Mental Health During Crisis: Development and Evaluation of the Post-disaster Spiritual Coping Scale in Turkey

This research presents the detailed development of the post-disaster spiritual coping scale, which aims to evaluate post-disaster spiritual coping processes. The study's first step in developing the scale has been to review the literature on the effects disasters have on the lives of individuals alongside spiritual coping's role in this process. The study has also taken into account the steps required when developing a scale. Data were initially collected from individuals who'd experienced the February 6 Kahramanmaraş earthquake, after which the scale items were created. In line with expert opinions, a pilot application of the scale was applied before the items took their final form. During the data collection phase, data were collected three times (N1 = 388, N2 = 194, N3 = 94). Exploratory factor analysis (EFA) was then performed, and the scale was concluded to consist of one dimension and 13 items. Afterward, confirmatory factor analysis (CFA) was performed over the 13-item scale, confirming the results from the previous analysis. The CFA results also showed acceptable goodness-of-fit values to have been obtained (χ2/df = 2.200; RMSEA = 0.061; SRMR = 0.024; CFI = 0.933; GFI = 0.908). At the same time, each item in the scale was concluded to have a sufficient loading value. As a result of the analysis of internal consistency for the scale, Cronbach's alpha was found to be 0.950. Significant values were also obtained as a result of the criterion validity analysis for the developed scale. In conclusion, the final version of the post-disaster spiritual coping scale has been developed and validated, with the reliability and validity coefficients of the scale being found sufficient. This scale can be used as a powerful tool for evaluating the spiritual coping mechanisms of individuals who are being affected by disaster.

A Framework for Examining Bioethical Issues from a Sunni Perspective: Maslaha

All religions should develop convincing responses to emerging bioethical problems stemming from medical and technological advancements. Additionally, believers need to know their faiths' interpretations of bioethical issues to be able to make medical decisions in line with their religious values. Therefore, Islamic bioethics should provide Muslims with conclusive and credible answers regarding newly rising problems in health care by revisiting the religious norms and decrees. However, the diversity in the Islamic denominations, the traditionalist aspect of the Sunni jurisprudence demanding strict compliance with the scriptural texts, the lack of unanimously accepted authority, and the limited number of academic works in Islamic bioethics (at least in English) complicate exploring new standards or rules for new ethical matters. In this view, the present paper aims to delineate two primary Islamic theological schools and propose al-Ghazali's maslaha as a general framework to analyze bioethical issues in the Sunni tradition. Maslaha allows exercising discretion in light of the protection of five fundamental values: religion, life, reason, lineage, and property. Maslaha has the potential to enable Sunni Muslims to appraise contemporary ethical questions, concerns, and dilemmas through an Islamic view and make more autonomous decisions by having religious guidelines.

Muslim Jurisprudence on Withdrawing Treatment from Incurable Patients: A Directed Content Analysis of the Papers of the Islamic Fiqh Council of the Muslim World League

This study investigates the views of contemporary Muslim jurists about withdrawing treatment of the terminally ill. Its aim is threefold. Firstly, it analyses jurists' views concerning core themes within the process of withdrawing treatment. Secondly, it provides insight into fatwas about withdrawing treatment. Thirdly, it compares these views with current medical standards in Europe and the Atlantic world on withdrawing treatment. The data consisted of six papers by Muslim jurists presented at the conference of the Islamic Fiqh Council in 2015. We conducted a directed content analysis (DCA) through a predetermined framework and compiled an overview of all previous fatwas referred to in the papers, which are also analysed. The results show that the general consensus is that if health cannot be restored, treatment may be withdrawn at the request of the patient and/or his family or on the initiative of the doctor. The accompanying fatwa emphasizes the importance of life-prolonging treatment if this does not harm the patient. It becomes apparent in the fatwa that the doctor has the monopoly in decision-making, which is inconsistent with current medical standards in Europe. Managing disclosure in view of the importance of maintaining the hope of Muslim patients may challenge the doctor's obligation to share a diagnosis with them.

Spiritual Coping in Family Caregivers of Patients With Advanced Cancer: A Cross-Sectional Study

CONTEXT

Family caregivers face significant challenges when providing care to individuals with advanced cancer. Spiritual coping strategies may support caregivers in addressing these challenges.

OBJECTIVES

We evaluated spiritual coping levels among Chinese family caregivers of patients with advanced cancer and explored associated factors.

