Islam 101: “How to take care of the Muslim

patients’ needs.”Dr.Muhammad AyubDr.Muhammad Ayub

Family Medicine Resident PGYFamily Medicine Resident PGY--33July 20, 2004July 20, 2004

Objectives

Basics of IslamBasics of Islam5 things to remember when dealing 5 things to remember when dealing with a Muslim patient.with a Muslim patient.Some pitfalls to avoid (faux pas)Some pitfalls to avoid (faux pas)

Some definitionsIslam Islam

The word "Islam" meansThe word "Islam" means peacepeace and and submissionsubmission. . Peace means to be at peace with yourself and your Peace means to be at peace with yourself and your surroundings and submission means submission to surroundings and submission means submission to the will of God. A broader meaning of the word the will of God. A broader meaning of the word "Islam" is to achieve peace by submitting to the "Islam" is to achieve peace by submitting to the will of God.will of God.

MuslimMuslimThe word "Muslim" means one who submits to the The word "Muslim" means one who submits to the will of God. This is done by declaring that will of God. This is done by declaring that "there "there is no god except one God and Muhammad is the is no god except one God and Muhammad is the messenger of God."messenger of God." In a broader sense, anyone In a broader sense, anyone who willingly submits to the will of God is a who willingly submits to the will of God is a Muslim.Muslim.

DemographicsOverOver 1.2 billion1.2 billion people from a vast range of races, people from a vast range of races, nationalities and cultures across the globe nationalities and cultures across the globe Southern Philippines to Nigeria Southern Philippines to Nigeria Only about Only about 18%18% live in the Arab worldlive in the Arab worldthe world's largest Muslim community is in the world's largest Muslim community is in Indonesia;Indonesia;substantial parts of Asia and most of Africa are substantial parts of Asia and most of Africa are Muslim, while significant minorities are to be Muslim, while significant minorities are to be found in Russia, China, North and South America, found in Russia, China, North and South America, and Europe.and Europe.

Belief System

5 Pillars of Islam5 Pillars of Islam7 Articles of Faith7 Articles of Faith

5 Pillars of Islam

Faith or belief in the Oneness of God (Allah) Faith or belief in the Oneness of God (Allah) and the finality of the and the finality of the ProphethoodProphethood of of Muhammad (Muhammad (pbuhpbuh); );

Establishment of the daily prayers; Establishment of the daily prayers;

Concern for and almsgiving to the needy; Concern for and almsgiving to the needy;

SelfSelf--purification through fasting; and purification through fasting; and

The pilgrimage to The pilgrimage to MakkahMakkah for those who are for those who are able. able.

7 Articles of Faith

1.1. The Belief in Allah The Belief in Allah 2.2. The Belief in the Angels The Belief in the Angels 3.3. The Belief in the Divine Scriptures The Belief in the Divine Scriptures 4.4. The Belief in the Messengers The Belief in the Messengers 5.5. The belief in the Final day The belief in the Final day 6.6. The belief in fate The belief in fate 7.7. The Belief in life after deathThe Belief in life after death

Holy Book - QuranAt the age of 40, while engaged in a meditative At the age of 40, while engaged in a meditative retreat, Muhammad,peace be upon him, received retreat, Muhammad,peace be upon him, received his first revelation from God through the Angel his first revelation from God through the Angel Gabriel. This revelation, which continued for 23 Gabriel. This revelation, which continued for 23 years, is known as the years, is known as the Quran.Quran.Literally, "that which is often recitedLiterally, "that which is often recited””Divine guidance for every MuslimDivine guidance for every MuslimConfirms the revelations given to earlier ProphetsConfirms the revelations given to earlier ProphetsDeals with all the subjects which concern human Deals with all the subjects which concern human beings: wisdom, doctrine, worship, transactions, beings: wisdom, doctrine, worship, transactions, law, etc. law, etc.

