CARING FOR OURMUSLIM PATIENTS Compiled and Presented by : Taqwa Surapati

Belief, Hospitalization, and Healthcare Issues For Muslims

PRESENTATION STRUCTURE-INTRODUCTION TO ISLAM AND MUSLIMS

-MEET OUR MUSLIM PATIENTS

-SPIRITUAL CARE NEEDS IN ILLNESS, DEATH AND DYING

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This document is a compilation of works from : Doha Hamza, Chaplain Kamal Abu-Shamsieh and Imam Kifah A. Mustapha My sincerest gratitude, may Allah the Most High rewards you with the best, Taqwa Mahrani Surapati

Gratitude

INTRODUCTION TO ISLAM AND MUSLIMSKnowledge about Islam. Experience observing, meeting and interacting with Muslims before, inside or outside the hospital. Muslims came from different countries and cultures.

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Not to be confused with…

DO YOU KNOW THESE MUSLIMS?

DO YOU KNOW WHICH MOSQUE ARE THESE?

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HISTORY AND THE BIRTHPLACE OF ISLAM

570 -Prophet Muhammad (Peace Be Upon Him) was born in Mecca610 -Prophet Muhammad at the age of 40, received the first revelation from God, through Archangel Gabriel, making him a prophet of Islam 622 -Prophet Muhammad moved to Medina632 -Prophet Muhammad died at the age of 632014 – Muslims, believer of Islam make 21%of world population, over 3 million in the US

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WORLD RELIGION MAP WIKIPEDIA 2007

57 COUNTRIES WITH MUSLIM AS A MAJORITY, INCLUDING 22 ARAB COUNTRIESONLY 18-20 % OF MUSLIMS ARE ARABS, BIGGEST MUSLIM COUNTRY IS INDONESIA

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WHAT IS ISLAMISLAM IS A RELIGION WITH A GOAL OF LIVING WITH A STATE OF INNER PIECE, THROUGH SUBMISSION TO GOD.

ISLAM IS A CONTINUATION OF THE SAME TRUTH THAT GOD REVEALED TO PROPHET ADAM, NOAH, MOSES AND JESUS (PEACE BE UPON THEM ALL)

ISLAM PROMOTES UNIVERSAL VALUES OF PEACE, JUSTICE, MERCY AND FORGIVENESS

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Foundation of Faith and Pillars of Practicing Islam

Believing in God Believing in

Angels Believing in

Scriptures Believing in

Prophets Believing in

Hereafter Believing in

Destiny

To Witness (Shahadah)

To Pray (Shalat) To Give Charity

(Zakat) To Fast (Sawm) To go to Pilgrimage

(Hajj)

Foundation of Faith

Pillars of Practicing Islam

BELIEVING IN GOD – ALLAH ISLAM IS BASED ON THE BELIEF OF ABSOLUTE ONENESS AND UNITY OF GOD : : “SAY: HE, ALLAH, IS ONE. ALLAH IS HE ON WHOM ALL DEPEND. HE BEGETS NOT, NOR IS HE BEGOTTEN. AND NONE IS LIKE HIM.” QURAN 112:1-4

“(O BELIEVERS!) YOU SHALL WORSHIP GOD (ALONE)

AND YOU SHALL NOT ASSOCIATE ANYTHING WITH HIM (THEREIN).”

QURAN 4:36

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BELIEVING IN GOD’S ANGELS Muslims believe that angels are pure entities, created from light, cannot disobey God and have no divine nature. Angels duties are assigned by God.

BELIEVING IN GOD’S BOOKS“Now We have sent down to you (O Muhammad), the Scripture (of the Quran) with the truth, as a confirmation of all the Scripture that preceded it – and as a guardian over it (to preserve divine guidance).”

Quran 5:48

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•THE QURAN IT MEANS “ THE RECITED”

MUSLIMS RECITE IT IN THE ORIGINAL ARABIC

DIVIDED INTO 114 CHAPTERS IN VARIOUS LENGTH

HAS STORIES, MANY MENTIONED IN THE BIBLE

MUSLIMS READ THE ENTIRE QURAN IN THE MONTH OF RAMADAN,

SOME MEMORIZE IT ALL

MUSLIMS BELIEVE THE THE QURAN IS THE WORD OF GOD SENT DOWN TO PROPHET MUHAMMAD (PBUH) AS TOLD TO HIM BY THE ANGEL GABRIEL. BEING THE ILLITERATE PROPHET, HE MEMORIZED IT AND TAUGHT HIS COMPANIONS TO MEMORIZE IT ALSO

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BELIEVING IN THE HEREAFTERMuslim believe that all humans will stand for trial at the Day of Judgment. Rewarded in Heaven shall be those who were righteous, and punished in Hell shall be those who were evil.