METHODS

This cross-sectional study recruited 358 family caregivers of patients with advanced cancer. The Spiritual Coping Scale was used to evaluate spiritual coping levels, while various scales, including the Caregiver Reaction Assessment Scale, General Self-Efficacy Scale-Schwarzer, and Perceived Social Support Scale, were used to identify influencing factors. T-tests and analysis of variance were used for group comparisons. Pearson's correlation and multivariate linear regression were used to analyze the associated factors.

RESULTS

Chinese family caregivers of patients with advanced cancer had moderate spiritual coping levels. Differences in spiritual coping levels were observed in sex, religion, and the presence or absence of anxiety and depression (p < 0.05). Women and caregivers who identified as religious had higher levels, while those with anxiety or depression had lower levels. Spiritual coping was positively correlated with self-efficacy and spiritual health (p < 0.01). Multiple linear regression analysis revealed that religion, anxiety, depression, self-efficacy, and spiritual health were statistically significant associated factors for spiritual coping scores, explaining 43.3% of the variance in scores (F = 53.769, p < 0.001).

CONCLUSION

The spiritual coping of Chinese family caregivers should be considered by health care providers, who should focus on alleviating their anxiety and depression while improving self-efficacy and spiritual health, especially among nonreligious caregivers.

Lived Religion in Religious Vaccine Exemptions

This essay explores a more inclusive and equitable interpretation of "religion" within the context of religious vaccine exemptions. The existing literature critiques the prevalent interpretation of the meaning of religion in religious exemption cases, but frequently overlooks the importance of incorporating the concept of "lived religion." This essay introduces the concept of lived religion from religious studies, elucidates why this lived religion approach is crucial for redefining "religion," and illustrates its application in the domain of religious vaccine exemptions. The author contends that broadening the meaning of religion by employing the concept of lived religion would promote a more inclusive and equitable implementation of religious vaccine exemptions.

A Christmas Miracle Pantoum: Weighing Reality and Hope

Between reality and hope, who am I to questionThe cortical ribbon dancing through your brainYour family praying for a Christmas miracleVisions of sugar plumsThe cortical ribbon dancing through your brainUp on the house top, click click clickVisions of sugar plumsFaithful friends who are dear to us, will be near to us once moreUp on the housetop, click click clickTriphasic waves on EEGFaithful friends who are dear to us, will be near to us once more,Including your deceased nana baking cookies in the hallwayTriphasic waves on EEGEvery time a bell rings, an angel gets its wingsIncluding your deceased nana baking cookies in the hallwayIn your conversations with usEvery time a bell rings, an angel gets its wingsYour wife asks if we have any other possible explanationIn our conversations with you, weTell tales of 14-3-3 and RT-QuICYour wife asks if we have any other possible explanationDown through the chimney with good St. NickTell tales of 14-3-3 and RT-QuICYour son wonders if we can try a Hail Mary pass treatmentDown through the chimney with good St. NickI have no new answers for youYour son wonders if we can try a Hail Mary pass treatmentI pass the giftshop display of the Virgin with ChildI have no new answers for youAs I finish my shift, step into the silent nightI pass the giftshop display of the Virgin with Child,Santa Claus is coming to townAs I finish my shift, step into the silent nightI think of Ms. C, ambulatory with 5/5 strength, disregarding her cervical cord astrocytoma haloSanta Claus is coming to townMy conversation with Mr. L, language spared after complete left MCA infarct1I think of Ms. C, ambulatory with 5/5 strength, disregarding her cervical cord astrocytoma haloDefying expectationsMy conversation with Mr. L, language spared after complete left MCA infarct1These miracles are not lost to meDefying expectations'Tis the season where all things are possibleThese miracles are not lost to meSo hang your stockings and say your prayers'Tis the season where all things are possibleYour family praying for a Christmas miracleSo hang your stockings and say your prayersBetween reality and hope, who am I to question.

Feelings, Difficulties and Attitudes in relation to Fasting: A Qualitative Study on Spiritual Coping Among Turkish Patients with Type 2 Diabetes

This study aims to reveal the feelings, difficulties, attitudes, and spiritual coping status of Turkish patients with Type 2 diabetes mellitus toward fasting during Ramadan. The sample of this descriptive qualitative study consists of 14 patients diagnosed with Type 2 diabetes. We determined two main themes and relevant sub-themes. The first was "the feelings and difficulties experienced due to diabetes mellitus" with the sub-themes of "negative emotions" and "difficulties in fasting." The second theme was identified as "religious and spiritual coping" with the sub-themes of "believing the disease comes from God," "having difficulty in adhering to disease-specific practices while fasting," and "feeling that fasting facilitates coping and provides relief." In conclusion, it was determined that the patients continued to fast despite the difficulties and that fasting facilitated coping and provided relaxation.

