Sharia Law Comes to the Operating Room

Glacier Bay, Alaska - photo by JoAnn Sturman

Scott Sturman
fliesinyoureyes.com

Sharia is the moral foundation and religious law of Islam. Its two primary sources are the Qur'an and the Sunnah, a compendium of Mohammed stated and tacit rules of conduct, actions, and habits. In essence, since Mohammed was a perfect man and incapable of wrong doing, then it follows his every act and word mirrored this perfection. To attain the goal of ultimate piety, the individual must emulate and extol these idiosyncrasies to the most precise detail. A discussion of sharia is beyond the scope of this article, other than to say it is utterly comprehensive and delves into the minutest aspects of personal and community life.


One can only imagine what it must be like to work in an atmosphere where the rules of daily life are totally pervasive and enforced by a fanatical cadre of thought police. At some point the workings of society grind to a halt to abide with the mass of rules enforced by zealots whose livelihoods are based on their ardor and interpretation of obscure principles which defy logic and can be recalled only by rote memory. What would it be like to live under Mecca’s or Tehran’s stultifying Sharia laws? A visit to an American hospital operating room during a JCAHO or state inspection is the closest experience outside the Muslim world to a fundamentalist Islamic theocracy.

To understand the hospital inspectors’ mindset, several broad but accurate observations are in order:

Most inspectors have paltry leadership ability and seek positions of arbitrary power to assuage their fragile egos. They are uncomfortable with normal human discourse essential for problem solving and thrive in situations where their opinion is incontestable.


Rules are enforced non uniformly depending on the inspector and those being inspected. This caprice allows for infractions to be discovered in any institution. Finding fault, whether imagined or real, translates to job security for inspectors. All mandates are clustered under the euphemism of patient safety but with rare exception it is really about power and control.


Inspectors insist their findings and recommendations are based on science and research. This contention is utterly ridiculous, for the bulk of data is based on pseudo science or individual impressions.


Efficiency and cost consciousness have no influence on inspectors’ decisions. New rules mean more documentation, less time to spend with patients, and added expenses, but greater job security for the inspectors. In the last thirty years I have never heard an inspector offer this advice: “These suggestions may help reduce your costs, enhance time management, and spend more time with your patients.”


Hospital inspectors are illogical by nature and unable to temper their zeal with even a modicum of common sense. If told that 95% of all people killed in traffic accidents ate a meal in the 12 hours preceding the fatality, they would conclude the meal was responsible for the accident. The obvious solution is to ban eating at least 12 hours before driving an automobile.


Just as no non royal Saudi is immune from the religious police, no hospital, employee, or physician has recourse against a “finding” made by a JCAHO or state inspector. To defy or challenge an accusation is tantamount to apostasy and heresy. All that is lacking are the flowing robes and a Qur'an in hand.

After so many years of suffering through these inquisitions, one begins to feel it is impossible to hatch anymore surprises. Never under estimate the capacity of a bureaucrat to trammel on common sense. The latest onslaught brought new heights of absurdity as the tentacles of the bureaucracy extended into the finest details of operating room apparel, facial hair, and syringe labeling. The point has come where practice management guidelines have exceeded any semblance of usefulness and are a significant distraction from patient care. If shoe cover protocol, being allowed to wear an undershirt beneath operating room scrubs, and sideburn length were that important, I’d move to Saudi Arabia.