Culture in Person-Centered Clinical Care and Public Health: Contributions of Medieval Arabic and Islamic Medicine

Abstract

Culture refers to shared practices reflected in language, religion, beliefs, rituals, family structure, and moral/legal systems. It is universal, local, generationally transmitted, and pervasive, as every living person is embedded within a cultural context. Culture is a key determinant of health-behavior, from the experience of illness and wellbeing, to the expression of distress and symptom manifestations, to attitude towards seeking care. Culture provides the framework of the patient-carer relationship and the expectations for care. Cultural Awareness and Responsiveness is one of the core concepts of Person-centered Medicine (PCM). PCM calls for considering ethnic identity, cultural values, language, communication needs, gender, sexual preference, spiritual needs as crucial components of optimal care for the individual and the community at large. Ancient and traditional medical practices are an expression of unique cultural heritage, many of which emphasize person-centered principles. The historical medical practices of Arabic and Islamic traditions during its golden age, was the most advanced of its time and echoed in many of its practices the principles of person-centered medicine. Arabic and Islamic historical medical practices during its golden age was a complex and transformative system of medical education and care. It represented the first example of a pre-modern system in terms of hospitals that were publicly funded and functioned both as a medical school as well as a hospital. Care provided was based on principles of social justice, benevolence, and egalitarianism in receiving care derived from religious traditions. An example is presented of one such hospital called Bimaristan Argun Alkamili in Aleppo, Syria (1354) (bimaristan is a Persian word for house of the sick) that was built specifically to care for the mentally ill. The Bimaristans became a prototype of modern hospitals in Europe. The Bimaristan Argun Al-Kamili embodied many person-centered principles by providing a host of personalized care elements, from medicinal plants, aroma, music and story-telling therapies to a forward-looking architectural design which provided an eco-habitat that promoted healing in a humanistic, caring and dignifying environment.