A Review of Materials and Medications with Religious or Dietary Significance in the Interventional Radiology Suite

Clinical Question

How can appropriate holistic considerations be implemented in a patient-centered care when incorporating different medications and medical devices with culturally or religiously sensitive ingredients in an interventional radiology suite?

Take Away Point

Different religions and cultures have different sets of restrictions with regards to specific sensitive ingredients present in appropriate medications or devices. This provides a spectrum of challenges depending on what the respective culture/religion allows or what it is willing to tolerate in specific scenarios which may prompt a necessary conversation between the physician and the patient.

Reference

Wilson R, Hu Z, Cormac O’Brien, Meer E, Agarwal A, Murray T. A Review of Materials and Medications with Religious or Dietary Significance in the Interventional Radiology Suite. Journal of Vascular and Interventional Radiology. 2023;34(10):1717-1721. doi:https://doi.org/10.1016/j.jvir.2023.06.035

click here for abstract

Study Design

Social Science Study

Funding Source

No reported funding

Setting

Academic, St. Paul’s Hospital, Vancouver, British Columbia, Canada
Academic, University of British Columbia, Vancouver, British Columbia, Canada
Academic, Schooland School of Medicine, Kingston, Ontario, Canada

Table 1.Dietary Restrictions of Specific Religions

Religion	Specific restriction
Christianity	Some denominations have specific restrictions during Lent or choose to forgo animal products and ethanol. Certain weekdays or holy days may also preclude meat/dairy consumption.
Jehovah’s Witnesses (Christian Denomination)	Avoid blood products (ie, blood transfusions).
Seventh-day Adventist (Christian Denomination)	Some choose to refrain from consuming animal products (excluding eggs).
Judaism	Strict followers may only consume kosher products. All porcine and shellfish products are prohibited. Land animals consumed must be mammals that chew their cud and have cloven hooves. Birds of prey are prohibited.
Islam	Strict followers may only consume animal products obtained through ritualistic method (halal). Porcine products and ethanol are prohibited.
Hinduism	Majority of followers are vegetarian and abstain from all animal products, including eggs. Those who are not vegetarian still abstain from bovine and porcine products, along with ethanol.
Buddhism	No universal restrictions. Those who are vegetarian refrain from consuming all animal products, including eggs.
Sikhism	Dietary restrictions are an individual choice. Those who are vegetarian refrain from consuming all animal products, including eggs. Those who are not vegetarian may abstain from consuming bovine and porcine products, along with ethanol. All products obtained from other religious guidelines (halal, kosher) are prohibited.
Veganism	All animal products, including eggs, are prohibited.

Figure

Table 1: Brief summary of different common religions/cultures and their associated restrictions

Summary

Globalization has exposed people to a wide variety of approaches to life dependent on personal and religious preferences. These different sets of practices implement specific restrictions and permissions which ultimately impact the decision one makes in his or her daily life. One of those specific sets of restrictions is the avoidance of certain animal-derived products which differ from practice to practice but are well-known ingredients in certain medications and medical devices.

The article briefly details consumptive restrictions and conditions that exist in major denominations of secular or religious groups. Afterwards the topic of autonomy is then brought forth, which the article alludes to as the basis for the potential need for this discussion. Specifically, competent patients have the right to make informed decisions, and part of the information that would help them impact their decision-making involves religiously or culturally sensitive ingredients that make up certain medications or devices. One proposed method is preprocedural screening flagging patients with relevant restrictions to animal-derived products.

Despite the important holistic consideration outlining sensitive ingredients would provide, there are multiple challenges. Firstly, the specific and even the magnitude of certain restrictions not only differ from religion to religion, but even amongst different sects of a particular religion. This makes it difficult to completely standardize restrictions for any one particular group. Secondly, new medications and devices are introduced at a high rate, further compounding the challenge of keeping a comprehensive list of all sensitive products to inform specific patients with.

Commentary

The authors in this study explored the prospect of culturally or religiously sensitive animal-derived products and the challenges that come with either informing patients appropriately or being up-to-date with all of them in the medical devices or medications. While autonomy is one of the central tenets of medicine and serves as the basis for justification of informing patients of culturally or religiously sensitive ingredients, the article explains why this is severely challenging.

Firstly, for the most part most, if not all, of the major world religions do not have an entire group agreeing on the specific details pertaining to permission or restrictions. For example, the article referenced how Muslims avoid porcine products, but the concept and application of “Dharurah,” which involves how certain forbidden products become permissible in the context of life-saving situations is not necessarily entirely agreed upon amongst all schools of thought in the Islamic scholarship. Thus, even if a physician were to meet a Muslim patient and were to inform them about a product, there is no guarantee that the patient follows a specific school of thought that would otherwise ameliorate options presented to him or her.

Secondly, with the rapidity of new medications and medical devices introduced to the market over time, it is nearly impossible to keep a comprehensive list of all the ingredients that may be present in such facets, even if the financial and other costs of such task were feasible.

These challenges brought forth explain why I do not have a perfect solution for addressing this challenge, even though this can significantly improve the holistic approach physicians can bring to their patients. However, were this to be successfully implemented, this can significantly improve the holistic care model brought about upon the patients.

Post author:
Naeem Patel, DO
Radiology Resident, PGY4
Department of Radiology, Interventional Radiology Division
Hartford Hospital, Hartford, CT
@Naeemp7Patel