By Natasha Z. Piracha, Lauren B. Nickel, Afiya Quryshi, Ramy Salah, and Aasim I. Padela
Published in the Journal of Pain and Symptom Management on January 11, 2024.
DOI: 10.1016/j.jpainsymman.2024.01.004
As the demographics of global societies continue to diversify, a cross-cultural understanding of healthcare is more critical than ever. One of the key areas where this understanding is paramount is in the provision of end-of-life care. In non-Muslim majority countries, where the number of Muslim residents is growing and aging, the need for culturally sensitive healthcare is not just a courtesy; it is a necessity for ensuring quality care and support during the most vulnerable times in a person’s life.
A groundbreaking study conducted by a team of researchers led by Natasha Z. Piracha has tackled this issue head-on. Through a systematic literature review, the team sought to unpack the complexities of Muslim experiences, needs, and challenges associated with end-of-life healthcare, including hospice and palliative care, in countries where Islam is not the primary religion. Published in the Journal of Pain and Symptom Management, the article “Muslims and End-of-Life Healthcare in Non-Muslim Majority Nations: A Systematic Literature Review” serves as a clarion call for healthcare professionals and policymakers alike.
The comprehensive review, spanning five relevant databases, including MEDLINE, Scopus, Web of Science, CINAHL, and the Cochrane Library, engaged in an in-depth analysis using key terms related to Islam and end-of-life healthcare. Scholastically robust and methodically refined, the process led to the identification of 29 empirical studies written in English that cover the thematic experiences of adult Muslims in minority settings.
The salient themes emerging from this analysis were multifold. Firstly, the role of family was underscored as not just a moral duty within the Islamic ethos but also as a practical support system for caregiving and surrogate decision-making.
Secondly, the review highlighted the troubling gaps in knowledge among healthcare providers regarding the specific needs of Muslim patients. Simultaneously, there was a reported lack of awareness among Muslim patients and their families about the procedures and benefits of advance care planning, an essential part of end-of-life care decision-making.
Thirdly, the research shone a light on how practicing Muslim physicians reconcile their professional responsibilities with their religious beliefs, exploring the dynamics this creates within the healthcare system.
This systematic review reveals just how scant the research on this topic is, considering the urgency and necessity of addressing the culturally appropriate end-of-life care for Muslims in non-Muslim majority countries. The findings point to an overarching need for educational initiatives tailored to healthcare providers on the religious and cultural nuances of Islam, as well as community outreach campaigns to Muslim populations regarding advance care planning and available end-of-life resources.
Let’s delve into the three main themes to understand the implications and steps that can be taken to bridge the existing gaps.
Theme 1: The Central Role of Family in Muslim End-of-Life Care
Within Muslim communities, the family’s role extends beyond emotional support to encompass physical care and medical decision-making. This study highlights the deep-seated obligation felt by Muslim family members to provide care, reflecting an intertwined sense of duty, love, and religious responsibility. In non-Muslim majority countries, where community support networks may be less dense, this can lead to additional pressure on families who may also face language barriers and cultural misunderstandings within the healthcare system.
Recommendations stemming from this finding include the need for healthcare providers to engage with whole families during the care process, appreciating their central role and providing support that acknowledges their heavy load. Advance care planning discussions should involve family members, ensuring that their cultural and religious values are respected in the caregiving journey.
Theme 2: Bridging Knowledge Gaps
A significant knowledge gap exists on both sides of the physician-patient divide. Many healthcare providers are reportedly not well-versed in the specific needs and beliefs of their Muslim patients, especially concerning end-of-life practices. This lack of understanding can lead to care that is not only ineffective but also sometimes inadvertently insensitive.
Conversely, Muslim patients and their families often lack awareness of the healthcare system’s resources, such as advance care planning, which could significantly assist them in managing end-of-life situations in line with their religious and personal preferences.
To combat this, the study suggests educational programs for healthcare providers focusing on cultural competency, particularly in the context of Islam and its approach to death and dying. On the patient and community side, there is a call for culturally sensitive information campaigns to raise awareness about end-of-life options and the importance of advance directives.
Theme 3: The Influence of Islam on Muslim Physicians
The interplay between professional duties and personal beliefs for Muslim physicians provides insight into another layer of the healthcare dynamic. Muslim doctors, when working in non-Muslim majority contexts, must navigate their commitment to their faith while adhering to the medical protocols and ethical standards of their profession. This has implications for how they communicate with and advise Muslim patients while also potentially serving as cultural bridges within the healthcare system.
Healthcare organizations could better accommodate and utilize these physicians’ unique perspectives by developing platforms for interfaith dialogue and collaboration, ultimately leading to more culturally attuned care practices.
Conclusion
As J Pain Symptom Manage documents through its meticulous review process, the need for culturally sensitive healthcare for Muslims at the end of life is significant and growing. Addressing this need is not simply a matter of ethics; it is a pressing issue of ensuring equitable healthcare standards for all.
With the research’s publication, Piracha and her co-authors offer a foundation for further studies and a comprehensive understanding of where improvements are necessary. They advocate for a healthcare environment in which every individual, regardless of cultural or religious background, can access and receive care that honors their dignity and respects their values, even in the final chapters of life.
References
1. Piracha, N. Z., Nickel, L. B., Quryshi, A., Salah, R., & Padela, A. I. (2024). Muslims and End-of-Life Healthcare in Non-Muslim Majority Nations: A Systematic Literature Review. Journal of Pain and Symptom Management. doi: 10.1016/j.jpainsymman.2024.01.004
2. & 3. Additional relevant references related to the topic
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Keywords
1. End-of-Life Care for Muslims
2. Healthcare Cultural Sensitivity
3. Palliative Care in Islam
4. Advance Care Planning Islam
5. Muslim Majority Healthcare Challenges
This article addresses the significant healthcare challenge of providing appropriate end-of-life care for Muslims in non-Muslim majority nations, based on a systematic literature review.