Medical Ethics in Qiṣāṣ (Eye-for-an-Eye) Punishment: An Islamic View; an Examination of Acid Throwing

Physicians in Islamic countries might be requested to participate in the Islamic legal code of qiṣāṣ, in which the victim or family has the right to an eye-for-an-eye retaliation. Qiṣāṣ is only used as a punishment in the case of murder or intentional physical injury. In situations such as throwing acid, the national legal system of some Islamic countries asks for assistance from physicians, because the punishment should be identical to the crime. The perpetrator could not be punished without a physician’s participation, because there is no way to guarantee that the sentence would be carried out without inflicting more injury than the initial victim had suffered. By examining two cases of acid throwing, this paper discusses issues related to physicians’ participation in qiṣāṣ from the perspective of medical ethics and Islamic Shari’a law. From the standpoint of medical ethics, physicians’ participation in qiṣāṣ is not appropriate. First, qiṣāṣ is in sharp contrast to the Hippocratic Oath and other codes of medical ethics. Second, by physicians’ participation in qiṣāṣ, medical practices are being used improperly to carry out government mandates. Third, physician participation in activities that cause intentional harm to people destroys the trust between patients and physicians and may adversely affect the patient–physician relationship more generally. From the standpoint of Shari’a, there is no consensus among Muslim scholars whether qiṣāṣ should be performed on every occasion. We argue that disallowing physician involvement in qiṣāṣ is necessary from the perspectives of both medical ethics and Shari’a law

Religious Involvement, the Serotonin Transporter Promoter Polymorphism, and Drug Use in Young Adults

We examine whether the genetic basis for religious involvement is common to the genetic basis for drug use/abuse, helping to explain the inverse relationship between religiosity and drug use. To test this hypothesis, we analyzed data on 2,537 young adult siblings participating in Wave III of the National Longitudinal Study of Adolescent Health on whom both genetic characteristics and religious participation were collected. Religion/spirituality was assessed with four measures: frequency of attendance at religious services and other religious youth meetings, frequency of private prayer, self-rated importance of religion and spirituality, and self-reported history of a life-changing spiritual experience. Each religious measure was examined individually and combined together into a summary scale. Illicit drug use (including prescription drug abuse) was assessed. Polymorphisms of the promoter region of the serotonin transporter gene, SLC6A4 (i.e., LL, SL, SS genotypes) were determined. Results indicated that (1) all religious measures were inversely related to drug use/abuse, (2) the SLC6A4 genotypes SS and SL were less common among those who were more religious, especially among non-whites, and (3) SS/SL genotypes were less common among those who used illegal drugs. Despite being less likely to have the protective SS/SL genotype, religious adolescents were still less likely to use drugs. (4) There was no evidence that the serotonin transporter genotype mediated the relationship between religiosity and illegal drug use. These findings suggest that genetic factors play a role in religiosity, especially in non-whites, and that both genotype and religiosity independently predict substance abuse

Religião, espiritualidade e transtornos psicóticos

BACKGROUND: Religion is often included in the beliefs and experiences of psychotic patients, and therefore becomes the target of psychiatric interventions. OBJECTIVES: This article examines religious beliefs and activities among non-psychotic persons in the United States, Brazil and other areas of the world; discusses historical factors contributing to the wall of separation between religion and psychiatry today; reviews studies on the prevalence of religious delusions in patients with schizophrenia, bipolar disorder, and other severe mental disorders; discusses how clinicians can distinguish pathological from non-pathological religious involvement; explores how persons with severe mental illness use non-pathological religious beliefs to cope with their disorder; examines the effects of religious involvement on disease course, psychotic exacerbations, and hospitalization; and describes religious or spiritual interventions that may assist in treatment. METHODS: Literature review. FINDINGS: While about one-third of psychoses have religious delusions, not all religious experiences are psychotic. In fact, they may even have positive effects on the course of severe mental illness, forcing clinicians to make a decision on whether to treat religious beliefs and discourage religious experiences, or to support them. CONCLUSIONS: Clinicians should understand the negative and positive roles that religion plays in those with psychotic disorders.CONTEXTO: A religião é freqüentemente incluída nas crenças e experiências de pacientes psicóticos, tornando-se, assim, alvo de intervenções psiquiátricas. OBJETIVOS: Este artigo, primeiramente, examina a prevalência de crenças e atividades religiosas entre pessoas não-psicóticas nos Estados Unidos, Brasil e em outras áreas do mundo. Segundo, discute os fatores históricos que têm contribuído para a barreira que separa religião de psiquiatria na atualidade. Terceiro, revisa os estudos sobre a prevalência de delírios religiosos em pacientes com esquizofrenia, transtorno bipolar e outros transtornos mentais graves, discutindo como os clínicos podem distinguir o envolvimento religioso patológico do não-patológico. Quarto, explora a possibilidade de que pessoas com doença mental grave usem práticas e crenças religiosas não-patológicas para lidar com seus transtornos mentais. Quinto, examina os efeitos do envolvimento religioso no curso da doença, das exacerbações psicóticas e das hospitalizações. Finalmente, este artigo descreve intervenções religiosas ou espirituais que possam auxiliar no tratamento. MÉTODOS: Revisão da literatura. RESULTADOS: Enquanto cerca de um terço das psicoses têm conteúdo religioso, nem todas as experiências religiosas são psicóticas. Na realidade, elas podem ter efeitos positivos no curso de doenças mentais graves, levando os clínicos a terem de decidir se devem tratar as crenças religiosas e desencorajar as experiências religiosas ou se devem apoiá-las. CONCLUSÃO: Clínicos devem compreender os papéis positivos e negativos que a religião desempenha nos pacientes com transtornos psicóticos

