Death Be Not Proud: A Commentary on Muslim Acceptance of Death in the Intensive Care Unit

Technologies used in medicine have meant that treatments can keep people biologically alive but often fail to provide meaningful recovery and quality of life. Many of those from the Islamic faith have relied on these technologies for recovery on religious grounds, even when it may be against clinical advice. This commentary seeks to challenge this notion among many Muslims and suggests there is a psycho-spiritual motivation within the Islamic tradition in not pursuing intensive care treatment that is deemed futile by clinicians. A wish to embrace death in these situations should be expressed to loved ones, and the dying person's loved ones should be encouraged to embrace death, in order to minimise harm from disagreements between clinical staff and family.

Clinical Interpretation of Jinn Possession and Cultural Formulation of Mental Illness

This article addresses common interpretations of jinn possession among health care professionals. The author addresses the following questions: How do mental health providers interpret jinn possession? How do they view traditional healing practices, such as prophetic medicine, and folk medicine, to explain the phenomenon of jinn possession? The aim of this paper is to contribute to theoretical knowledge of existing research in this area and explore the possibility of improvement of the clinical practice with clients who claim to be possessed by jinn.

Safety and efficacy of Empagliflozin in Pakistani Muslim patients with type 2 diabetes (SAFE-PAK); a randomized clinical trial

BACKGROUND

Sodium-Glucose-Co-Transporter 2 (SGLT2) inhibitor (Empagliflozin) is an effective drug in controlling blood glucose through predominantly glycosuria. Glycosuria increases the risk of genitourinary infections in diabetes. This study was aimed to establish the safety and efficacy of Empagliflozin (Group-A) versus standard care (Group-B) in Pakistani Muslim individuals with type 2 diabetes.

METHODS

A multicenter, randomized clinical trial was conducted in five cities across Pakistan from July 2019 to August 2020. Patients of both genders aged 18-75 years, body mass index (BMI) ≤ 45 kg/m², glycosylated hemoglobin (HbA1c) 7-10% (53 mmol/mol to 86 mmol/mol) and treatment-naive to Empagliflozin were included. Treatment was given for 24 weeks, and allocation was done through randomization.

RESULTS

Out of 745 screened patients, 333 met the eligibility criteria, and a total of 244 (73.3%) patients were enrolled. More hypoglycemic events were reported in the standard care group, whereas positive urine culture, fungal infection, dehydration, and hypotension occurrence were comparable between the two groups. The 6 months mean HbA1c reduction was significant in both groups; (Group-A: 0.91 ± 0.15; p < 0.001 vs. Group-B2: 0.79 ± 0.14; p < 0.001). Efficacy comparison at 6 months revealed a significant reduction in weight and systolic blood pressure (SBP) in Group A only (Group-A: 1.4 ± 0.4 kg; p < 0.002 vs. Group-B: 0.01 ± 0.5 kg; p < 1.00), (Group-A: 5.1 ± 1.7 mmHg; p < 0.012 vs. Group-B: 2.3 ± 1.7 mmHg; p < 0.526).

CONCLUSIONS

Empagliflozin was a safe drug compared to standard care in Pakistani Muslim patients with diabetes. It was as effective as standard care in the clinical setting but achieved glycemic control by reducing weight and SBP in type 2 diabetes patients.

TRIAL REGISTRATION

This study was registered in the NIH US National Library of Medicine clinical trials registry at Clinicaltrials.gov with the registration number: NCT04665284 on 11/12/2020.

Death and Dying Through the Lens of Jordanian Muslim Patients and Caregivers

The current phenomenological-qualitative study explored the meaning of death and dying from a Jordanian-Muslim perspective. Data were collected through face-to-face interviews with eight patients and five family caregivers, then analyzed following the Braun and Clarke steps. The analysis revealed two main themes; confronting death and preparing for a good death. The experience of terminal illness compelled the patients and their family caregivers to think of imminent death and want to prepare for it. On the other hand, Muslim terminally-ill patients accepted death and surrendered to God's decree; however, they feared the unknown of the dying experience. Furthermore, the patients were concerned about being a burden to their families during the last days of their lives. Additionally, Muslim patients and caregivers identified five components of a 'good death' from the Arab-Muslims' perspectives, including having a good closure, dying with dignity, coming to peace, not dying alone, and having a religious engagement.