BELIEVING IN DIVINE PREDESTINATION Life and death are predetermined. One has control over choices one make in this life, having the capacity to choose. Life are opportunities to prepare for the Hereafter. Muslim also believe nothing happens but by the permission and will of God, with his knowledge encompasses everything in the universe

“Oh God! Help me over the hardship and agony of death.” Prophet Muhammad said on his death bed.

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The Sunnah: sayings and deeds of Prophet Muhammad (PBUH) The Quran and the Sunnah are considered the primary sources of the Islamic theological, ethical, and legal systemsGOALS OF SHARIA / JURISPRUDENCE :1. PRESERVATION OF LIFE, 2. RELIGION, 3. MIND, 4. PROPERTY AND5. LINEAGE

Sharia, Laws of Religion

God is the legislator. The QuranThe Prophet: SunnahThen Law of deductive Logic, Consensus, & Analogy

Sharia is essential to the life of a Muslim, because it immediately regulates Acts of Worship and Rituals (For GOD) and Acts of Individual and Collective Justice (For fellow humans)

Sources of Sharia

No harm endured, or reciprocatedHarm must be removed, by lesser evilsSeeking public benefit (istislah) Protection against distress and constrictionAlleviate HardshipThings are judged by their intentions.

Guiding Legal Maxims

• LEADERSHIP IN ISLAM - ROLE OF MOSQUESMuslims do not have clergy. Title of leadership : Imam : is the person who lead the prayer in Arabic, and has basic knowledge of Islam Sheikh : is the person who has solid knowledge about Islam and serves the religious needs of peopleScholar : is the person who can interpret the text and make rulings or judgments

Role of Mosques / Masjids Masjids are places where Muslims meet to offer prayers to God. Services in mosques include prayers, funerals, arbitration, marriages, divorces, counseling, youth activities, voter registration, religious education, civic and social services, etc.

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MEET OUR MUSLIM PATIENTSSpiritual understanding of illness – life is a gift with many dimensionsSacredness of life, a Muslim should seek cure – opportunity to get closer to Allah, the Healer – recommended reciting the Quran near the sick peopleThe prophet said: “Allah has created illness and He has created cure, so (seek) cure”“…and He is the One who feeds me and gives me drink. And when I become ill, He (is the one who) heals me.” Quran 26: 79-80

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VIEWS ON ILLNESS AND SUFFERING CHOICE OF CONDUCT 1. For those who suffer (if they are mentally competent adults accountable for their deeds)2. For others who are under moral obligation to use their means to help the sufferers

SICKNESS IS ALSO VIEWED AS EXPIATION FROM PREVIOUS SINSthis explanation doesn’t apply to children who are born innocent, seen as sinless and free from religious responsibilities, however some parents may see their child’s illness or death as divine punishment for their sin—contrary to Islamic teachings

THE SUFFERING SOULS (including children who are not accountable for their own deeds) will be compensated “without measure” in the hereafter for their suffering.

PATIENT HAS AN ELEVATED STATUS IN GOD’S EYES by virtue of being sickpatient encouraged to have positive attitude towards sickness be it temporary or terminal

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MEET YOUR MUSLIM PATIENTS Islam gave the framework for living: Culture or Religion Religious preference identification : over 20% NRP reluctant to disclosePatients and chaplains – sometime skeptical/fearful, maybe welcomedSpiritual care needs – many unaware of own spiritual needs Culture, Language and Gender Practices

PATIENT BACKGROUND Indigenous / Immigrants / ConvertReligious Practicing / SecularVarious Schools of Law: (Sunni-Maliki, Shafei, Hambali, Hanafi) Strong family / Independent Assimilation / Acculturation

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SPIRITUAL NEEDS OF MUSLIM PATIENTS Prayer / Supplications / QuranPlace for prayer / Direction / Schedule Ablution (wudhu) or Dry ablution (tayamum)Halal Food / list of restaurants (zabiha.com) : no pork or alcohol Funeral & Burial Information Preservation of modesty, same gender provider for private care

