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The Need to Adjust the Informed Consent for Jewish Patients for Treatments Involving Porcine Medical Constituents

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Abstract

In order to obtain full informed consent for medical treatments, it is imperative to provide patients of diverse ethnic backgrounds with all relevant information. Since the pig is considered an impure animal in Judaism, Jewish patients may wish to be informed of porcine-derived substances used in treating. The present study is the first to explore the level of knowledge of Jewish participants as to whether the medical use of pig is permitted by their religion, and the extent to which they believe it should be permitted. 714 Jewish participants completed a study questionnaire that included 15 medical uses of pigs. Findings indicated that the knowledge of Jewish law regarding these uses is a significant mediator in predicting the attitude toward the permissibility of these uses. I conclude with practical recommendations as to how to enhance cultural competence and improve the informed consent process when treating Jewish patients with porcine-derived constituents.

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References

  1. ‏1. Author, Coll a, b, c, 2020

  2. Curlin FA, Roach CJ, Gorawara-Bhat R, et al. When patients choose faith over medicine: physician perspectives on religiously related conflict in the medical encounter. Arch Intern Med. 2005;165(1):88–91. https://doi.org/10.1001/archinte.165.1.88.

    Article  Google Scholar 

  3. Padela AI, Duivenbode R. The ethics of organ donation, donation after circulatory determination of death, and xenotransplantation from an Islamic perspective. Xenotransplantation. 2018;25(3):1–12. https://doi.org/10.1111/xen.12421.

    Article  Google Scholar 

  4. Sattar SP, Ahmed MS, Majeed F, et al. Inert medication constituents causing nonadherence due to religious beliefs. Ann Pharmacother. 2004;38(4):621–4.

    Article  Google Scholar 

  5. Shiwani MH. The use of porcine mesh implants in the repair of abdominal wall hernia: an Islamic perspective for an informed consent. J Br Islamic Med Assoc. 2020;4(2):30–7.

    Google Scholar 

  6. Sattar SP, Ahmed MS, Madison J, et al. Patient and physician attitudes to using medications with religiously forbidden constituents. Ann Pharmacother. 2004;38(11):1830–5. https://doi.org/10.1345/aph.1E001.

    Article  Google Scholar 

  7. Koshy RM, Kane EG, Grocock C. A review of the use of biological mesh products in modern UK surgical practice: a religious and cultural perspective. Ann R Coll Surg Engl. 2020;102(8):566–70. https://doi.org/10.1308/rcsann.2020.0114.

    Article  CAS  Google Scholar 

  8. Sabbouh R. Cultural issues for ethnic minority Muslim patients in medical interpretation [dissertation] University of Leeds; 2021.‏

  9. Greenblum J, Hubbard RK. Responding to religious patients: why physicians have no business doing theology. J Med Ethics. 2019;45(11):705–10. https://doi.org/10.1136/medethics-2019-105452.

    Article  Google Scholar 

  10. Gatrad AR, Mynors G, Hunt P, et al. Patient choice in medicine taking: religious sensitivities must be respected. Arch Dis Child. 2005;90(9):983–4. https://doi.org/10.1136/adc.2004.069435.

    Article  CAS  Google Scholar 

  11. Zulkarnain NN, Anuar N, Abd Rahman N, et al. Cell-based influenza vaccine: current production, halal status assessment, and recommendations towards Islamic-compliant manufacturing. Hum VaccinImmunother. 2021;17(7):2158–68. https://doi.org/10.1080/21645515.2020.1865044.

    Article  Google Scholar 

  12. Anonymous. Implications of religious and cultural beliefs on selection of medicines. Drug Ther Bull 2016; 54:45–48. https://doi.org/10.1136/dtb.2016.4.0396.

  13. Ross CJ, Hsu MC, Baumwart R, et al. Quantification of load-dependent changes in the collagen fiber architecture for the strut chordae tendineae-leaflet insertion of porcine atrioventricular heart valves. Biomech Model Mechanobiol. 2021;20(1):223–41. https://doi.org/10.1007/s10237-020-01379-.

    Article  Google Scholar 

  14. Padilla LA, Hurst D, Lopez R. Attitudes to clinical pig kidney xenotransplantation among medical providers and patients. Kidney. 2020;360:10–34067.

    Google Scholar 

  15. Gunardi S. Porcine DNA in medicine toward postpartum patients from medical and Islamicperspectives in Malaysia. Int J Halal Res. 2021;3(1):29–31.