Adaptation and Innovation in Spiritual-Psycho-Social Support of Displaced Muslim Refugees

There are over 26 million refugees worldwide, and the majority are Muslims who hail from diverse cultural and geographical backgrounds. It is widely recognized that refugees are at high risk for mental health concerns and are in need of cultural and psychological adaptations to improve their well-being. Given the paucity of data in religio-spiritual adaptation using psychological interventions, the authors propose developing a religio-spiritual training resource that could help humanitarian aid workers and other professionals understand the needs of displaced Muslim refugees (Al-Nuaimi & Qoronfleh, 2020). Here, the authors present a religio-spiritual model that uses evidence-based psychological interventions to provide transcultural religiously and spiritually driven psychological care for displaced Muslim refugees.

The psychological impact of sexual torture: A gender-critical study of the perspective of UK-based clinicians and survivors

Despite the high prevalence of sexual torture and its close link with gender, little work has been published on refugee torture survivors from Muslim-majority countries. The aim of this project was to introduce a gender-critical framework, that draws on post-modern and post-colonial feminism, to the study of sexual torture in terms of its operationalization and psychological impact in Iranian, Afghan, and Kurdish refugees in the United Kingdom (UK). This exploratory qualitative research was conducted in collaboration with two voluntary organizations in the UK. Mental healthcare providers (HCPs) were invited to participate through convenience sampling from amongst their staff as well as from community mental health services. Torture survivors were recruited through snowball sampling. The study consists of two parts: 1) semi-structured face-to-face interviews with a total of eight experts (doctors and therapists) and three torture survivors; followed by 2) a focus group with four experts to discuss the emerging results from the interviews and together reflect on the politics of gender and sexuality in the context of torture ('assisted sense-making'). A thematic gender-critical analysis was performed for the qualitative data. Our findings from interviews with (only Kurdish) torture survivors and HCPs suggest that gender mediates the impact of sexual torture at the intersection of gender, cultural norms, forms of social inequality, and body politics. The conclusions of the study will have implications for health services by deepening our understanding of variables that intersect in an entangled and unpredictable network.

Turkish imams and their role in decision-making in palliative care: A Directed Content and Narrative analysis

BACKGROUND

Muslims are the largest religious minority in Europe. When confronted with life-threatening illness, they turn to their local imams for religious guidance.

AIM

To gain knowledge about how imams shape their roles in decision-making in palliative care.

DESIGN

Direct Content Analysis through a typology of imam roles. To explore motives, this was complemented by Narrative Analysis.

SETTING/PARTICIPANTS

Ten Turkish imams working in the Netherlands, with experience in guiding congregants in palliative care.

RESULTS

The roles of Jurist, Exegete, Missionary, Advisor and Ritual Guide were identified. Three narratives emerged: Hope can work miracles, Responsibility needs to be shared, and Mask your grief. Participants urged patients not to consent to withholding or terminating treatment but to search for a cure, since this might be rewarded with miraculous healing. When giving consent seemed unavoidable, the fear of being held responsible by God for wrongful death was often managed by requesting fatwa from committees of religious experts. Relatives were urged to hide their grief from dying patients so they would not lose hope in God.

CONCLUSION

Imams urge patients' relatives to show faith in God by seeking maximum treatment. This attitude is motivated by the fear that all Muslims involved will be held accountable by God for questioning His omnipotence to heal. Therefore, doctors may be urged to offer treatment that contradicts medical standards for good palliative care. To bridge this gap, tailor-made palliative care should be developed in collaboration with imams. Future research might include imams of other Muslim organizations.