Psychometric characteristics of the Muslim Religiosity Scale in Iranian patients with cancer

Objective: Cancer is a leading cause of death worldwide. Religiosity is a factor that may help cancer patients to cope with their disease. The aim of the current study was to validate a Persian translation of the Muslim Religiosity Scale (MRS) in a population of Iranian patientswith cancer. Method: Two thousand patients were invited to participate in this multisite study, of whom 1,879 participated. Patients completed a demographic questionnaire, the MRS, and several scales, including the Patient Health Questionnaire–9, the Hospital Anxiety and Depression Scale, the Perceived Social Support Scale, and the SF–12 quality of life measure. Backward– forward translation was employed to develop a Persian-language version of theMRS. Cronbach’s alpha and two-week test–retest reliability were also assessed. Convergent and discriminative validity as well as the factor structure of the scale were also examined. Results: The internal reliability (a) of the religious practices and beliefs subscales was 0.88 and 0.92, respectively. The intraclass correlation coefficient (ICC) was 0.92 (range ¼ 0.75–1.0). The scale demonstrated solid convergent and discriminative validity. Factor analysis indicated two main factors, as predicted, with an appropriate goodness of fit (x2 ¼ 76.23,RMSEA ¼ 0.065). Such factors asmarital status, quality of life, social support, and self-efficacy were positively associated with MRS total score, while anxiety, depression, and suicide ideation had negative associations. Significance of results: TheMRS is a useful tool for assessing religiosity in Iranian patientswith cancer and is associated with a number of important health outcomes

Religious beliefs and alcohol control policies: a Brazilian nationwide study

Objective: The connection between lower alcohol use and religiousness has been extensively examined. Nevertheless, few studies have assessed how religion and religiousness influence public policies. The present study seeks to understand the influence of religious beliefs on attitudes toward alcohol use. Methods: A door-to-door, nationwide, multistage population-based survey was carried out. Self-reported religiousness, religious attendance, and attitudes toward use of alcohol policies (such as approval of public health interventions, attitudes about drinking and driving, and attitudes toward other alcohol problems and their harmful effects) were examined. Multiple logistic regression was used to control for confounders and to assess explanatory variables. Results: The sample was composed of 3,007 participants; 57.3% were female and mean age was 35.7 years. Religiousness was generally associated with more negative attitudes toward alcohol, such as limiting hours of sale (p < 0.01), not having alcohol available in corner shops (p < 0.01), prohibiting alcohol advertisements on TV (p < 0.01), raising the legal drinking age (p < 0.01), and raising taxes on alcohol (p < 0.05). Higher religious attendance was associated with less alcohol problems (OR: 0.61, 95%CI 0.40-0.91, p = 0.017), and self-reported religiousness was associated with less harmful effects of drinking (OR: 0.61, 95%CI 0.43-0.88, p = 0.009). Conclusions: Those with high levels of religiousness support more restrictive alcohol policies. These findings corroborate previous studies showing that religious people consume less alcohol and have fewer alcohol-related problems.Universidade Federal de Juiz de Fora (UFJF) Department of MedicineHospital João Evangelista (HOJE)Associação Médico-Espírita InternacionalDuke University Medical CenterUniversidade Federal de São Paulo (UNIFESP) Department of PsychiatryUniversidade de São Paulo (USP) Department of PsychiatryUNIFESP, Department of PsychiatrySciEL

Religiosity, depression, and quality of life in bipolar disorder: a two-year prospective study

Objective: Few quantitative studies have examined the effect of religious involvement on the course of bipolar disorder (BD). We investigated the effects of religious activity and coping behaviors on the course of depression, mania, and quality of life (QoL) in patients with BD. Methods: Two-year longitudinal study of 168 outpatients with BD. Linear regression was used to examine associations between religious predictors and outcome variables (manic symptoms, depression, QoL), controlling for sociodemographic variables. Results: Among the 158 patients reassessed after 2 years, positive religious coping at T1 predicted better QoL across all four domains: physical (β = 10.2, 95%CI 4.2 to 16.1), mental (β = 13.4, 95%CI 7.1 to 19.7), social (β = 10.5, 95%CI 3.6 to 17.33), and environmental (β = 11.1, 95%CI 6.2 to 16.1) at T2. Negative religious coping at T1 predicted worse mental (β = -28.1, 95%CI -52.06 to -4.2) and environmental (β = -20.4, 95%CI -39.3 to -1.6) QoL. Intrinsic religiosity at T1 predicted better environmental QoL (β = 9.56, 95%CI 2.76 to 16.36) at T2. Negative religious coping at T1 predicted manic symptoms (β = 4.1) at T2. Conclusion: Religiosity/spirituality (R/S) may influence the QoL of patients with BD over time, even among euthymic patients. Targeting R/S (especially positive and negative religious coping) in psychosocial interventions may enhance the quality of recovery in patients with BD.