St. Zenobius, the Patron Saint of Injured Children and Non-accidental Trauma

St. Zenobius (337-417), second only to John the Baptist as a Patron Saint of Florence, revived a 5-year-old boy who appeared to be dead after he was struck by an ox cart, one of his several acts of resurrection for which he was revered. His miracles inspired some of the greatest artists of the Florentine Republic, including Ghiberti and Botticelli. Celebrated from Late Antiquity as protector of the city, St. Zenobius might also be considered the guardian of injured children. But it wasn't the only instance where he had to revivify an injured child: a boy died while he was entrusted to the saint's care, a circumstance that today would qualify as non-accidental trauma (NAT) from neglect and prompt an investigation from the police and child protective services.

Religious and Spiritual Coping Elements in Dealing with Chronic Diseases: A Qualitative Exploration of the Perspectives of Older Iranian Zoroastrians

Religiosity is a desirable alternative coping strategy for many people when facing negative life events including age-related infirmities and stressors. Religious coping mechanisms (RCMs) have been investigated meagerly with regard to religious minorities around the world and, to the best of current knowledge, no study has been conducted on Iranian Zorostrians to explore their religious coping mechanisms in dealing with age-related chronic diseases. This qualitative research, therefore, was aimed to canvas perceptions about RCMs that are utilized by Iranian Zoroastrian older adults to deal with chronic diseases in the city of Yazd, Iran. Semi-structured interviews were conducted with purposefully selected fourteen Zoroastrian older patients and four Zoroastrian priests in 2019. The main extracted themes included performing certain religious behaviors and having sincere religion-based beliefs as employed mechanisms for better coping with their chronic diseases. Prevalent dilemmas/barriers with mitigating impact on the coping capacities in dealing with a persistent illness was another predominant identified theme. Identification of RCMs that religious and ethnic minorities are using to better confront diverse life events, such as chronic diseases, could pave the path to expand new approaches in planing sustainable disease management and proactive quality of life improvement initiatives.

Investigation of the Relationship Between Spiritual Coping Styles and Hope Levels in Mothers with Disabled Children in Turkey

The birth of a child is a process in which family life and daily routines undergo significant changes and adjustments. This study aims to investigate the relationship between spiritual coping styles and hope levels in mothers with disabled children. The study was conducted between January and April 2022 with mothers whose children were enrolled in a rehabilitation center of a district located in eastern Turkey. The target population of the study was 110 mothers who had children enrolled in the rehabilitation center. The sample of the study was 102 mothers who agreed to participate in the study. Data were collected through the Personal Information Form, the Trait Hope Scale, and the Maternal Spiritual Coping Scale. Spiritual coping mean scores were high in mothers who had a female disabled child, did not have any other disabled children, received support from the state for their child's care, did not ignore their other children's care due to the special condition of the disabled child and did not feel guilty, and were worried about their children's future. The difference between the mean scores was statistically significant (p < 0.05). Hope mean scores were found to be high in women who had children with physical and hearing disability, were illiterate, had a low economic condition, and received psychological support for the condition of their children. The difference between the mean scores was statistically significant (p < 0.05). A positive relationship was found between maternal spiritual coping levels and hope levels. In-line with this result, it is recommended to organize programs to help mothers to accept their children's condition and cope with their situation.

[Islam and assisted reproduction treatments: an empirical study on the relationship between science and religion in Tangier and Barcelona.]

In recent decades there have been significant developments in assisted reproduction techniques, which have aided couples with difficulties in having children. These techniques have been well received in different parts of the world, and Muslim countries have been no exception. Adopting sociologist Michèle Lamont's theoretical perspective on "boundaries", semi-structured interviews were conducted with 20 health professionals and Islamic community leaders in the cities of Tangier and Barcelona during 2022. The aim of this article is twofold: first, to analyze how key actors in the Muslim community conceive of the relationship between Islam and science; second, to explain how this understanding is negotiated in relation to assisted reproduction treatments. The article concludes with a consideration of the complexities related to drawing the line between the positions of science and religion, and emphasized the importance of examining empirical cases in order to better capture the complex relationship between these two spheres and gain a deeper understanding of existing bioethical debates.

