The Right To Know

It upsets me to learn that some fellow doctors do not bother revealing the origin of low molecular weight heparin (LMWH) to their patients. It upsets me even more that they think that those who do, shouldn't!

On what grounds? Look, I know most of us have the genuine intention to treat our patients to the best of our abilities. Therefore, my opponents think that withholding a minor detail such as that above is done in the patient's best interest - a so-called therapeutic advantage. They argue that most Muslim patients who were told of LMWH's porcine origin ended up declining its use. They are after all offering the best treatment there is (in the case of acute coronary syndrome - ACS).

But still I ask, on what grounds? If you're a Muslim, don't you want to know if your treatment is halal? If there is no better alternative, the origin or religious legitimacy of a particular therapy does not preclude its use. I usually make it a point to counsel a Muslim patient before I administer LMWH. Yes, it's porcine in origin. Yes, it's the best treatment available (for ACS). Yes, there is an alternative, albeit an inferior one. Yes, in my professional opinion, you should receive this form of heparin. And yes, the final decision is yours.

In the end, if you are mentally competent, able to comprehend and retain this information, the final decision is yours. It's your right, the right to self-determination. In my limited experience, most of my Muslim patients have no objection to using LMWH, since it is undoubtedly the one thing that can save their lives when they present with ACS.



We'd like to think that doctors know best (and want the best for their patients), but let's not also forget that ultimately it is the patient's right to decide what they really want. Autonomy still rules.