A Guide for Health Care Professionals and Pastoral CarersThe purpose of this information is to assist non-Muslim healthcare professionals to come to a better understanding of Islam so that they can provide appropriate and effective care to their Muslim patients. Most healthcare professionals may have to care for a Muslim patient at some stage. Being cared for in a hospital, day surgery facility or nursing home can be a very stressful experience. For carers, knowledge of and sensitivity towards a patient’s religious and cultural background can help in lowering stress, make the hospital stay more comfortable and speed recovery.
One Islam – Many MuslimsThough Islam is a single religion, it is important to recognise that Muslim people are not a single homogenous group. There are approximately +400,000 Muslims in Australia, who have come from over 70 countries all around the world: from Europe (ie Albania, Bosnia, Turkey), Africa, Asia (including Central Asia, South Asia, South East Asia), Pacific Islands, and North and South America. The cultural diversity of the Muslim community in Victoria makes it difficult for anyone to prejudge the expectations or needs of individual patients, for example, with regard to religious observance. When in doubt, it is always best to ask.
Aspects of General care
- Preservation of life overrides all matters presented in this brochure.
- Islam places the onus of practising religion on the individual.
- Cleanliness is part of Islamic faith.
- Strong emphasis on the virtues of visiting the sick.
- Where choice exists, medicines containing alcohol/pork derivates should NOT be used.
- Same sex health professional as the patient whenever possible. Unnecessary touching between non-related people of the opposite sex should be avoided.
- . For female patients, there is an overriding objective of modesty and privacy. In some cases, a close family member of the same sex may assist in the washing of the sick person.
- A beard is considered a very important religious symbol to some Muslim male patients. Like any other patient, permission must be obtained to shave any part of the beard.
- Reversible contraception (eg pill, condoms) is acceptable.
- Termination of a pregnancy is mandatory if the pregnancy constitutes a serious threat to the life of the mother, then termination is permissible irrespective of the period of gestation.
- There are other situations where termination of a pregnancy is permitted (severe congenital abnormality is an example). It is a not a decision that should be made lightly.
- Muslims consider the fetus after the age of 120 days is a viable baby.
- After delivery, the placenta (which is part baby) should be offered to the parents for disposal.
- It is important for a newborn child to have a prayer call recited in each ear soon after birth. It is possible that the parents may want a learned person (an Imam or Sheik) to perform this task.
- It is a traditional religious observance to shave the head of newborn babies on the seventh day after birth, or thereabouts.
- Circumcision is performed on all male children. The timing of this varies, but it must be done before puberty.
- The practice of female genital mutilation not supported by the Islamic faith. It is illegal under Australian law, and has no basis in religion.
- Pig meat and all its products (ham, bacon, etc) are forbidden to Muslims.
- Alcohol and any other intoxicating substance are prohibited in Islam.
- Muslims eat halal meat—the animal must be slaughtered according to Islamic rites. This practice is similar to the Jewish practice to make their meat kosher. Halal meat is readily available in Victoria.
- Muslims are allowed to eat seafood and dairy products.
End of Life
- Once treatment has been intensified to save a patient’s life, life-saving equipment cannot be turned off unless the physicians are certain about the inevitability of death (Islamic Juridical Council).
- Islamic law permits withdrawal of futile and disproportionate treatment on the basis of consent of immediate family members who act on the professional advice of the physician in charge of the case.
- “It is the process of life that is to be preserved, not the process of death.” (Islamic Organisation for Medical Sciences Symposium).
- Death is seen as something predestined by God.
- Families may thus appear inappropriately calm and accepting by Western standards.
- The death of a fetus after 120 days post conception of the have a after should be given to the parents for proper burial.
- If a patient is in a coma, it is preferred that the patient be turned to face Mecca (in Australia, roughly west-north-west). It is important for Muslims to recite the Qu’ran or prayers in front of the dying patient or in a room close by.
- For a patient who has just died, the face of the deceased
- should be turned in the direction of Mecca.
- The whole body of the deceased must be covered by a sheet and should be handled as little as possible. The body should be handled with the utmost respect by a person of the same sex.
- A cross must never be placed on the body. The body should not be washed, as this will be done as part of a special religious ritual before burial.
- Muslim burials are performed as soon as possible after death, sometimes on the same day. Never cremated.
- Major concerns of relatives:
- Respect for the deceased
- Delay in burial
- deemed necessary to establish cause of death
- significant public health interest
- required by law (suspicious circumstances, Coroner’s case)
- Not accepted for routine documentation / curiosity
Withdrawal of Treatment
- Challenge for ALL families, not just Muslims:
- Confusion: is it euthanasia or withdrawal of futile treatment? (Suicide and euthanasia are forbidden in Islam).
- Many Muslims may not realise the permissibility of treatment withdrawal in some cases.
- Some may question the inevitability of death (some scholars have suggested the opinion of two doctors be sought).
- The decision to end the life of a loved one is difficult; regardless of one’s religious or ethnic background.
Blood and Organ Donation
- Muslims accept blood transfusions and transplants of various human organs.
- It is acceptable for Muslims to donate blood and organs, as the saving of life is considered an act of great virtue.
Tips when caring for Muslim patients
- Given the centrality of the family, consider informing family of medical information, and to be involved in the decision-making process.
- Good communication -develop and maintain trust.
- Do not point the soles of the feet to the patient as this is considered disrespectful.
- In Islam, sick people are exempt from fasting in Ramadan (as well as the elderly, children and expecting mothers). If they insist on fasting, compliance with medication can be enhanced by prescribing with Ramadan in mind.
- . Consider using elderly members of the community – as they are often the controlling force in the family and with increased age comes increased respect and authority.
- Time does not dictate need, instead it is need that dictates time – consider when scheduling appointments.
- Misconception that male is decision maker.
- Nothing to prevent older teens being involved in decision making.
- Ask family to seek assistance from Muslim chaplain or the ICV.
Visiting the Sick
- Strong emphasis is placed on the virtues of visiting the sick. This brochure only hints at the complexities within Islam and its impact
- The sick Muslim is usually happy to receive many visitors.
Some final points
- Don’t assume every Muslim’s behaviour is due to their religion, it may be their culture, upbringing, or simply their personality type.
- Muslims are not a homogenous group; they are extremely diverse.
- There are some cultural practices that contradict Islamic teachings.