Spiritual Coping Among Families of Children With Cancer: A Qualitative Study

The impact of a childhood cancer diagnosis precipitates caregiver's engagement in spiritual coping. This study aimed to explore spirituality among Malaysian Muslim caregivers of children with acute lymphoblastic leukemia. A total of 13 eligible caregivers participated in this qualitative semi-structured interview via purposive sampling. Each interview was audio recorded, transcribed verbatim, and analyzed using NVivo 12 via thematic analysis. Three main themes revolved around hope through the act of praying and recitation (du'ā' and dhikr), acceptance of God's will (redha), and faith toward God as the Provider of sustenance (rezeki). The findings of this study contribute to a holistic supportive care system in pediatric oncology as it informs health care providers the role of spirituality in mitigating the emotional impact of a cancer diagnosis and promoting psychological adaptation. As a multicultural country, future studies may explore spirituality in other cultures and religion in the country.

Mitochondrial Replacement Therapy: An Islamic Perspective

Mitochondrial replacement technology (MRT) is an emerging and complex bioethical issue. This treatment aims to eliminate maternal inherited mitochondrial DNA (mtDNA) disorders. For Muslims, its introduction affects every aspect of human life, especially the five essential interests of human beings-namely, religion, life, lineage, intellect, and property. Thus, this technology must be assessed using a comprehensive and holistic approach addressing these human essential interests. Consequently, this article analyses and assesses tri-parent baby technology from the perspective of Maqasidic bioethics-that is, Islamic bioethics based on the framework of Maqasid al-Shariah. Using this analysis, this article suggests that tri-parent baby technology should not be permitted for Muslims due to the existence of third-party cell gametes which lead to lineage mixing and due to the uncertain safety of the therapy itself and because the major aim of the technology is to fulfil the affected couples interest to conceive their own genetically healthy child, not to treat and cure mtDNA disorders sufferers.

Effects of Mindfulness-Based Elder Care (MBEC) on symptoms of depression and anxiety and spiritual well-being of institutionalized seniors with disabilities: a randomized controlled trial

BACKGROUND

Despite the need to incorporate seniors from various settings into mindfulness-based empirical research, issues of geriatric frailties and non-compliance remain. This study aimed to evaluate the effects of a mindfulness-based elder care (MBEC) program on mental health and spiritual well-being among seniors with disabilities in long-term care residential settings.

METHODS

This single-blind, randomized controlled trial (RCT) randomly assigned seventy-seven participants into an MBEC group or control group of an eight-week MBEC program. Participants were assessed every four weeks at baseline (T0), mid-intervention (T1), post-intervention (T2) and follow-up (T3) using the Geriatric Depression Scale Short Form (GDS-SF), the State-Trait Anxiety Inventory (STAI) and the Spiritual Well-Being Scale (SWBS), respectively.

RESULTS

Linear mixed model (LMM) showed that MBEC participants' mental health improved significantly after completing the intervention; compared with controls, the MBEC group exhibited significantly lower anxiety (state-anxiety at T2; trait-anxiety at T2 and T3) and fewer depressive symptoms. Spiritual well-being was also significantly enhanced compared to that in the control group.

CONCLUSIONS

MBEC has positive effects on both mental health and spiritual well-being outcomes among seniors with disabilities. In long-term care facilities, seniors with abilities have the potential to adhere to and engage in activities of a mindfulness-based intervention. This low risk, easily accessible, and effective 8-week program is recommended to be integrated into regular long-term care institutional routines.

TRIAL REGISTRATION

This study was registered with Clinical Trial Registry (ClinicalTrials.gov - U.S. National Library of Medicine #NCT05123261. Retrospectively registered on 07/04/2021.). The CONSORT 2010 guidelines were used in this study for properly reporting how the randomized trial was conducted.

Modern approaches to address the concept of territorial division in Islamic jurisprudence

Background: This article examines how current jurists can deal with a juristic division of the world into abode of "Islam" and "infidelity". The success with which jurists re-evaluate this dichotomy will have major impacts on how an Islamic state interacts with non-Muslim governments on the one hand, and Muslims residing temporarily or permanently in a non-Muslim territory on the other. Methods: Here, an attempt made to review the concepts of Dar Al-Islam and Dar Al-Harb from two perspectives: that of the dialectical limits and liberalization, as discussed in secondary material such as books, research articles, and reports. Results: this paper has explored and discussed the criteria for identifying Dar Al-Islam and Dar Al-Harb in Islamic jurisprudence. Conclusions: This article analyzes the various arguments put forward to establish new ways of peaceful coexisting and maintaining healthy international connections.

Spiritual coping strategies: Relationship with physical, anxiety, and depression symptoms of patients with cancer

Introduction

Spirituality is considered an important source against chronic diseases and can promote self-esteem, mental comfort, and hope in patients. Concerning its importance, the present study aims to investigate spiritual coping strategies and its relationship with physical, anxiety, and depression symptoms of patients with cancer who are referred to the oncologic ward.

