{"id":336,"date":"2010-04-12T13:05:41","date_gmt":"2010-04-12T12:05:41","guid":{"rendered":"https:\/\/blogs.bmj.com\/medical-ethics\/?p=336"},"modified":"2010-04-15T21:06:01","modified_gmt":"2010-04-15T20:06:01","slug":"muslims-mrsa-or-how-journalism-works","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/medical-ethics\/2010\/04\/12\/muslims-mrsa-or-how-journalism-works\/","title":{"rendered":"Muslims! MRSA! or: How Journalism Works"},"content":{"rendered":"

The increasingly-tabloid Freethinker<\/em> is running an indignant story<\/a> about how – apparently – rules about bare arms have allegedly been relaxed for Muslim staff within the NHS (scroll down a bit – they’re indignant about quite a lot).<\/p>\n

Female staff who follow the Islamic faith\u00a0will be allowed to cover their arms to preserve their modesty despite earlier guidance that all staff should be \u201cbare below the elbow\u201d.<\/p>\n

The Department of Health has also relaxed rules prohibiting jewellery so that Sikh members of staff can wear bangles linked with their faith, providing they are pushed up the arm while the medic treats a patient.<\/p><\/blockquote>\n

It goes without saying that anyone who thinks that exposing their forearms is being immodest is silly, and that anyone who thinks that this “immodesty” is so grave that the hygiene implications of wearing sleeves are minor in comparison is just about certifiable. \u00a0So, if the story is true, it’s worrying.<\/p>\n

If the story is true.<\/p>\n

If.<\/p>\n

It doesn’t sound as though it’s true, though, does it? \u00a0I mean: it somehow lacks a sense of plausibility. \u00a0So where did The Freethinker<\/em> find it? \u00a0Well, their story offers a link to the <\/a>Telegraph<\/a><\/em>; and the Telegraph<\/em> offers a link to… er, actually, it offers no links. \u00a0But it does tell us that<\/p>\n

The\u00a0Mail on Sunday<\/em> reported the change had been made after female Muslims obje…<\/p><\/blockquote>\n

Ah. \u00a0Let me stop you there. \u00a0Any citation the either the Daily <\/em>Fail<\/em> or the Wail on Sunday<\/em> ought always to carry some sort of warning (“DANGER: BOLLOCKS AHEAD”); but I held my nose and followed the lead. \u00a0Sure enough<\/a>…<\/p>\n

Muslim doctors and nurses are to be allowed to wear long sleeves for religious reasons – despite the risk of spreading deadly superbugs.<\/p>\n

The Department of Health will allow female Muslim staff to opt out of a strict NHS dress code to cover their arms and protect their modesty.<\/p><\/blockquote>\n

It’ll come as a surprise to noone that the story also has no link – just a quotation from an unnamed Department of Health spokesperson.<\/p>\n

So went to the DoH website and had a look around for the guidance. \u00a0It’s hard to find: there’s a search box, and I tried terms like “muslim”, “sleeve”, “MRSA”, “political correctness gone mad”, but none of them gave me the story in question. \u00a0Obviously, the next step was to ring the press office at the DoH. \u00a0I explained who I was, and asked about the story, and how I suspected that it was nonsense: was there a link the press officer could send me? \u00a0I could almost hear the sound of eyes rolling at the other end of the line; but a link was provided to the latest guidance on dress codes<\/a>.<\/p>\n

And, indeed, the guidance does talk (in Appendix B) about accommodating the bizarre wishes of those who think it immodest to show their forearms in public. \u00a0I’ll come to that in a moment.<\/p>\n

The body of the guidance on dress-codes is clear, though. \u00a0(The bold emphasis is all mine.)<\/p>\n

Where, for religious reasons, members of\u00a0staff wish to cover their forearms or wear\u00a0a bracelet when not engaged in patient\u00a0care, ensure that sleeves or bracelets can\u00a0be pushed up the arm and secured in place\u00a0for hand washing and direct patient\u00a0care activity.*<\/p><\/blockquote>\n