FAMILY SYSTEM Indigenous / Immigrants / ConvertReligious Practicing / SecularStrong family / Independent Assimilation / Acculturation Various Schools of Law: (Sunni-Maliki, Shafei, Hambali, Hanafi

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PATIENT

Circle of Care

Interpreter

Nurses Ethicists

SocialWorker

Chaplain

Physicians

Case Manager

Family/Friends

Your view

Patient/family view

ROLE OF SOCIAL AND FAMILY SUPPORT -Social support is seen as an act of worship in Islam -Generally a close family/social structure, if the family open sharing illness with others – may differ from one case to another-All family members expected to be present and participating in patient care-Visiting the sick considered a very rewarding deed-Adult children considered it a duty to provide financial and physical care for parents. May tend to be protective of patient in delivering grave medical condition – act as advocates, spokesperson and interpreters-Visitor to keep a short visit, give supplications to the ill person, with optimistic words and offering support and help for the family

PALLIATIVE CARE : Family makes decisions with consultation with imamsCHAPLAIN”S ROLE : Bridging communication between family and staff, facilitate communication with the imam

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PRACTICING ISLAM DURING ILLNESS Should be performed in a matter that does not burden the person or worsen condition. PRAYERS : if not able to do it standing up, then sitting down or laying down FASTING : only if not worsen conditions, allowed by doctorsRELIGIOUS NEEDS : cleanliness, no family conference with staff during Friday congregation prayers or during sunset time in Ramadan

RESPONSE TO TERMINAL ILLNESS : diverse responses, sadness, grief, fear, anger, hopelessness. TIME OF DEATH, is determined by God alone. Fighting for life and accepting fate are two goals a Muslim strives for. Medicine is a tool or attempt to cure.

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DEATH AND DYING Muslims balance between the reality of death, loss and grief and the fact that no one is immortal. Muslims cope with death and seek healing through faith and patience. Muslims are to seek forgiveness from one another and repentance from God, until the last breathGOD the most Compassionate and Merciful, will grant forgiveness to whoever ask for it, dying person are encourage to expect the best from Him - The severity of the mistake is trivial compared asking God for forgivenessDeath is viewed as a moment of submission to the Will of God. Muslims believe that each person is returning to His Lord at time of death. No one is authorized to deliberate act of ending life. Murder, suicide, euthanasia and mercy killing are not allowed in Islam.

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CARE FOR THE DYING PATIENT

GIVE COMFORT, remind of God’s Mercy and ForgivenessRECITE the Quran, give physical comfort, encourage reciting the Shahada FACE MECCA if possibleGIVE FAMILY space and privacyUSE OF SEDATIVES: medication to alleviate suffering or maintaining consciousness, is allowed. The benefit is to gain relief from pain and allowing observance of the worship ritesDNR PATIENTS: opposing views – Quran 5:32 “If you save one soul, you save entire humanity” vs. to reduce suffering “Actions are to be judged by their intentions.” COMFORT CARE are Ok. Hydrate and feed. KEY WORD: NOT TO PROLONGED DEATH

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RESPONSIBILITIES TOWARDS THE DEAD Encourage family to remain calm, pray for the departedClose eyes and mouth, cover body temporarily with clean sheet Crying and grieving are normal, remind that God is the one who gives life and takes it away. Announce death to others, family to offer to pay off any debt the deceased had. Offer condolences, prayers, and help for the family. Quick burial and expedited process of paperwork from hospital always appreciated (Disposition of Remains, Death Certificate) RITUALS ARE : washing the body, shrouding, congregation prayers for the deceased, burial in ground method. No cremation or putting body in mausoleum above ground. Muslim believes that the soul remains in the body, should be treated with greatest respect and gentleness.

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BURIAL PROCESS AND GRAVEYARD SERVICE

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END OF LIFE TOPICS Withdrawal of life supportPermissible in case of total and irreversible loss of brain function after a diligent and exhaustive investigation by (Muslim) medical professionalsSpiritual care service role: providing religious scholars and support Organ donationUnder the concept of saving one life is equivalent to saving all humanity, organ donation is encourage with conditionsAbortionthe original ruling is of prohibition. Some opinions allow abortion within the first 120 days in cases of dire necessityAutopsy prohibited unless necessary

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