Muslim GP ethics have been put in the spotlight by the Health Secretary Patricia Hewitt. She accused some Muslim GPs of sharing confidential information about Muslim women with their families and community members. However, the Department of Health say her remarks have been misquoted claiming that that she was only recounting evidence from the Muslim Women\'s Network (MWN). The MWN report “She Who Disputes” highlights that some Muslim women are afraid that their GP may breach confidentiality on sensitive issues.Even if Hewitt is not singling out Muslim GPs, it is obvious that the Muslim women who fear that their confidentiality will not be respected are referring to GPs from their own communities – in other words Asian and Muslim GPs.
I am dismayed by the amount of criticism Hewitt has received by some Muslims who are denying that confidentiality breaches are occurring.One Muslim GP, Dr Reefat Drabu, who is also chair of the Muslim Council of Britain\'s social and family affairs committee has been quoted as saying that “No GP would breach confidentiality because if they break it, they are liable to be sacked.” Yes, there may be a strict disciplinary procedure in place but this alone is not evidence that trust is not being broken.The Muslim Doctors and Dentists Association (MDDA) have also criticized Hewitt saying that confidentiality is deeply entrenched in Islamic teachings and the suggestion that Muslim women may not enjoy the trust of their immediate families is a further insult to their culture.
Critics may find it inconceivable that GPs are leaking patient information but some women do not share that view.It is not just women who are having their trust broken. The MWN findings have only reinforced concerns over confidentiality breaches that other organizations have already raised. Those defending Muslim GPs are ignoring the concerns of Muslim women, whose voices are rarely heard. I agree breaches are happening in all communities by GPs of different faiths and ethnicities. However, that does not mean we disregard what is happening within our own community. With the current attitude we run the risk of allowing wrongful practices to continue.
Despite what is going on in other communities, we need to be honest. Perhaps we should consider why Muslims and Asians may have more reason to fear confidentiality breaches. Self criticism is not easy, but it needs to be done. Within our communities there is an obvious intolerance of certain issues such as homosexuality, relationships before marriage and conception of children outside marriage. Not all Asians or Muslims working in the NHS may be sympathetic to patients who are seeking an abortion, have sexually transmitted diseases or suffering from domestic violence.The consequences of confidentiality breaches for Asian or Muslim patients are likely to be more serious because of culture and religion. We must not forget Asian women are one of the most vulnerable groups. For example, the suicide rate amongst 16-24 year old Asian women is three times that of white British women of the same age group.
Apart from MWN other organizations have highlighted that Asians do fear GP confidentiality breaches.In 2002 a joint study by Southern Derby Mental Health Trust and the women’s group Karma Nirvana found that there was the perception and the fear that an Asian GP would divulge problems to families.Mind, a leading mental health charity has also raised similar concerns. According to research carried out in 1999 by Khan and Ditton on ethnic minority drug use in Glasgow, young Asians believed that a visit to a drug agency or a GP would result in their parents and the whole community finding out due to an efficient gossip network.Anxiety over confidentiality are not only restricted to GPs but include other staff who are from the same community.For example, translators from the same community are not trusted by some patients.
It can be difficult to prove a breach of confidentiality - how do you prove a piece of gossip?This may explain the lack of patients making formal complaints. Also it can be difficult to make a public complaint as it exposes one to the very problem the breach presents in the first place. Some patients may be afraid that they will not be able to register with another GP due to long waiting lists while others are unaware of complaints procedures.
Although confidentiality is central to trust between doctors and patients, some Asians are clearly reluctant to approach their GPs if they are well known by the wider family or community. Even if most Asian or Muslim GPs are not divulging confidential information, the perception that they may do so, is a barrier for some to access the health service. Some patients are viewing their GPs as Asian or Muslim first and then doctor second.
It may only be a minority of GPs that are breaking the professional code and tarnishing the image of the majority who are doing a fantastic and highly pressurized job in an under resourced sector – but that does not mean we bury our head in the sand. It may be impossible to eliminate the risk of confidentiality breaches in any community but at least we can raise awareness and find ways to minimize this risk. It is a shame that this issue has only received attention after Hewitt made her comments.
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Muslim GP ethics have been put in the spotlight by the Health Secretary Patricia Hewitt. She accused some Muslim GPs of sharing confidential information about Muslim women with their families and community members. 