Hand hygiene is paramount, and accidental\u00a0contact of clothes or bracelets with patients\u00a0is to be avoided.<\/strong><\/p>\n

*In a few instances, staff have expressed a preference for disposable over-sleeves \u2013 elasticated at the wrist and elbow \u2013 to cover\u00a0forearms during patient care activity. Disposable over-sleeves can be worn where gloves are used<\/strong>, but strict adherence to\u00a0washing hands and wrists must be observed before and after use. Over-sleeves must be discarded in exactly the same way\u00a0as disposable gloves.<\/p><\/blockquote>\n

So the policy amounts to this: if you’re not treating patients, there’s a bit more leeway in respect of dresscodes; but the primacy of patients’ welfare is unaffected anyway. \u00a0If you are<\/em> treating patients, and if you do have weird beliefs about the propriety of having your forearm on show, you can use disposable sleeves if and only if gloves are used in similar circumstances<\/strong>. \u00a0In other words, it looks like the sleeves are treated in the same way as gloves – which is reasonable – and if gloves would be inappropriate, then so would be sleeves. \u00a0This, actually, looks pretty unobjectionable.\u00a0 <\/strong><\/p>\n

On to the appendix. \u00a0This seems fairly accommodationist (and, for the sake of greasing the wheels, there’s nothing obviously problematic about that), but the accommodations offered are fairly small all the same. \u00a0The first thing to note is that we’re talking about recommendations here, not policy. \u00a0The second is that\u00a0it’s explicit that<\/p>\n

[i]ncorporating any of these recommendations into trust policy will have to be agreed in\u00a0conjunction with clinical managers and the local infection prevention and control team<\/strong>.<\/p><\/blockquote>\n

That is: if you want to change the standard arrangements, you have to get the approval of the infection bods. \u00a0In other words, they have a veto on changes. \u00a0This seems like the right approach.<\/p>\n

More importantly, though, the recommendations are simply that<\/p>\n

Uniforms may<\/strong> include provision for sleeves that can be full length when staff are not\u00a0engaged in direct patient care activity<\/strong>.<\/p><\/blockquote>\n

Uniforms can have three-quarter length sleeves.<\/p>\n

Any full or three-quarter length sleeves must not be loose or dangling. They must be able\u00a0to be rolled or pulled back and kept securely in place during hand-washing and direct\u00a0patient care activity.<\/p>\n

Disposable over-sleeves, elasticated at the elbow and wrist, may be used but must be\u00a0put on and discarded in exactly the same way as disposable gloves<\/strong>. Strict procedures for\u00a0washing hands and wrists must still be observed.<\/p><\/blockquote>\n

In essence, this just iterates the main body of the policy; but, once again, as soon as\u00a0patients are involved, all bets are off.<\/p>\n

So, in other words, this “relaxation” of the policy on bare arms actually boils down to this: impose on yourself whatever crazy restrictions you like, unless<\/strong> patients are involved, and providing that<\/strong> you adhere to a couple of other supplementary rules for the sake of patient safety<\/em>.<\/p>\n

But that doesn’t generate quite the same headline, does it?<\/p>\n","protected":false},"excerpt":{"rendered":"

The increasingly-tabloid Freethinker is running an indignant story about how – apparently – rules about bare arms have allegedly been relaxed for Muslim staff within the NHS (scroll down a bit – they’re indignant about quite a lot). Female staff who follow the Islamic faith\u00a0will be allowed to cover their arms to preserve their modesty […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[511,475,1544],"tags":[1615],"class_list":["post-336","post","type-post","status-publish","format-standard","hentry","category-in-the-news","category-politics","category-the-nhs","tag-tthe-inc"],"yoast_head":"\nMuslims! MRSA! or: How Journalism Works - Journal of Medical Ethics blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2010\/04\/12\/muslims-mrsa-or-how-journalism-works\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Muslims! 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