Is social egg freezing (oocyte cryopreservation) for single women permissible in Islam? A perspective from Singapore

Elective egg freezing (oocyte cryopreservation) for fertility preservation - commonly referred to as social egg freezing or non-medical egg freezing, will be permitted in Singapore from 2023. There is a need for clear religious directives on social egg freezing for the minority Muslim population in Singapore, due to conflicting Fatwas on this medical procedure that were issued in different Islamic countries, in particular Egypt and Malaysia. Although social egg freezing would be beneficial for the fertility preservation of many single Muslim women who are unable to start a family due to various personal circumstances, there are also various potential risks and harms of this medical procedure at the individual and societal level. Hence, based on Maqasid Al-Shariah, by which preventing harm takes precedence over securing benefit in medical treatment (Tadawi), it is posited that social egg freezing should be classified as Makruh, which is permissible but discouraged in Islam.

Exploring Muslims' Health-Related Behaviours in Portugal: Any Impact on Quotidian Community Pharmacy Practice?

Muslims are a growing community in European countries. General health habits, including therapy-related behaviours, have been described, though implications to pharmacy practice might vary with the local dominant culture and setting. This exploratory study aimed to describe Muslims’ prevalent health and medication-related practices and possible implications for culturally competent community pharmacy practice. A descriptive cross-sectional survey was administered to a convenient sample of 100 participants at Lisbon Central Mosque, Portugal. Demographics, dietary, Traditional Arabic and Islamic Medicine (TAIM) and religious practices were examined, including health conditions and conventional biomedical treatments. Participant reported ailments (26%) were aligned with prevalent conditions in the general population. Ill participants were significantly associated with TAIM and Islamic dictates (p < 0.05), particularly Zam-Zam water and milk thistle usage. Participants’ orientation to dietary options and Qur’an restrictions were observed regarding forbidden substances in medication, raising issues on medication adherence for some oral dosage forms. TAIM and religious beliefs supplement illness recovery and health improvement instead of replacing conventional healthcare in a religious minority well integrated within the dominant culture. Portuguese community pharmacists should not neglect religious specificities if seamless care is delivered, enhancing professionals’ collaboration skills with multicultural patients.

Death From COVID-19, Muslim Death Rituals and Disenfranchised Grief - A Patient-Centered Care Perspective

In Islam, religious directives regarding death are derived from the Quran and Islamic tradition, but there is a variety of death rituals and practices, lived by Muslims across contexts and geographies. This narrative study explored the dynamics of death and bereavement resulting from COVID-19 death among religious Muslims in Israel. Narrative interviews were conducted with 32 religious Muslims ages 73-85. Findings suggest several absent death rituals in COVID-19 deaths (i.e., the physical and spiritual purification of the body, the shrouding of the body, the funeral, and the will). Theoretically, this study linked death from COVID-19 with patient-centered care, highlighting disenfranchised grief due to the clash of health authority guidelines with religious death practices. Methodologically, this narrative study voices the perspectives of elder religious Muslims in Israel. Practically, this study suggests ways to implement the cultural perspective in COVID-19 deaths and enable a healthy bereavement process.

Transcendence, the Most Important Spiritual Need of Muslim Older Adults: A Content Analysis Study

Healthcare providers agree that promoting spirituality among older adults while caring for them increases their quality of life. However, there is little knowledge about the spiritual needs of the elderly, especially in the Muslim community. This qualitative study attempted to explore the spiritual needs of Muslim older adults. Fifteen non-hospitalized Muslim older adults from Hamadan City, Iran, were interviewed. The semi-structured interviews were analyzed using conventional content analysis. After identifying semantic units from the text, related codes were extracted and placed in subcategories and categories based on their similarities. Once the data were analyzed, one theme was formed. The study's findings showed that the spiritual needs of older adults fell into three main categories: religious needs, the need for transcendence, and the need for connection. Religious needs included subcategories of religious practices and beliefs, and the need for transcendence included the search for meaning and purpose in life, and the need for peace and stability and balance. Also, the need for connection included the need to connect with nature and connect with others. Healthcare professionals and family caregivers should be trained in the specific competence of recognizing older people's unmet spiritual needs and fulfilling them.