Method

This was a descriptive-correlative study that 159 patients with cancer participated in the study. Information was collected using a four-part questionnaire including sociodemographic characteristics, Spiritual Coping Strategies Scale, physical symptoms as well as anxiety and depression symptoms. Data were analyzed using the Mann-Whitney U test, Kruskal-Wallis, and Spearman correlation coefficient.

Results

Results of the study showed that the mean (±SD) of the application of methods of spiritual coping strategies was 35.69 ± 10.92 and for its subscales the mean (±SD) of the application of religious coping and nonreligious coping strategies were 16.92 ± 5.6 and 18.77 ± 6.24, respectively. Furthermore, physical symptoms perceived by patients were tiredness, drowsiness, and lack of appetite. There was no significant correlation between physical, anxiety, and depression symptoms and spiritual coping strategies (r = -0.12, P = 0.12; r = 0.07, P = 0.41; and r = -0.05, P = 0.5 respectively).

Discussion

Regarding no significant relationship between physical, anxiety and depression symptoms and spiritual (religious and nonreligious) coping strategies in this study, belief towards cancer and cultural aspects of patients may be more essential to their sense of wellness and help them to cope with negative aspects of illness or treatment. Therefore, more study needs to be done in this area.

Chaplaincy, Clergy, Prayer, Cancer and Measuring Religion and Health

This third issue of JORH for 2023 revisits a number of themes previously highlighted in JORH, along with the addition of two new themes. Since JORH's first special issue on 'Chaplaincy' (JORH, 2022, 61:2), this area of research within JORH has now flourished, with a total of three JORH issues now incorporating the allied health discipline of chaplaincy. Two new article collections in this JORH issue relate to clergy 'faith leaders' and research related to 'prayer.' This issue also revisits the topic of cancer-a recurrent focus within JORH which has, over the past six decades, examined nearly every type of known cancer in the context of religion/spirituality. Finally, JORH collates once again, a number of articles relating to the empirical measurement of religion and health-an increasingly important area of research.

Breast Cancer in Two Ex-Votos, A Millennia Apart: Patients' Hope and Faith Expressed Through the Centuries in Votive Offerings

A votive offering or ex-voto includes a variety of usually non-professional artworks offered to divinities and placed in religious sites to fulfill a vow or in gratitude for recovery from an illness or injury. Unfortunately, the ancient period lacks a scientifically verifiable understanding of the true nature of cancer and its natural history and, consequently, a lack of effective treatment. This paper discusses two ex-votos potentially related to breast cancer distant more than 2000 years, one from the other. The ex-votos convey the complex relationship of humans with illness through an art expression stemming from the heart and minds of ordinary people.

Healing Body and Soul: Islamic Morality, Practitioner Obligations and Extramarital Pregnancy

Extramarital pregnancy is a scarcely explored socio-ethical topic in Muslim countries. Extramarital sexual intercourse is legally prohibited and deemed shameful by conservative Muslim societies. The legal and social implications of an extramarital pregnancy prevent access to care and lead to concealment and/or infant abandonment. This paper argues that the medical community must not become complicit in the criminalization and stigmatization of unmarried pregnant women, but must become a safe and reliable refuge instead. The paper also finds strong Islamic moral commitments that warrant the provision of confidential, non-judgmental care, and encourage compassion and forgiveness over reprimand and punishment.

Management of Gender Determination of Newborns and Children with Disorders of Sex Development Using a Multidisciplinary Approach: An Exploratory Study of Islamic Perspective in Malaysia

Management of newborns with disorders of sex development (DSD), especially in deciding the need for a sex assignment surgery, is a complex matter. It is associated with many bioethical issues, such as concerns about the rights and welfare of the newborns and the reliability of parents' consent to the paternalistic disposition of physicians in making the best decisions. This paper, containing interviews with six medical experts and three religious' experts, aims to raise awareness of the multidisciplinary approach, which uses a combination of medicine, religion, and ethics in managing children with DSD, particularly in Malaysia, to avoid unnecessary psychological, biological, emotional, and societal ramifications.

Votive Offerings from Floresti Orthodox Monastery in Romania: An Ophthalmological Lesson from the Eighteenth and Nineteenth Centuries CE

Since Antiquity, votive offerings were deposited in temples dedicated to deities in order to fulfil a special request of a supplicant. Later, in Orthodox churches, votive offerings entered in the form of anatomical ex-voto or tamata, metallic effigies that realistically represented the disease-affected portion of the body. In this paper, we show four tamata from eighteenth-nineteenth century identified in the museum of the Orthodox monastery of Floresti (Romania); votive offerings that represent ocular pathologies. Even if the supplicants did not have a medical background and often did not fully understand their diseases, the votive offerings demonstrate their ability to observe pathological changes, at the same time emphasising the importance of their faith in the healing process.

