Abstract
Although Western biomedical ethics emphasizes respect for autonomy, the medical decision-making of Muslim patients interacting with Western healthcare systems is more likely to be motivated by relational ethical and religious commitments that reflect the ideals of equity, reciprocity, and justice. Based on an in-depth cross-cultural comparison of Islamic and Western systems of biomedical ethics and an assessment of conceptual alignments and differences, we argue that, when working with Muslim patients, an ethics of respect extends to facilitating decision-making grounded in the patient’s justice-related customs, beliefs, and obligations. We offer an overview of the philosophical contestations of autonomy-enhancing practices from the Islamic tradition of biomedical ethics, and examples that demonstrate a recommended shift of emphasis from an autonomy-centered to a justice-focused approach to culturally competent agency-promotion.
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References
Due Pre, Athena, and Barbara Cook Overton. 2020. Communicating about health: Current issues and perspectives. New York: Oxford University Press.
Attum, Basem, Sumaiya Hafiz, Ahmad Malik, and Zafar Shamoon. 2022. Cultural competence in the care of Muslim patients and their families. Treasure Island (FL): StatPearls Publishing.
Sachedina, Abdulaziz. 2009. Islamic biomedical ethics: Principles and application. New York: Oxford University Press.
Betancourt, Joseph R., Alexander R. Green, J. Emilio Carrillo, and Owusu Ananeh-Firempong. 2003. Defining cultural competence: A practical framework for addressing racial/ethnic disparities in health and health care. Public Health Reports. https://doi.org/10.1093/phr/118.4.293.
The Joint Commission. 2010. Advancing effective communication, cultural competence, and patient- and family-centered care: A roadmap for Hospitals. Oakbrook Terrace, IL: The Joint Commission.
Martin, Mary B. 2015. Perceived discrimination of Muslims in health care. Journal of Muslim Mental Health. https://doi.org/10.3998/jmmh.10381607.0009.203.
Rivenbark, Joshua G., and Mathieu Ichou. 2020. Discrimination in healthcare as a barrier to care: Experiences of socially disadvantaged populations in France from a nationally representative survey. BMC Public Health. https://doi.org/10.1186/s12889-019-8124-z.
Laird, Lance D., Mona M. Amer, Elizabeth D. Barnett, and Linda L. Barnes. 2007. Muslim patients and health disparities in the UK and the US. Archives of Disease in Childhood. https://doi.org/10.1136/adc.2006.104364.
Padela, Aasim I., Katie Gunter, Amal Killawi, and Michele Heisler. 2012. Religious values and healthcare accommodations: Voices from the American Muslim Community. Journal of General Internal Medicine. https://doi.org/10.1007/s11606-011-1965-5.
Padela, Aasim I., and Danish Zaidi. 2018. The Islamic tradition and health inequities: A preliminary conceptual model based on a systematic literature review of Muslim health-care disparities. Avicenna Journal of Medicine. https://doi.org/10.4103/ajm.AJM_134_17.
Beauchamp, Tom, and James Childress. 2019. Principles of biomedical ethics, 8th ed. New York: Oxford University Press.
Paasche-Orlow, Michael. 2004. The ethics of cultural competence. Academic Medicine. https://doi.org/10.1097/00001888-200404000-00012.
Reitmanova, Sylvia, and Diana L. Gustafson. 2008. ‘They can’t understand it’: Maternity health and care needs of immigrant Muslim women in St. John’s, Newfoundland. Maternal and Child Health Journal. https://doi.org/10.1007/s10995-007-0213-4.
Al-Bar, Mohammed Ali, and Hassan Chamsi-Pasha. 2015. Contemporary bioethics: Islamic perspective. Springer. https://doi.org/10.1007/978-3-319-18428-9.
Atighetchi, Dariusch. 2007. Islamic bioethics: Problems and perspectives. Dordrecht: Springer.
