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Consider patients’ religious faith in the selection of knee arthroscopy products
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The results of a database search and questionnaire given by researchers in India and Sweden highlight religious restrictions among patients regarding the use of animal-derived products for cartilage repair and need for surgeons to tell patients about the source of these products.
“Products of biological origin have a definite restriction for various religions, with few exceptions,” the researchers wrote in their study abstract. “Surgeons should know the source of the product and should be aware of the basic requirements of the patient’s faith. Patients should be informed about the source of the product and alternative if available, and an informed consent may be considered.”
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The researchers performed a search of numerous databases to indentify religious views on the use of biological products for surgery. The investigators found that Hindu patients are generally against the use of products with bovine origins, while Muslim and Jewish patients have faith-based restrictions on porcine-derived products. The study also revealed a lack of such restrictions among most Christian patients and noted a code of non-violence to animals among Buddhist patients.
When a product poses a potential conflict, “it is also important for the surgeon to know if there is any alternative available. There may be a situation when use of the product is the only alternative for the clinicians, and as part of his study, he has to use it,” the researchers stated in the study. “But then, it should form part of his informed consent.”
Disclosure: The authors have no relevant financial disclosures.
Perspective
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John D. Kelly IV, MD
The article by Goyal and colleagues brings to mind the neglect of surgeons in considering personal belief systems when choosing animal-based products. The longer I have been engaged in practice, the more I realize that a patient’s beliefs, more than the surgery itself, are often the largest determinant of a successful surgical outcome. It is patently unethical and unfair to a patient not to respect his or her religious beliefs when surgery is undertaken. A great deal of emotional anguish can be averted if discussions about the exact nature of treatment are disclosed to the patient.
Many options are availed to the arthroscopist with respect to choice of biologic materials. If the surgeon deems that only one product is truly indicated, then it must be agreeable to the patient after it is fully disclosed. Thankfully, these are not life and death decisions; nonetheless, every patient has a right to know what is going into his or her body.
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