Religion and Belief

Discrimination with a focus on religious belief and religious difference is not a new phenomenon. For many years the West of Scotland has been characterised by sectarianism which continues today. Religious discrimination, and suspicion of religions, has come to the fore again due to a rise in Islamophobia – particularly after September 11th and the July 7 bombings in London.

In the past there was no specific protection against discrimination for most religious groups. There was, however, protection for people from Sikh and Jewish communities who were protected under the Race Relations Amendment Act as an ethnic group. Religion is often woven in with race and culture to form personal or group identity. Black/Minority ethnic communities, who can be on the outskirts of society, have often used religion to express and to sustain their identity.

There is now greater protection from religious discrimination through the Equality Act 2010. Religion & belief is a protected characteristic and everyone who is protected under law from discrimination, harassment or victimisation is afforded the same level of protection.

For some people, their religion is important to their health yet often the cultural and practical dimensions of religion are not assessed and taken account of when individuals attend for health care. This can be considered as a form of discrimination, can cause distress and as a result can have a negative impact on the effectiveness of diagnosis and treatment. In the same way that other examples of equality categories often remain invisible to health care organisations and therefore in the way that services are planned, there is lack of data on patients for whom religion is significant to their wellbeing. In addition, strong views on any particular form of religion can lead to prejudice and discrimination against other beliefs – often referred to as sectarianism. This too can have an impact on the physical and psychological wellbeing of individuals.There can also be assumptions that everyone has a faith of some description despite of a large percentage of people who consider themselves to be atheist. Any assumptions about faith can lead to experience of discrimination.

Following is a short film by the Equality & Human Rights Commission titled ‘What is religion and belief discrimination?’.

There may be examples of poor health resulting from the disharmony between some followers of religion and other equality groups. For example, people within the LGBT communities who practice or follow a religion may face additional health issues such as mental health problems or feel isolated, perhaps due to discrimination within their faith community.

A person’s value system, sense of purpose and inner strength, whether resulting from religious or other sources, has been linked to how they respond to illness and treatment. Our approach in NHSGGC focuses on ‘spiritual care’ and ‘spiritual needs’ as outlined in the Spiritual Care Policy. This recognises that all people, whether religious or not, have spiritual needs that may or may not include aspects of formal religion or belief. People will gain comfort and strength to face illness from being allowed to practice their religion while in hospital.

Appropriate recognition of religious practices and preferences, and consideration of the patient’s spiritual needs, are particularly important in the care of the dying and in dealing with the deceased and their family after death. This also has a relevance to the care offered in our Maternity Units at a time of peri-natal or neo-natal death. Consideration of spiritual needs equally applies to people who have a non-religious stance.

Religion and Belief within a health care environment can also impact on

• Gender and choice of staff;
• Disclosure of sensitive information;
• Attitudes towards illness and health practices;

Religious views may also affect the way in which health promotion messages are received and acted upon. Some religious practices, such as not drinking alcohol or vegetarianism, may have positive links to health. Others may affect whether or not certain medications can be taken due to animal/alcohol by-products.

NHSGGC has a multi-levelled response in tackling inequalities associated within religion and belief.

• The organisation actively pursues the capture of religion / belief from its staff at recruitment stage as well during the course of employment (SWISS) to ensure that it doesn’t discriminate against one group of staff.
• We have developed a Spiritual Care Policy outlining the nature of spiritual care, the provision of spiritual care facilities in our hospitals, training and education, the role of all staff in delivering spiritual care and the importance of consultation with faith and belief groups.
• Healthcare Chaplaincy, as an NHS service, has a key role in responding to the spiritual and religious needs of staff, patients and visitors. Healthcare Chaplains function on a ‘generic basis’ whereby their service is for all people, regardless of faith or belief. They are a point of contact to draw in care and support from particular faith and belief groups.
• The organisation provides training to staff at induction level and during the course of employment on equality and diversity which includes religious/ belief issues. Training on subjects such as Loss and Bereavement include reference to the needs of those from faith communities.
• Our Equality Impact Assessment can identify whether services are actively addressing issues associated with religion and belief and put in place necessary actions.
• The Catering Service provides Halal, Kosher and vegetarian meals upon request. Work is being undertaken to meet the needs of other religious groups.

Baldeep’s Story

Baldeep is a baptised Sikh and follows the practice of wearing the 5 ‘Ks’ – this includes wearing the Kirpan. The Kirpan is a very small sword. As is the custom, Baldeep wears hers under her clothing in a cloth sheath. For her, and for all baptised Sikhs, it is a symbol of the commitment she has made to follow the Sikh way of life and carries a deep spiritual significance. She will never remove it unless absolutely necessary.

Unfortunately, one day Baldeep felt very unwell and had to go the nearest Accident and Emergency Department. Whilst she removed clothing to be examined the nurse asked what it was that she was wearing. The nurse became alarmed that Baldeep was carrying what looked like a knife and refused Baldeep any further assistance until the Kirpan was removed. Baldeep explained that the Kirpan was a sacred item in her faith and she could not remove it; was it absolutely necessary to remove it in order to be examined? The nurse said that on health and safety grounds no patient should be carrying a weapon. Baldeep argued that if treatment was denied to her because she was wearing this sacred symbol, it was tantamount to religious discrimination.

The nurse seemed unsure about this and consulted her ward manager. The ward manager came to meet Baldeep and enquired more about her faith and the Kirpan. It was clear that treatment could not be denied as Baldeep was observing the requirements of her faith in the wearing of the Kirpan. This had to be respected. It was agreed that she could be examined whilst wearing it but if an x-ray or any other sort of scan was required it would have to be removed. Baldeep understood this and before going to the x-ray her Kirpan was removed, along with the Kara (the steel wristband) and held by the nurse during the procedure. Baldeep then replaced it accompanied by the saying of a prayer.

Comment and Background Information:

The wearing of the Kirpan is permitted by UK law as it is an intrinsic part of the Sikh faith and Sikh religious observance. It is generally not visible. Legislation makes it clear that a service cannot be denied to anyone on grounds of the religion or belief and the ward manager above was correct to see this. The discussion that took place leading to an agreed solution was also appropriate and correct.

Further information about the Sikh religion can be found in the resources identified in section 6 – Support and Resources.

Publications

• A Multi-Faith Resource for Healthcare Staff
• Advice to British Hajjis
• Faith and Belief Communities Manual
• Information and Guidance on Visiting Hospitals for Faith and Belief Community Representatives
• Ramadan Health Guide
• Seen and Not Heard – Voices of Young British Muslims
• Spiritual Care Policy
• Values in Harmony

Websites

• Al-Khair
• Almeezan
• Central Mosque
• Glasgow Gurdwara
• Glasgow Unitarians
• Hindu Mandir Glasgow
• Methodist Church in Scotland
• Nil By Mouth
• Orthodox Church
• Salvation Army
• Scottish Baptist
• Scottish Lutherans
• United Reformed Church