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Caring for the Muslim Patient

3DH3 Palliative Care

Ke My

on 21 May 2014

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Transcript of Caring for the Muslim Patient

The health care provider needs to understand that family plays an important role in the decision-making process, so expect them to provide input in discussions.
It is important to maintain good communication with the patient since some Muslim patients may not be proficient at the English language. Accept assistance from a family member if present or use an interpreter if necessary
(ISPI, 2006)
Respect the patient's privacy and modesty. This will allow the patient to feel comfortable.
Death is reflected upon frequently in Muslim society. The health care provider can expect patients to be understanding of their illness in most cases, however one should still use a sensitive approach to breaking bad news
(Al-Shahri & Al-Khenaizan, 2005)
Unique Traditional
Health Care Practices
End-of-Life Decision Making
Death Rights/Traditions & Beliefs
Raghad Almalky, Sarah Booth, Maha Iqbal, Elena Moerkerken, & Kelly Mycroft

Caring for the Muslim Patient
Traditional Beliefs of Illness
Causes of Death and Illness
It is Allah who determines when life begins and ends.
Death has many causes, all given by Allah. These include illness, injury and old age. These are seen as a means to an end, given by Allah
(Al-Islam, n.d.)

Wellness and Healing

Comes from Allah only
Healthcare providers are considered Allah’s agents of healing
Praying is just as essential as seeking medical care
Honey is considered holistic in health care, as the Qur'an mentions it has unique healing properties
(Alberta Health Services, n.d.)
Black cumin seeds are a remedy for every disease, according to Prophet Mohammed (PBUH)
(El-Naggar, n.d.)
Visiting the sick is a duty for Muslims - visitations are usually done by family members and close friends of the patient
(ISOS, 2009)
Traditional Beliefs and the Patient
Daily Prayer
It is important if the patient is capable, that they continue to perform the 5 daily prayers
Role of the health care provider should include:
assistance with washing prior to prayer
providing a clean sheet to the patient laid on the floor to perform prayer
knowledge of the direction of Mecca (northeast) for proper positioning
(Alberta Health Services, n.d.; Sheikh & Gatrad, 2002, p.20)

Forbidden Medications
Medications such as pig-derived insulin or those which contain alcohol are not permitted for use unless no alternative is available
(Alberta Health Services, n.d)
Communication and the Muslim Patient
Verbal Communication
Many Muslim patients are new immigrants, so a language barrier may be present
Having a family member or interpreter present will help relay all pertinent information regarding tests and procedures
(ISPI, 2006)

Non-Verbal Communication
The healthcare provider should limit touch with the patient, especially with the opposite sex
Muslim patients may not maintain full eye-contact during conversation. This is viewed as being respectful.
(ISPI, 2006)

Communicating Bad News
Attitude Towards Death
Death is a topic that is reflected upon frequently in Muslim society
The health care provider should expect Muslim patients to be understanding of their illness, often resulting in a smooth conversation. Nevertheless, sensitive delivery should not be denied
(Al-Shahri & Al-Khenaizan, 2005)

The Presence of Family
A family member will most likely be present with the patient during appointments
If family member is present, they may choose to personally deliver the bad news in a gradual manner to the patient, even more so in cases where the patient does not speak English
(Muslim Volunteers Group of Stanford University, n.d.)

Sacredness of Life
Death as the Divine Plan
The sacredness and gift that life is, shapes the beliefs:
Cannot hasten death, with assisted suicide or euthanasia.
Exception: when undue suffering is present or there is no hope for recovery, it is permitted to stop medical treatment
(Queensland Health & Islamic Council of Queensland, 2010)
Death is part of the divine plan, and should not be resisted. It is merely a period of transition
(Sheikh & Gatrad, 2008)

Life Support
It is permitted so long as the patient has not been declared brain dead.
Removing the patient from life support is allowed if they continue in a persistent vegetative state.
(BBC, 2012)

