Iman & Ihsan, application in physician training and the therapeutic relationship

The journey from illness to health may be fraught with unfavorable outcomes, inadvertent errors, or even medical malpractice. Indeed, alleged medical negligence or malpractice is emblematic of the underlying dissonance in what should otherwise be an ideal therapeutic relationship between physicians and patients. The increasing incidence of alleged medical negligence in the West and in the Muslim world has led physicians to fear the threat of litigation. Consequently, this results in defensive medicine, avoiding higher risk medical and surgical specialties or procedures, and potentially adversarial patient-physician interactions. Medical schools have adopted white coat ceremonies as a symbolic attempt to inculcate students in the healing tradition and; along with the pledging of the Hippocratic Oath, to imbue them with a sense of compassion and duty towards the ill. Such endeavors should serve to motivate trainees and physicians to respond to suffering with continued empathy and effort rather than with suspicion and fear of an unfavorable outcome or alleged negligence. Objective: The purpose of this paper is to offer a novel, complimentary approach to the white coat ceremony and the pledging of the Hippocratic Oath, by discerning the Islamic principles of Iman (faith) and Ihsan (a call to virtue) to define an appropriate healing relationship between physicians and patients. In order to introduce students to this tradition of healing, this alternative approach may be introduced, taught, and modeled for physicians-in-training in their actual clinical practice. Philosophical Perspective: Since inception of the white coat ceremony in 1993, the Hippocratic perspective has been applied to inculcate a sense of compassion and duty to the ill. Along with recognition of the Human Condition or Fitra; the concept of Iman and Ihsan within the Muslim world should be applied by physicians-in-training to define their duty and their approach to future patients, themselves and their Creator. Such an approach demands a higher level calling than that outlined by the expected standards of Islamic law or Shari’a. Conclusion: Instilling Iman and Ihsan principles as an embedded component of medical treatment potentially should curtail medical malpractice exposure, simplify due process, and improve patient physician healing relationships.