Disentangling the Role of Religiosity in Human Papillomavirus Vaccination Amidst COVID-19 Pandemic

Religion is a complex and sociocultural driver of human papillomavirus (HPV) vaccination decisions, but its exact role has been mixed/unclear. We used a cross-sectional study of 342 Christian parents to examine the associations between the three domains of religiosity (organizational, non-organizational, and intrinsic) and the intention to (i) seek HPV information and (ii) receive the HPV vaccine. Organizational religiosity was the only domain that was positively associated with information-seeking intention regardless of the type of covariates included. Mixed findings in the association between religiosity and HPV vaccination decisions may depend on the religiosity domain being assessed.

Mosque as a vaccination site for ethnic minority in Kanagawa, Japan: leaving no one behind amid the COVID-19 pandemic

Ethnic minorities with different languages and religions are potentially vulnerable not only during natural hazard-related disasters, but also during the COVID-19 pandemic. Their vaccination coverage may be lower, and vaccination strategies should prevent them from being left behind. This report presents the first case in Japan where a mosque, being the hub of foreign Muslims, was used as a vaccination site from the end of July 2021. The targeted mosque was Ebina Mosque in Kanagawa Prefecture, and most of the vaccine recipients were foreign Muslims. The mosque differed from other vaccination sites in that reservations could be made easily through the managers, and linguistic diversity (i.e., the mosque managers and mosque-related volunteers served as interpreters) and gender were considered. These efforts are likely to have removed some barriers to vaccination for ethnic minorities and contributed to "no one will be left behind."

Perceptions of Spiritual Dryness in Iran During the COVID-19 Pandemic

This study addresses perceptions of spiritual dryness (a specific form of spiritual struggle) during the COVID-19 pandemic among Iranian Muslims (n = 362), and how these perceptions can be predicted. Spiritual dryness was perceived often to regularly by 27% and occasionally by 35%. Regression models revealed that the best predictors of spiritual dryness (SDS-7) were usage of mood-enhancing medications, loneliness/social isolation and praying as positive predictors, and being restricted in daily life concerns as negative predictor. The pandemic challenges mental stability of people worldwide and may also challenge trust in God. Reliable and humble support of people experiencing these phases is required.

Racialized minorities, trust, and crisis: Muslim-American nonprofits, their leadership and government relations during COVID-19

The COVID-19 pandemic disproportionately affects already-vulnerable minorities, highlighting the need for strong, trusting relationships between governments and minority nonprofits for everyone's benefit. The current scholarship suggests minority members often lack trust in government. This study contributes to the field by examining trust levels Muslim-American nonprofits have for federal, state, and local government. Nearly two-thirds (65%) of Muslim nonprofit leaders believe that they may be discriminated against in the award of CARES Act funding, but on racial rather than religious ones. Moreover, partisanship affects trust levels. Muslim nonprofits in Republican "red" states show less trust in government compared with those in Democratic "blue" states. This study finds evidence that past relationships with the government strengthen trust. Past awards of government grants correlated positively with higher trust at both federal and local levels.

Intercultural Communication Concepts in Clinical Pastoral Education: The Intercultural Experience of Muslim Students

This essay argues that inclusivity and multicultural-theological representation in CPE is its most valuable component. We will explore Muslim students' interaction, communication, and other processes, including conceptual analysis during their CPE training. Furthermore, gaps in the CPE curriculum will be addressed.