    Article  Google Scholar 

  16. Binti Irfan, NI. Detection of bovine and porcine gelatine in dental constituents. ‏[master’sthesis] Malaysia, International Islamic University Malaysia; 2019. http://studentrepo.iium.edu.my/handle/123456789/9568

  17. Güngörmüş Z, Güngörmüş M. Effect of religious belief on selecting of graft constituents used in oral and maxillofacial surgery. J Oral Maxillofac Surg. 2017;75(11):2347–53. https://doi.org/10.1016/j.joms.2017.07.160.

    Article  Google Scholar 

  18. Loike JD, Kadish A. Outer limits of biotechnologies: a Jewish perspective. Rambam Maimonides Med J. 2018;9(1): e0008. https://doi.org/10.5041/RMMJ.10328.

    Article  Google Scholar 

  19. Easterbrook C, Maddern G. Porcine and bovine surgical products: Jewish, Muslim, and Hindu perspectives. Arch Surg. 2008;143(4):366–70. https://doi.org/10.1001/archsurg.143.4.366.

    Article  Google Scholar 

  20. Eriksson A, Burcharth J, Rosenberg J. Animal derived products may conflict with religious patients’ beliefs. BMC Med Ethics. 2013;1(14):48. https://doi.org/10.1186/1472-6939-14-48.

    Article  Google Scholar 

  21. Paris W, Seidler RJH, FitzGerald K, et al. Jewish, Christian and Muslim theological perspectives about xenotransplantation. Xenotransplantation. 2018;25(3):e12400. https://doi.org/10.1111/xen.12400.

    Article  Google Scholar 

  22. Shemesh AO. Did Jews avoid using products made of pigs as medical constituents? “And the swine it is unclean unto you (Deut).” Vesalius. 2014;20(2):89–94.

    Google Scholar 

  23. Lawson T, Ralph C. Perioperative Jehovah’s witnesses: a review. Br J Anaesth. 2015;115(5):676–87. https://doi.org/10.1093/bja/aev161.

    Article  CAS  Google Scholar 

  24. Rodger D, Blackshaw BP. Using animal-derived constituents in anaesthesia and surgery: the case for disclosing to patients. BMC Med Ethics. 2019. https://doi.org/10.1186/s12910-019-0351-4.

    Article  Google Scholar 

  25. Byrne BM. Structural equation modelling with AMOS: Basic concepts, applications, and programming. 2nd ed. New York: Routledge; 2016.

    Book  Google Scholar 

  26. Dayton MT. Porcine and bovine surgical products: Jewish, Muslim, and Hindu perspectives—invited critique. Arch Surg. 2008;143(4):370. https://doi.org/10.1001/archsurg.143.4.370.

    Article  Google Scholar 

  27. Babos MB, Perry JD, Reed SA, et al. Animal-derived medications: cultural considerations and available alternatives. J Osteopath Med. 2021;121(4):361–70. https://doi.org/10.1515/jom-2020-0052.

    Article  Google Scholar 

  28. Cengiz N, Wareham CS. Ethical considerations in xenotransplantation: a review. Curr Opin Organ Transplant. 2020;25(5):483–8. https://doi.org/10.1097/MOT.0000000000000796.

    Article  Google Scholar 

  29. Author & Colleague, 2017

  30. Enoch S, Shaaban H, Dunn KW. Informed consent should be obtained from patients to use products (skin substitutes) and dressings containing biological material. J Med Ethics. 2005;31(1):2–6. https://doi.org/10.1136/jme.2003.005272.

    Article  CAS  Google Scholar 

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Acknowledgements

The author is grateful to the anonymous reviewers for their helpful comments and suggestions.

Funding

This work was supported by The Israel Academic College of Ramat Gan (Grant No. 2021-24484057).

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N/A; YBC is the sole author.

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Correspondence to Ya’arit Bokek-Cohen.

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The manuscript has not been published elsewhere and is not under submission elsewhere. There is no conflict of interest.

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The study was approved by the IRB ethics committee of the Academic College of Tel-Aviv-Jaffa.

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Bokek-Cohen, Y. The Need to Adjust the Informed Consent for Jewish Patients for Treatments Involving Porcine Medical Constituents. J Immigrant Minority Health 25, 142–150 (2023). https://doi.org/10.1007/s10903-022-01383-z

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