Some debunking of myths

Islam was NOT spread by the swordIslam was NOT spread by the swordNot all Muslim men have 4 wivesNot all Muslim men have 4 wivesMuslims are NOT antiMuslims are NOT anti--JesusJesus

"...And nearest among them in love to the "...And nearest among them in love to the believers wilt thou find those who say: 'We are believers wilt thou find those who say: 'We are Christians': because among these are men Christians': because among these are men devoted to learning and men who have devoted to learning and men who have renounced the world. And they are not renounced the world. And they are not arrogant." (The Holy Quran 5:82)arrogant." (The Holy Quran 5:82)

Sacrifices on the Third day of Hajj in Makkah – Feast of Abraham

5 Things To Remember

1.1. Food Food -- make SURE that there is no pork make SURE that there is no pork on their meal trays or they will not eat on their meal trays or they will not eat anything on the tray; ask the patient if anything on the tray; ask the patient if they prefer all vegetarian meals they prefer all vegetarian meals

2.2. Remember to knock first Remember to knock first –– especially with especially with a female patient, knock and wait for their a female patient, knock and wait for their response as she may not be properly response as she may not be properly coveredcovered

3. If you enter the room and the patient is 3. If you enter the room and the patient is praying, come back in a few minutes; do not praying, come back in a few minutes; do not walk in front of the patient at this timewalk in front of the patient at this time

4. Encourage visitation by family and friends; 4. Encourage visitation by family and friends; Muslims are encouraged to visit the sick as Muslims are encouraged to visit the sick as it is a blessing for them; if patient has no it is a blessing for them; if patient has no dietary restrictions, encourage family to dietary restrictions, encourage family to bring patientbring patient’’s favorite foodss favorite foods

5. Female patient5. Female patient’’s will appreciate having s will appreciate having only female health care providers if at all only female health care providers if at all possible; malepossible; male’’s will prefer male.s will prefer male.

Beliefs Related to Health CareMuslim patients do not consider illness to Muslim patients do not consider illness to be a punishment from God. They also be a punishment from God. They also believe that dying is a part of living and an believe that dying is a part of living and an entrance to the next life; a transformation entrance to the next life; a transformation from one life to another, a part of a journey, from one life to another, a part of a journey, and a contract and part of their faith in God. and a contract and part of their faith in God. The Qur'an says, "They (true believers) say: The Qur'an says, "They (true believers) say: To God we belong and to Him is our To God we belong and to Him is our return."return."

Some tit-bits …. The sanctity of life is an injunction. The sanctity of life is an injunction. Abortion is not advised except to save the mother's Abortion is not advised except to save the mother's life or in very limited circumstances in early life or in very limited circumstances in early pregnancy due to medical or fetal indications. pregnancy due to medical or fetal indications. Individual decisions may vary. Individual decisions may vary. It is a religious custom that an elder says the It is a religious custom that an elder says the Islamic prayer call in an infant's right ear shortly Islamic prayer call in an infant's right ear shortly after birth. after birth. Circumcision of male infants is recommended and Circumcision of male infants is recommended and is universally practiced. is universally practiced. Blood transfusions are allowed. Blood transfusions are allowed.

More trivia …..

Artificial reproductive technology is permitted Artificial reproductive technology is permitted only during the span of intact marriage between only during the span of intact marriage between husband and wife. husband and wife. Organ transplantation, both donating and Organ transplantation, both donating and receiving, is allowed with some restrictions (donor receiving, is allowed with some restrictions (donor material of porcine origin). material of porcine origin). Genetic engineering to cure a disease is Genetic engineering to cure a disease is acceptable. To date, Muslim jurists have called for acceptable. To date, Muslim jurists have called for a ban on human cloning. a ban on human cloning.

Keep this in mind ….

Islam does not prohibit Muslim physicians from Islam does not prohibit Muslim physicians from caring for AIDS patients or those with other caring for AIDS patients or those with other sexually transmitted diseases. sexually transmitted diseases. Assisted suicide and euthanasia are not permitted. Assisted suicide and euthanasia are not permitted. Maintaining a terminal patient on artificial life Maintaining a terminal patient on artificial life support for a prolonged period in a vegetative state support for a prolonged period in a vegetative state is not encouraged. is not encouraged. Autopsy is not encouraged. However, it is Autopsy is not encouraged. However, it is permitted if required by law. permitted if required by law.