Sacred-in-Practice: A Framework for Teaching Religion, Health, and Medicine

This essay proposes an unconventional approach to teaching "religion and medicine" to American medical students. Received frameworks for such teaching-articulated around faith denomination or "spirituality"-may imply that religiosities and their health effects are grounded in theology or transcendence, respectively. These frameworks may reify, or misrepresent relationships between, religion and science-for example, in supporting notions of conflict, or of an essentially secular character of technical progress. They can neglect ways in which biomedicine and its institutions are themselves engaged with and productive of religious values. In order to move toward fuller student appreciation of diverse religious materialities and embodiments in health and biomedicine, the essay proposes "the sacred, in practice" as an organizing rubric. This pedagogical intervention pivots on notions of sacrality in anthropologies of religion and offers students a wide path to consider a spectrum of material, gestural conditions, and activities-transformative techniques, intensely valued objects, trusted texts, rituals-that mark and propagate religious valences and commitments within and around contemporary biomedicine. This sacred-in-practice approach meshes with standard theological and spiritual framings of the religion/health/medicine nexus, yet offers more capacious and flexible connections to work for which medical students are training, involving vulnerable bodies and material technologies of tremendous life- and world-shaping potency.

Commentary on "Circumcision"

This commentary draws upon the author's experience in bioethics and as a physician, ordained Rabbi, and certified Mohel (a Jewish professional qualified to perform infant male circumcisions (MC)). People's identity and adherence to a religious belief are frequently cited reasons for deciding whether to circumcise their male children. For Jewish and Muslim males, circumcision is considered essential. In this commentary, the author uses his medical, religious, and bioethical knowledge, expertise, and experience to address common arguments used in opposing nontherapeutic male circumcision of minors. In these narratives, half of the parents agreed with circumcision, and half did not. The parents against circumcision cite human rights violations, security, privacy, and bodily integrity issues and refer to circumcision as genital mutilation, while those who agree argue that circumcision should be done for religious reasons to prevent health issues, promote hygiene and cleanness, avoid cancer, or for later sexual enjoyment. After evaluating the evidence, the author states that parents should be free to either consent or decline MC for a son. Though a reoccurring theme in these narratives was for mothers to leave the circumcision decision up to their male partners, the author concludes that women have considerable power regarding the decision.

Religious preferences in healthcare: A welfarist approach

This paper offers a general approach to ethics before considering its implications for the question of how to respond to religious preferences in healthcare, especially those of patients and healthcare workers. The first section outlines the two main components of the approach: (1) demoralizing, that is, seeking to avoid moral terminology in the discussion of reasons for action; (2) welfarism, the view that our ultimate reasons are grounded solely in the well-being of individuals. Section 2 elucidates the notion of religious preferences and describes the history and importance of their protection by human rights legislation. The following section defends the 'Preference Principle', according to which there is a reason to satisfy any preference (in so far as that satisfaction advances well-being). Section 4 discusses the implications of this principle for religious preferences in healthcare, again seeking to bring out the special social and political importance of respect, and respect for such preferences in particular. The paper ends with a brief description of how to approach such problems from the perspective of a demoralized welfarism.

A Close Shave: Balancing Religious Tolerance and Patient Care in the Age of COVID-19

In this essay we discuss an ethical dilemma that recently arose in our institution, involving healthcare workers who lamented the requirement to shave their facial hair as a condition to care for COVID-19 patients. The essay represents a genuine attempt to grapple with the dilemma sensibly and vigorously. We first provide a brief introduction, focusing on the tension between religious tolerance and the institutional obligation to optimize patient care and public health in the age of COVID-19. We then discuss the complex relationship between facial hair and cultural as well as religious factors throughout history. Next, we make a case, based on several principles in Islam jurisprudence, that Muslim healthcare professionals in our institution should be expected to shave their facial hair so they could care for COVID patients. We end with considering two alternative solutions that were offered in the literature.

Death Be Not Proud: A Commentary on Muslim Acceptance of Death in the Intensive Care Unit

Technologies used in medicine have meant that treatments can keep people biologically alive but often fail to provide meaningful recovery and quality of life. Many of those from the Islamic faith have relied on these technologies for recovery on religious grounds, even when it may be against clinical advice. This commentary seeks to challenge this notion among many Muslims and suggests there is a psycho-spiritual motivation within the Islamic tradition in not pursuing intensive care treatment that is deemed futile by clinicians. A wish to embrace death in these situations should be expressed to loved ones, and the dying person's loved ones should be encouraged to embrace death, in order to minimise harm from disagreements between clinical staff and family.