Do Not Resuscitate (DNR) Orders/Living Wills
Only Allah has the right to determine when someone will die. Therefore:
DNR orders are not permissible. Only under special circumstances may this change.
Advanced directives and living wills are not permitted
(Steinberg, 2011)

Organ Donation
There is variation in beliefs among the Muslim society with regards to organ donation
It is believed by many that organ donations are permissible if they save or significantly enhance another human life, as long as benefit outweighs personal cost.
Therefore, physicians should clarify with the Muslim patient about their stance on organ donation
(NHSBT, 2012)
Life and Death Decisions
The Final Days
A Meaningful Death
Islamic traditions dictate that death should occur at home
(Sheikh & Gatrad, 2008)
Similar to when the patient has fallen ill, the dying individual will have many visitors prior to their death
(Queensland Health & Islamic Council of Queensland, 2010)
Prayer plays a pivotal role during this time of suffering and distress:
A family member will always remain at the person’s bedside and recite passages from the Qur'an, with the belief that by doing so, hope will be instilled into the person’s heart
(Sheikh & Gatrad, 2008).

Izra'il: The Angel of Death
Izra'il is the Angel of Death. Izra'il collects the souls of those who are nearing death, only when Allah commands it
(Al-Islam, n.d.)

Immediately Following Death
Upon death the following is done to prepare the body:
Closure of the eyes and mouth
Straightening of the limbs
Body is positioned facing Mecca
Body is washed and dressed in simple white cloth (normally what was worn as a pilgrim during Hajj)
(Sheikh & Gatrad, 2008)

Laying the Patient to Rest
Funeral is held as soon as possible at the local mosque, followed by burial with community and family members present at the graveyard
A final prayer is said at the graveyard, and the body is laid to rest facing Mecca
(Sheikh & Gatrad, 2008)

Final Thoughts
Implications to Clinical Practice
Al-Islam. (n.d.).
Retrieved May 17, 2014, from Death: http://www.al-islam.org/the-hereafter-maad-ayatullah-dastaghaib-shirazi/death

Al-Shahri, M.Z. & Al-Khenaizan, A. (2005). Palliative care for Muslim patients.
The Journal of Supportive Oncology, 3(6)
, pp.432-436.
Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/16350430

Alberta Health Services. (n.d.).
Health Care Religious Beliefs.
Retrieved from http://www.albertahealthservices.ca/ps-1026227-health-care-religious-

BBC. (2012).
Islam: euthanasia, assisted dying, medical ethics and suicide
. Retrieved from http://www.bbc.co.uk/religion/religions/islam/islamethics/

El-Naggar, Z. (n.d.).
The Black Cumin Seed is a Remedy for Every Disease.
Retrieved from http://www.elnaggarzr.com/en/main.php?id=17

International Strategy and Policy Institute. (2006).
Guidelines for health care providers interacting with Muslim patients and their families.
Retrieved from

ISOS (2009, March 2).
Health Care Training Handbook for Muslim Patients.
Retrieved from http://www.i-sos.org/Documents/ISOS%20Heath%20Car

Muslim Volunteers Group of Stanford University. (n.d.)
A guide on Muslim patients.
Retrieved from http://www.google.ca/url

NHS Blood and Transplant. (2012).
Islam and organ donation.
Retrieved from http://www.organdonation.nhs.uk/how_to_become_a_donor/

Sheikh, A., & Gatrad, A. (Eds.). (2000).
Caring for muslim patients.
Abingdon, United Kingdom: Radcliffe Publishing Ltd.

Sheikh, A., & Gatrad, A. (Eds.). (2008).
Caring for muslim patients
. Abingdon, United Kingdom: Radcliffe Publishing Ltd.

Steinberg, S. M. (2011). Cultural and religious aspects of palliative care.
International Journal of Critical Illness and Injury Science, 1,

Queensland Health & Islamic Council of Queensland. (2010).
Health Care Providers' Handbook on Muslim Patient
s (2nd ed.). Brisbane: Queensland Health.

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