Skip to main content
SpringerLink
Log in

A Pilot Efficacy Trial to Educate Muslim Americans about the Islamic Bioethical Perspectives in End-of-Life Healthcare

  • Original Paper
  • Published:
Journal of Immigrant and Minority Health Aims and scope Submit manuscript

Abstract

In the US, end-of-life health care (EOLHC) is often intensive and invasive, and at times may involve care that is inconsistent with patient values. US Muslims may not receive appropriate religious support, experience uncertainty around end-of-life decision-making, and under-utilize palliative and hospice care. As technological advancements and treatment options rise in EOLHC, Muslim American patients and their families need to understand more about the treatment options that are consistent with their beliefs. The objective of this study was to determine the efficacy of a pilot mosque-based educational workshop focused on increasing Muslim Americans’ religious bioethics knowledge about end-of-life healthcare. Intervention sites were four mosques with racially and ethnically diverse members, two in the Chicago metropolitan area and two in the Washington, D.C. area. Eligible participants were self-reported Muslims, aged 18 years or older, who were proficient in English. The intervention included a pre and post-test survey and a workshop focused on the Islamic bioethical perspectives on EOLHC. Knowledge was measured with six true-false questions. Baseline and post-intervention scores were analyzed by McNemar’s test and bivariate correlation. Overall, the analysis showed a significant improvement in post-intervention participant knowledge. There was increased knowledge of Islamic bioethical views on the moral status of seeking healthcare, brain death controversies, and religious perspectives on withholding or withdrawing life support near the end of life. Our pilot intervention successfully increased participant knowledge and underscores the need to improve the Muslim community’s knowledge about the bioethical dimensions of EOLHC.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Curtis JR, et al. End-of-life care in the intensive care unit: can we simultaneously increase quality and reduce costs? Am J Respir Crit Care Med. 2012;186(7):587–92.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Smith TJ, et al. A high-volume specialist palliative care unit and team may reduce in-hospital end-of-life care costs. J Palliat Med. 2003;6(5):699–705.

    Article  PubMed  Google Scholar 

  3. Duffy SA, et al. Racial/ethnic preferences, sex preferences, and perceived discrimination related to end-of‐life care. J Am Geriatr Soc. 2006;54(1):150–7.

    Article  PubMed  Google Scholar 

  4. Boucher NA, Siddiqui EA, Koenig HG. Supporting muslim patients during advanced illness. Permanente J, 2017. 21.

  5. Al-Heeti RM. Why nursing homes will not work: caring for the needs of the aging muslim american population. Elder LJ. 2007;15:205.

    Google Scholar 

  6. Younis M. Muslim Americans Exemplify Diversity, Potential. 2009 [cited 2010 November 12]; Available from: http://www.gallup.com/poll/116260/Muslim-Americans-Exemplify-Diversity-Potential.aspx.

  7. Pew Research Center. U.S. Muslims Concerned About Their Place in Society, but Continue to Believe in the American Dream. Religion & Public Life 2017 [cited 2019 May 15]; Available from: https://www.pewforum.org/2017/07/26/findings-from-pew-research-centers-2017-survey-of-us-muslims/.

  8. Pew Research Center. Black Muslims account for a fifth of all U.S. Muslims, and about half are converts to Islam. Religion 2017 [cited 2023 July 7]; https://www.pewresearch.org/short-reads/2019/01/17/black-muslims-account-for-a-fifth-of-all-u-s-muslims-and-about-half-are-converts-to-islam/.

  9. Mohamed B. New estimates show US muslim population continues to grow. Pew Research Center; 2018. p. 3.

  10. Padela A, Curlin F. Religion and Disparities: considering the Influences of Islam on the health of american Muslims. J Relig Health, 2012.

  11. Zaidi AIPD. The islamic tradition and health inequities: a preliminary conceptual model based on a systematic literature review of muslim health-care disparities. Avicenna J Med, 2018. 8(1).

  12. Arozullah AM, et al. Causes and means of healing: an islamic ontological perspective. J Relig Health. 2020;59(2):796–803.