Medicine Versus Religion: A Religio-Cultural Study of Death and Dying in Contemporary Kashian Society

The religious context of death has deep implications in shaping the phenomenon of death for the denizens of Kashi. The present paper argues that religious understanding of death confronts the medical issue(s) in the contemporary scenario. To explore the abysmal religio-cultural underpinning(s) of the episteme of death and dying in the era of hegemonic medical technologies is the purpose of this study. Further, it will discuss the enigma of death and dying and will represent some insights into it from the vantage point of religion.

Appraisals of cancer, religious/spiritual coping, and hope in patients with colorectal cancer

PURPOSE/OBJECTIVES

To examine the extent to which religious/spiritual coping moderates the association between stress appraisals and hope among patients with colorectal cancer.

DESIGN/RESEARCH APPROACH

A longitudinal, prospective examination of hope, stress appraisals of cancer, and religious/spiritual coping through self-report questionnaires at baseline, 6-months, and 12-months post-surgery.

SAMPLE/PARTICIPANTS

One hundred thirty-nine newly diagnosed patients with colorectal cancer recruited from tertiary medical centers.

FINDINGS

Challenge and threat appraisals predicted hope. Only the relationship between hope and challenge appraisals was significantly moderated by coping through religion/spirituality, such that those who were both low on challenge and low in religious/spiritual coping reported the lowest hope.

CONCLUSIONS/INTERPRETATION

Hope is predicted by how people appraise their cancer. Hope was lowest among participants who reported both low challenge appraisals and religious/spiritual coping.

IMPLICATIONS FOR PSYCHOSOCIAL PROVIDERS

Understanding how patients appraise their cancer and use religion/spirituality to cope may help providers understand which patients are at risk for low hope.

José Gregorio Hernández: At the crossroads of medicine and religion in Venezuela

After being ravished by a bloody civil war in the 1860 s, Venezuela's healthcare system was very precarious. In this context, one particularly bright medical student stood out, José Gregorio Hernández. As part of a program to modernize medicine in Venezuela, José Gregorio was sent on a scholarship to pursue medical studies in Europe. He brought back to Venezuela equipment and medical knowledge in bacteriology and pathophysiology. This was instrumental in laying the foundations for major healthcare modernization in Venezuela. Throughout his life, José Gregorio negotiated his intense Catholic faith, with his scientific leanings as a physician. His untimely tragic death in 1919 elevated him to a saintly status amongst Venezuelans. Consequently, his image became a powerful symbol for practitioners of prescientific medicine.

[Development of the concept of positive spirituality in health]

Positive spirituality has three central attributes: connectedness, meaning of life, and identity. Six factors are likely to contribute to its emergence and it can allow the development of ten positive consequences.

Salvation Expectations of Patients of Medicine, Complementary and Alternative Medicine and Religion

Health and holistic quality of life, physical and emotional needs, somatic and spiritual aspects contain a comprehensive promise of healing. The aim of the current study is to measure the expectations of patients of medicine, alternative medicine and religion related to health and illness. The survey was carried out among 103 patients of a rural general practitioner from May to June 2013 and among 103 patients of the outpatient department for endocrinology and metabolic disease of the Jena University Hospital in 2013. All patients were asked by one interviewer (HM) on fears in relation to health/illness and expectations of help for its own life, medicine, alternative medicine and religion. The biggest fear of patients is "being in need of help of others." There is no significant difference between religious and non-religious patients. Overall, the expectations of medicine were significantly higher in all sectors than in alternative medicine or religion. Comparing alternative medicine and religion, the expectations of alternative medicine were significantly higher excluding consolation and inner peace. The expectations for medicine in general and for the physician are very high and comprehensive and go beyond diagnosis and realization of therapies. Patients expect hope, guidance, support, comfort, inner peace and advice most from medicine. This results in considerable challenges for the physician, especially in a healthcare system with limited resources and without suitable offers. There is an urgent need to integrate these requirements into daily routine.