Has Muslim Got Benefited from the National Health Mission? A Situational Analysis of Maternal Health Services in India

Background

It is a marked recognition that when the population is disaggregated by religion, wide disparities in the utilization of maternal health care services can be observed. The study was aimed to analyze the levels and trends of maternal health services among Muslims in India. The study also delineated the investigation of confounding factors attributed to maternal health services among the selected population.

Methods

The study utilized the data from the third and fourth round of National Family Health Survey (NFHS), conducted in 2005–06 and 2015–16 respectively. The bivariate and multivariate logistic regression models were employed to accomplish the study objectives.

Result

There is an increasing trend in the distributional patterns of all three indicators (full ANC, SBA and PNC) during the last two successive surveys. Muslim women belonging to Southern States were seen to be utilizing more maternal health care services as compared to Muslim women in the Northern States. Muslim populated States like Assam, Bihar, Jharkhand, Uttar Pradesh and West Bengal were far cry to achieve the MDG-15 target of utilization of 100 percent skilled birth attendants in 2015. Education, media exposure and wealth status appeared to be major confounding factors for determining the utilization of maternal health services.

Conclusion

The study revealed that the utilizations of maternal health services among Muslims have progressed during the last decade. It can be concluded that the NHM policy has played an instrumental role in increasing the utilization of maternal health services among Muslims.

Investigation of the Spiritual Care Effects on Anxiety, Depression, Psychological Distress and Spiritual Levels of Turkish Muslim Radiotherapy Patients

The aim of this study is to examine the spiritual care support given to Muslim cancer patients undergoing radiotherapy with an experimental study on the spirituality, anxiety, depression and distress levels of these patients. In this study, experimental research design with experimental control group was used. Personal information form designed by researchers, HAD scale, DT scale and Spirituality Scale was used for personal information. In conclusion, it was determined that the support for Islamic spiritual care had positive effects on hospitalized radiotherapy patients. According to the results obtained, it is recommended to examine in larger sample groups in different treatment programs in order to reveal the effect of spiritual care support.

Evaluating health-related quality of life and emotions in Muslim and Jewish kidney transplant patients

BACKGROUND

The scholarship on the impact of the source of the donated kidney (living donor (LD) or deceased donor) and the ethnoreligious background on the quality of life post-transplantation have received little scientific attention. The purpose of the present research is to evaluate health-related quality of life and psychological feelings among kidney transplant (KT) recipients.

OBJECTIVE

To compare the health related quality of life and psychological feelings between kidney transplant (KT) recipients who received a graft from a living versus a deceased donor, and between Muslim and Jewish patients.

METHODS

Two hundred and sixty-two renal recipients completed the health-related quality of life (HRQOL; World Health Organization Quality of Life Brief Version (WHOQOL-BREF)) questionnaire and answered the Transplant Effects Questionnaire assessing their post-transplantation emotional and psychological responses.

RESULTS

KT recipients reported medium levels of physical, psychological, social and environmental dimensions of HRQOL. Muslim recipients reported significantly higher levels of physical, psychological and social dimensions of HRQOL than Jews. Recipients of kidneys from LD reported higher levels of HRQOL and reported significantly higher levels of guilt and responsibility to be healthy.

CONCLUSIONS

Our findings indicate that receiving a graft from an LD contributes to the HRQOL in the physical, psychological and environmental dimensions. Hence, donations from LD should be encouraged, by investing efforts in promoting public awareness of the importance of donating kidneys by LDs. Muslim KT recipients enjoy better physical, social and psychological HRQOL; this difference can be explained by the supportive and embracing familial and social networks characterizing traditional Arab communities. Post-transplantation support programs should be designed in order to provide further support and improve emotional and psychological responses to postoperative reality.

Understanding the stigma: a novel quantitative study comparing mental health attitudes and perceptions between young British Muslims and their non-Muslims peers

BACKGROUND

A significant proportion of young British Muslims identify themselves by religious identity rather than ethnicity however very few mental health studies have focused on this cohort.

