (b) looking at nakedness (`awra), and (c) seclusion (khalwa).
-The basis is that physical contact is only permitted in cases where the female practitioner deems it required or useful to accurately ascertain the patients condition and provide effective treatment. This applies moreso to young and middle-aged men; the ruling of physical contact with elderly men (i.e. those not normally considered sexually active) in regions other than their nakedness (`awra) is more lenient.
-Touching the nakedness (`awra) of a male patient, particularly his private parts, should only be done when necessary and when a female practitioner cannot instruct another male practitioner/assistant to perform the examination to the standards that she would be able to. However, a female practitioner need not seek out a male colleague/assistant each time such a case arises (or even most times), since this is highly impractical. Rather, it is sufficient for her to exercise her own judgment based on her understanding/experience and in light of the considerations previously mentioned, such as reputation, career determent, medical liability, and so forth, when deciding whether she wants to instruct someone else to perform the examination. So, if she knows she works in a clinic where such assistance is not readily available, or where she is more qualified than others, or where it will negtively impact on her practice, she can directly proceed to examine the patient herself.
Looking at Nakedness
-The nakedness (`awra) of a man is the area extending from just below the navel up to and including the knees.
-This area can be viewed with the same conditions mentioned for physical contact since looking is a less serious matter than actually touching and since the latter usually entails the former.
-Efforts should be made to only expose the amount required to effectively examine the patient, and this area should be covered as soon as possible. This does not mean that one has to be quick in their examination, since a practitioner is expected to examine the patient properly regardless of the amount of time this takes.
-Seclusion (khalwa) is defined as a man and a woman who are of unmarriageable kin (mahram) being alone in an enclosed area in such a way that a third party cannot enter upon them or be aware of what they are doing.
-The basis is that seclusion is prohibited. However, because there are ethical and legal rights of privacy that a patient possesses, it would be permissible to remain in a secluded setting with a male patient when required.
-This permissibility is again based on the considerations mentioned at the very beginning regarding when a female practitioner can treat a male patient. If one is reasonably able to avoid such a situation then one should.
[Ibn `Abidin, Radd al-Muhtar (6:371); al-Kasani, Bada`i al-Sana`i (5:124); Fatawa Hindiyya (5:330)]
As I have mentioned previously, many of these points are general guidelines. They have a subjective element to them that different medical practitioners will understand and apply in different manners based on their own unique contexts. The key is to understand these points for precisely what they are, and then use your own common sense and experience to take appropriate courses of action. I cannot stress this enough. There is no need to make the issue difficult on yourself as there is sufficient leeway on this issue.
3. This is not necessary. It would return to your personal preference and what you feel most comfortable with. Yes, there are specializations that would place you in situations where male patients would have to be dealt with on a regular basis, but we still require women to be specializing in many of these areas to be of service to other women.
The only areas of specialization that should be absolutely avoided are those that deal specifically with one gender or require dealing exclusively with male nakedness. Urology would perhaps be an example of this.
Checked & Approved by Shaykh Faraz Rabbani