End-of-Life Care Considerations for Muslim Patients

An individual’s background influences their needs and preferences regarding decision making and the dying experience.  Habib (2022) and colleagues summarized the published medical literature relating to the need for inclusive aspects of end-of-life care for Muslim patients.

The authors also highlight that Muslims come from various sects, subsects, cultural and geographic backgrounds resulting in different social, religious, and personal practices.  They caution that nothing noted in this review will be true for every Muslim patient and while these considerations are important to understand, individualized inquiry, assessment, and care is required.

The authors categorize the considerations into 6 aspects of care:

Suffering and Palliative Medications

• Many Muslims attribute the occurrence of suffering to the will of Allah and the concept of “redemptive suffering” can be a spiritual source of comfort for many.
• Medications are acceptable if they do not cause unnecessary sedation that may interfere with saying regular prayers.

Family and Caregiver Involvement

• Families are often closely involved in decision making.
• If a patient is incapacitated, an older male relative will often help with the decision.

 Life Sustaining Treatment Preferences

• Islamic teachings do not specifically address life sustaining treatment and there is considerable variation in personal preferences.
• Islam clearly prohibits suicide and euthanasia.
• Medically administered nutrition and hydration may be provided if indicated unless it shortens life or causes more harm than benefit.

Care at the Time of Death

• Islam recognizes death as cessation of breathing, while there is minimal spiritual guidance on death using neurological criteria. Collaborate with an Imam or chaplain to provide support in the case of death using neurological criteria.
• Many Muslims prefer that the face of the individual who is imminently dying or recently deceased be repositioned toward Kaaba (Holy Mosque in Makkah, Saudi Arabia).
• Loved ones may recite prayers.

Care of the Body

• Post-mortem examinations are usually not acceptable unless required by law.
• The body may be given a final bath, usually by same gender family members.
• The body is often wrapped in a white cloth for burial.

Other Considerations

• Modesty: Knocking on the door and waiting for permission to enter is recommended as many Muslim women cover their head. Clinicians should seek permission prior to applying physical touch. Same gender clinicians are often preferred.
• Dietary restrictions: many Muslim patients prefer Halal food and avoid pork products.
• Muslim spiritual and traditional treatments:  nutritional items such as black cumin, honey, and water that comes from a holy mosque are valued for their spiritual and health properties.

 

Source: Habib, M. H., Khan, S., Rizvi, F., & Raza, S. (2022). End-of-Life Care Considerations for Muslim Patients# 435. Journal of Palliative Medicine, 25(4), 678-679.