Medical & Nursing CareRespect modesty and privacy (knock on the door, Respect modesty and privacy (knock on the door, announce your arrival, etc.). announce your arrival, etc.). Limit eye contact. Limit eye contact. Do not touch while talking. Do not touch while talking. Some Muslim women will insist on covering their Some Muslim women will insist on covering their whole bodies except for the face, hands and feet at whole bodies except for the face, hands and feet at all times. Some examinations may be done while a all times. Some examinations may be done while a patient wears a gown. Hospital gowns should be patient wears a gown. Hospital gowns should be long, with long sleeves. If such clothing is long, with long sleeves. If such clothing is unavailable, Muslim women should be allowed to unavailable, Muslim women should be allowed to use their own gowns. use their own gowns.

Although Islam does not ban treatment by the Although Islam does not ban treatment by the opposite sex, providing the patient with a nurse opposite sex, providing the patient with a nurse and/or physician of the same sex when possible is and/or physician of the same sex when possible is recommended, especially if the patient feels recommended, especially if the patient feels strongly about it. Alternately, a male physician strongly about it. Alternately, a male physician should examine a female patient in the presence of should examine a female patient in the presence of her husband or another female if the patient her husband or another female if the patient desires, when possible. desires, when possible. Many Muslims are new immigrants from a wide Many Muslims are new immigrants from a wide variety of countries and may have language variety of countries and may have language comprehension problems. Therefore, take time to comprehension problems. Therefore, take time to explain tests, procedures and treatments to the explain tests, procedures and treatments to the patient and appropriate family members. It may be patient and appropriate family members. It may be necessary to arrange for an interpreter. necessary to arrange for an interpreter.

End of Life Care In matters of terminal care, the attending physician In matters of terminal care, the attending physician should consult the patient, the family, the ethicist, and should consult the patient, the family, the ethicist, and preferably, an Islamic scholar before making a final preferably, an Islamic scholar before making a final decision. decision. Health care providers (including nurses, physicians and Health care providers (including nurses, physicians and chaplains) should comfort the terminally ill patient, chaplains) should comfort the terminally ill patient, making sure he/she is painmaking sure he/she is pain--free, have his/her relatives free, have his/her relatives and friends nearby, and have access to a Muslim Imam and friends nearby, and have access to a Muslim Imam who can read the Qur'an and make special prayers. who can read the Qur'an and make special prayers. It is important that funeral and burial arrangements be It is important that funeral and burial arrangements be made in advance in consultation with the family and made in advance in consultation with the family and according to the wishes of the dying or deceased patient according to the wishes of the dying or deceased patient if possible if possible

With minimum delay, the body is to be removed With minimum delay, the body is to be removed to the funeral home because Muslims prefer an to the funeral home because Muslims prefer an expeditious burial. Provide routine postexpeditious burial. Provide routine post--mortem mortem care; the body should be gowned and shrouded. care; the body should be gowned and shrouded. Allow the family and Imam to follow Islamic Allow the family and Imam to follow Islamic guidelines for preparing the dead body for an guidelines for preparing the dead body for an Islamic funeral. The dead body should be given Islamic funeral. The dead body should be given the same respect and privacy as during life. the same respect and privacy as during life. For hospice care, the family may prepare for For hospice care, the family may prepare for washing and shrouding of the body immediately washing and shrouding of the body immediately after death, prior to removal. after death, prior to removal.

Summary

5 things to keep in mind5 things to keep in mindLet us be open, accommodativeLet us be open, accommodativeMuslims are actually scared thruMuslims are actually scared thru’’ these these timestimesYes, We are UNITED NATIONSYes, We are UNITED NATIONSA bouquet of FlowersA bouquet of Flowers

Thank you …..

For your patient listening. For your patient listening. For inviting meFor inviting mePlease feel free to ePlease feel free to e--mail with any questions mail with any questions or clarifications. or clarifications. If I donIf I don’’t know the answer, I shall find out t know the answer, I shall find out for you ! for you ! Mayub@swmail.sw.orgMayub@swmail.sw.org