    Article  PubMed  Google Scholar 

  13. Padela AI, et al. American Muslim perceptions of healing: key agents in healing, and their roles. Qual Health Res. 2012;22(6):846–58.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Yacoub AAA, et al. The Fiqh of Medicine: responses in islamic jurisprudence to development in Medical Science. London, UK: Ta-Ha Publishers Ltd. 360; 2001.

    Google Scholar 

  15. Martin MB. Perceived discrimination of Muslims in Health Care. J Muslim Mental Health. 2015;9(2):41–69.

    Article  Google Scholar 

  16. Padela AI, Heisler M. The association of perceived abuse and discrimination after September 11, 2001, with psychological distress, level of happiness, and health status among arab Americans. Am J Public Health. 2010;100(2):284–91.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Rippy A, Newman E. Perceived religious discrimination and its relationship to anxiety and paranoia among Muslim Americans. J Muslim Mental Health. 2006;1:5–20.

    Article  Google Scholar 

  18. Samari G. Islamophobia and Public Health in the United States. Am J Public Health. 2016;106(11):1920–5.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Samuels EA, et al. Health care utilization before and after the Muslim Ban executive order among people born in muslim-majority countries and living in the US. JAMA Netw Open. 2021;4(7):e2118216–6.

    Article  PubMed  PubMed Central  Google Scholar 

  20. McLaughlin MH, et al. Attitudes of Muslims living in the United States toward long-term care decisions and diagnosis disclosure for elderly family members. J Am Geriatr Soc. 2016;64(10):2132–7.

    Article  PubMed  Google Scholar 

  21. Madni A, et al. Top ten Tips Palliative Care Clinicians should know about caring for Muslims. Journal of palliative medicine; 2021.

  22. Chamsi-Pasha H, Albar MA. Do not resuscitate, brain death, and organ transplantation: islamic perspective. Avicenna J Med. 2017;7(2):35.

    PubMed  PubMed Central  Google Scholar 

  23. Chamsi-Pasha H, Albar MA. Ethical dilemmas at the end of life: islamic perspective. J Relig Health. 2017;56(2):400–10.

    Article  PubMed  Google Scholar 

  24. Padela AI, Arozullah A, Moosa E. Brain death in islamic ethico-legal deliberation: challenges for applied islamic bioethics. Bioethics. 2013;27(3):132–9.

    Article  PubMed  Google Scholar 

  25. Padela AI, et al. Informing american Muslims about living donation through tailored health education: a randomized controlled crossover trial evaluating increase in biomedical and religious knowledge. Am J Transplant. 2021;21(3):1227–37.

    Article  PubMed  Google Scholar 

  26. Ghaly M, et al. Palliative care and islamic ethics: exploring Key issues and best practice. Qatar Foundation: Doha Qatar; 2018.

    Google Scholar 

  27. Choong KA. Islam and palliative care. Global Bioeth. 2015;26(1):28–42.

    Article  Google Scholar 

  28. Sachedina A. End-of-life: the islamic view. The Lancet. 2005;366(9487):774–9.

    Article  Google Scholar 

  29. Padela AI, Qureshi O. Islamic perspectives on clinical intervention near the end-of-life: we can but must we? Med Health Care Philos. 2017;20(4):545–59.

    Article  PubMed  Google Scholar 

  30. Leong M, et al. How Islam influences end-of-life care: education for palliative care clinicians. J Pain Symptom Manag. 2016;52(6):771–4. e3.

    Article  Google Scholar 

  31. Moale AC, et al. Educational intervention enhances clinician awareness of Christian, jewish, and islamic teachings around end-of-life care. J Palliat Med. 2019;22(1):62–70.

    Article  PubMed  Google Scholar 

  32. Fink M, et al. Evaluating the use of standardized patients in teaching spiritual care at the end of life. Clin Simul Nurs. 2014;10(11):559–66.

    Article  Google Scholar 

  33. Padela AI, et al. The impact of religiously tailored and ethically balanced education on intention for living organ donation among Muslim Americans. Clin Transplant. 2020;34(12):e14111.