Jehovah's Witnesses and Their Compliance with Regulations on Smoking and Blood Treatment

Jehovah's Witnesses (JWs) are known as a religious group compliant with the national laws in the case of smoking, but not-compliant when it comes to blood treatment. Their beliefs prevent them from taking part in a blood transfusion, which is widely included in standard methods of a life-saving treatment. The aim of this study was to compare the behavior of JWs regarding their approach to blood treatment and to smoking in relation to legal regulations in the field of health. We measured JWs' compliance with health laws regarding blood treatment and smoking (the Framework Convention on Tobacco Control-FCTC). We used the concept of a semi-autonomous social field by Moore and the theory of planned behavior developed by Ajzen. Our findings show that in the case of JWs, the group rules often prevail over state rules contained in generally-binding legislation. In the case of smoking, this means that they seem compliant to the FCTC and to their group rules. In the case of blood treatment, it seems that they are breaking the national rules, because of their group rules. Breaking the latter can result in exclusion from the JWs community. JWs are compliant with national laws as long as these are congruent with their own group rules. If this is not the case, the group influence is very strong and the fear of exclusion from the JW group is often greater than the potential negative health consequences in real life.

Physicians' religious/spiritual characteristics and their behavior regarding religiosity and spirituality in clinical practice: A meta-analysis of individual participant data

BACKGROUND

Religiosity and/or spirituality (R/S) of physicians have been reported to inform behavior regarding religiosity and spirituality in clinical practice (R/S-B). Our aim was to study this association.

METHODS

Building upon a large international data pool of physician values we performed network and systematic literature searches using Google Scholar, Web of Science, Embase, Medline, and PsycInfo. Measures for R/S and R/S-B were selected for comparability with existing research. We performed a two-stage IPDMA using R/S coefficients from sample-wise multiple regression analyses as summary measures. We controlled for age, gender, and medical specialty. An additional sub-analysis compared psychiatrists to non-psychiatrists.

RESULTS

We found 11 eligible surveys from 8 countries (n = 3159). We found a positive association between R/S and R/S-B with an overall R/S coefficient of 0.65 (0.48-0.83). All samples revealed a positive association between R/S and R/S-B. Only 2 out of the 11 samples differed from the overall confidence interval. Psychiatrists had a higher degree of R/S-B, but associations with R/S did not differ compared to non-psychiatrists.

CONCLUSIONS

We confirmed a significant association between R/S and R/S-B in this study. Despite large cultural differences between samples, coefficients remained almost constant when controlling for confounders, indicating a cultural independent effect of R/S on R/S-B, which to our knowledge has not been documented before.Such interaction can constitute both facilitators and barriers for high quality health care and should be considered in all aspects of patient and relationship-centered medicine.

Belly fat or bloating? New insights into the physical appearance of St Anthony of Padua

Over the centuries, iconographic representations of St Anthony of Padua, one of the most revered saints in the Catholic world, have been inspired by literary sources, which described the Saint as either naturally corpulent or with a swollen abdomen due to dropsy (i.e. fluid accumulation in the body cavities). Even recent attempts to reconstruct the face of the Saint have yielded discordant results regarding his outward appearance. To address questions about the real appearance of St Anthony, we applied body mass estimation equations to the osteometric measurements taken in 1981, during the public recognition of the Saint’s skeletal remains. Both the biomechanical and the morphometric approach were employed to solve some intrinsic limitations in the equations for body mass estimation from skeletal remains. The estimated body mass was used to assess the physique of the Saint with the body mass index. The outcomes of this investigation reveal interesting information about the body type of the Saint throughout his lifetime.

Factors Influencing the Compliance of Pregnant Women with Iron and Folic Acid Supplementation in the Philippines: 2017 Philippine Demographic and Health Survey Analysis

Anemia in pregnancy, which is a public health concern for most developing countries, is predominantly caused by iron deficiency. At least, 180 days of iron and folic acid (IFA) supplementation is recommended for pregnant women to mitigate anemia and its adverse effects. This study aimed to examine compliance with the recommendation of IFA supplementation and its underlying factors using the 2017 Philippine National Demographic and Health Survey data. The variables assessed included age, highest level of education, occupation, wealth index, ethnicity, religion, residence, number of pregnancies, time of first antenatal care (ANC) visit and number of ANC visits. Compliance with the recommendation of at least 180 days of IFA supplementation was the outcome variable. The study assessed 7983 women aged 15-49 years with a history of pregnancy. Of these participants, 25.8% complied with the IFA supplementation recommendation. Multiple logistic regression analysis showed that pregnant women of Islamic faith and non-Indigenous Muslim ethnicity were less likely to comply with the IFA supplementation recommendation. Being aged between 25 and 34 years, having better education and higher wealth status, rural residency, initiating ANC visits during the first trimester of pregnancy and having at least four ANC visits positively influenced compliance with IFA supplementation. The effect of residence on IFA adherence differed across the wealth classes. Strategies targeted at specific groups, such as religious minorities, poor urban residents, the less educated and young women, should be strengthened to encourage early and regular antenatal care visits for improving compliance.