AIMS

To explore whether young British Muslims' knowledge, awareness and perceptions of mental illness differ to their non-Muslim peers.

METHOD

Population based survey of second generation Muslims (n = 83) and non-Muslims (n = 76) aged 18-35. Anonymised 38-item questionnaire on mental health attitudes, perceptions and help seeking behaviours.

RESULTS

Muslims were less likely to correctly identify symptoms of mental illness compared to their non-Muslim peers. Stigma and awareness remains a major issue. A third of Muslims would consider stopping medication on advice of a religious leader. Nearly half of Muslims were more likely to attend a dedicated ethnic/religious mental health service.

CONCLUSIONS

British Muslim views and attitudes of mental health differ from their non-Muslim counterparts. Services should ensure they are religiously sensitive.

This Being is a Guest House: Embracing Humility, Liberation & Strengths in Therapy with Sexual and Gender Diverse Muslims

The complexity of the lives of sexual and gender diverse Muslims within the United States calls for mental health providers to own our power and privilege. Embracing cultural humility in service of aligning ourselves with liberation psychology, we call for an intersectionally informed, strengths-based approach to empowering/affirming clients whose diverse religious experiences intersect with their experiences of marginalization as sexual and gender diverse (SGD) Muslims. Drawing on extant personal narratives around mental health and therapy of this population, the authors offer critical reflections, processes and opportunities for clinicians to take responsibility in honoring the diverse journeys and experiences of SGD Muslims in serving them in journeys of healing.

A Cross-Sectional Survey of Pakistani Muslims Coping with Health Anxiety through Religiosity during the COVID-19 Pandemic

Investigating the role of religiosity in coping with health anxiety during the outbreak of COVID-19 assumes significance given the continued onslaught of the pandemic and the importance of religion in many societies of the world. The aim of this study is to test the relationship between religious coping and health anxiety in Pakistani Muslims. The online survey method was used to collect data from 408 respondents. Structural equational modeling was performed, with results indicating that people who are suffering with health anxiety opt for religious coping (β = .54, R² = .29, p < .001). We conclude that it is important to consider the role of religion and spirituality during pandemic-induced anxiety. There are implications for counselors, physicians and researchers to integrate religious coping methods when planning mental health interventions during pandemics and otherwise.

The Role of Grandparents in Israeli Muslim Families with Intellectually Disabled Fathers: Social Workers' Perspectives

Within Israeli Muslim society, men with intellectual disabilities are likely to marry nondisabled women through arranged marriages and create families. This article explores the role of grandparents with these families from the perspective of each family's social worker. A thematic analysis was conducted of 19 semistructured interviews with Muslim social workers serving Muslim families with intellectually disabled fathers. Consistent with cultural norms, paternal grandparents are extremely involved in the lives of these couples and hold responsibilities in many aspects of these couples' family lives. Social workers reported that the nondisabled wives, however, viewed the engagement as intrusive and controlling. Maternal grandparents' contributions were crucially supportive, albeit limited by Muslim cultural norms that placed households under paternal family control. Social workers had conflicted feelings regarding paternal grandparent involvement. Social workers working with Muslim fathers with intellectual disabilities should promote supportive paternal grandparent involvement and ensure that such engagement does not undermine the autonomy or well-being of the nondisabled mothers. Practice guidelines are presented.

"My Existence is not Haram": Intersectional Lives in LGBTQ Muslims Living in Canada

Little is known about the lived experiences of Lesbian, Gay, Bisexual, Transgendered and Queer (LGBTQ) Muslims living in Canada. Using an intersectional theoretical perspective and a qualitative methodology, this paper examines key themes emerging in the stories of six LGBTQ Muslim women and men living in Canada. The key themes emerging in this research were the tension between perceived family obligations and religious values, the ambiguous relationship with Islam, and coping with mental health issues. The research points to the importance of understanding such experiences as occurring in a matrix of identities and processes, as postulated by intersectionality theory.