    Article  PubMed  Google Scholar 

  34. Padela AI, et al. Reducing muslim mammography disparities: outcomes from a religiously tailored mosque-based intervention. Health Educ Behav. 2018;45(6):1025–35.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Vu M, et al. Muslim women’s perspectives on designing mosque-based women’s health interventions—an exploratory qualitative study. Women Health. 2018;58(3):334–46.

    Article  PubMed  Google Scholar 

  36. Padela AI, et al. Study protocol for ‘informing american Muslims about organ donation (I AM a LD)’. Social Sci Protocols. 2019;2:1–17.

    Article  Google Scholar 

  37. Padela AI, et al. Associations between religion-related factors and breast cancer screening among american Muslims. J Immigr Minor Health. 2015;17:660–9.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Padela AI. Islamic Initatice on Islam and Medicine: Insitlling Hikmah in Healthcare. Workshops: Islamic Bioethics 2020; Available from: https://www.medicineandislam.org/.

  39. Padela AI, Shanawani H, Arozullah A. Medical experts & islamic scholars deliberating over Brain Death: gaps in the Applied Islamic Bioethics Discourse. Muslim World. 2011;101(1):53–72.

    Article  PubMed  Google Scholar 

  40. Mohiuddin A, et al. When can Muslims withdraw or withhold life support? A narrative review of islamic juridical rulings. Global Bioeth. 2020;31(1):29–46.

    Article  Google Scholar 

  41. Qureshi O, Padela A. When must a patient seek healthcare? Bringing the perspectives of islamic jurists and clinicians into dialogue. Zygon. 2016;51(3):592–625.

    Article  Google Scholar 

  42. Koenig HG, Büssing A. The Duke University Religion Index (DUREL): a five-item measure for use in epidemological studies. Religions. 2010;1(1):78–85.

    Article  Google Scholar 

  43. Peek ME, et al. Adapting the everyday discrimination scale to medical settings: reliability and validity testing in a sample of african american patients. Volume 21. Ethnicity & disease; 2011. p. 502. 4.

  44. Sternthal MJ, Slopen N, Williams DR. Racial disparities in health: how much does stress really matter? 1 Du Bois review: social science research on race, 2011. 8(1): p. 95–113.

  45. Saeed F, et al. End-of-life care beliefs among muslim physicians. Am J Hospice Palliat Medicine®. 2015;32(4):388–92.

    Article  Google Scholar 

  46. Gatrad A, Sheikh A. Palliative care for Muslims and issues before death. Int J Palliat Nurs. 2002;8(11):526–31.

    Article  CAS  PubMed  Google Scholar 

  47. Lipka M. Muslims and Islam: Key findings in the US and around the world Pew Research Center, 2017. 9: p. 2017.

  48. Wood R, Bandura A. Impact of conceptions of ability on self-regulatory mechanisms and complex decision making. J Personal Soc Psychol. 1989;56(3):407.

    Article  CAS  Google Scholar 

  49. Abu-El-Noor NI, Abu-El-Noor MK. End of Life-Decisions: an islamic perspective. Online J Health Ethics, 2014. 10(1).

Download references

Author information

Authors and Affiliations

  1. Section of General Internal Medicine, Department of Medicine, University of Chicago Medical Center, 5841 S. Maryland Ave., MC2007, Chicago, IL, 60637, USA

    Milda Saunders, Michael Quinn & Lindsay Zasadzinski

  2. Department of Women and Children’s Health, Uppsala University, Uppsala, Sweden

    Rosie Duivenbode

  3. Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee, WI, USA

    Aasim I. Padela

Authors
  1. Milda Saunders
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michael Quinn
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rosie Duivenbode
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Lindsay Zasadzinski
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Aasim I. Padela
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Milda Saunders.

Ethics declarations

Competing interests

The authors have no relevant financial or non-financial interests to disclose.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Saunders, M., Quinn, M., Duivenbode, R. et al. A Pilot Efficacy Trial to Educate Muslim Americans about the Islamic Bioethical Perspectives in End-of-Life Healthcare. J Immigrant Minority Health 26, 133–139 (2024). https://doi.org/10.1007/s10903-023-01541-x

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10903-023-01541-x

Keywords

Search

Navigation