Lovering, Sandra. 2012. The Crescent of Care: A nursing model to guide the care of Arab Muslim patents. Diversity and Equality in Health and Care 9: 171–178.
Salman, Khlood, and Ricj Zoucha. 2010. Considering faith within culture when caring for the terminally Ill Muslim patient and family. Journal of Hospice & Palliative Nursing. https://doi.org/10.1097/NJH.0b013e3181d76d26.
Ghaly, Mohammed. 2016. Deliberations within the Islamic tradition on principle-based bioethics: an enduring task. In Islamic perspectives on the principles of biomedical ethics: Muslim religious scholars and biomedical scientists in face-to-face dialogue with western bioethicists. Ed. Mohammed Ghaly, 3–39. London: World Scientific Publishing.
Mustafa, Yassar. 2014. Islam and the four principles of medical ethics. Journal of Medical Ethics. https://doi.org/10.1136/medethics-2012-101309.
Padela, Aasim I. 2007. Islamic medical ethics: A primer. Bioethics. https://doi.org/10.1111/j.1467-8519.2007.00540.x.
Shabana, Ayman. 2014. Bioethics in Islamic Thought. Religion Compass 8(11): 337–346.
Ghaly, Mohammed. 2015. Biomedical scientists as co-muftis: their contribution to contemporary Islamic Bioethics. Die Welt Des Islams 55(3–4): 286–311.
Chamsi-Pasha, Hassan, and Mohammed Albar. 2017. Do not resuscitate, brain death, and organ transplantation: Islamic perspective. Avicenna Journal of Medicine 7(2): 35–45.
Scher, Stephen, and Kasia Kozlowska. 2018. The rise of bioethics: A historical overview. In Rethinking health care ethics 31–44. https://doi.org/10.1007/978-981-13-0830-7_3. Singapore: Palgrave.
Ghaly, Mohammed. ed. 2016. Islamic perspectives on the principles of biomedical ethics: Muslim religious scholars and biomedical scientists in face-to-face dialogue with western bioethicists. London: World Scientific Publishing.
Beauchamp, Tom L. 1988. Does ethical theory have a future in bioethics? In Standing on Principles: Collected Essays, 229–246. New York: Oxford University Press.
Moosapour, Hamideh, Jannat Mashayekhi, Farzaneh Zahedi, Akbar Soltani, and Bagher Larijani. 2018. General approaches to ethical reasoning in Islamic biomedical ethics discourse. Journal of Medical Ethics and History of Medicine 11: 11.
Mashayekhi, Jannat, Mansure Madani, and Saeedeh S. Tehrani. 2015. Ethical considerations on advance directives: an overview of the ethical and legal aspects in the context of Islamic teachings. Journal of Medical Ethics and History of Medicine 8: 15–26.
Van Bommel, A. 1999. Medical Ethics from the Muslim Perspective. In Neurosurgery and Medical Ethics ed. H. August van Alphen. Vienna: Springer: 17–27.
Gillon, Raanan. 1994. Medical ethics: four principles plus attention to scope. British Medical Journal. https://doi.org/10.1136/bmj.309.6948.184.
Badawi, Gamal. 2011. Muslim attitudes towards end-of-life decisions. Journal of the Islamic Medical Association of North America. https://doi.org/10.5915/43-3-8602.
The Noble Quran. 2006. Transl. Usmani, Muhammad Taqi. Maktaba Ma’ariful Quran.
Ismail, Khalid Bin. 2010. Islam and the concept of justice. Jurnal Intelek 5(2): 1–12.
Meleis, Afaf I. 1981. The Arab American in the health care system. The American Journal of Nursing 81(6): 1180–1183.
Lane, Sandra D. 1994. Research Bioethics in Egypt. In Principles of Health Care Ethics. Ed. Raanan Gillon, 885–894. Chichester: John Wiley & Sons.
Scharf, Amy, Louis Voigt, Santosha Vardhana, Konstantina Matsoukas, Lisa M. Wall, Maria Arevalo, and Lisa C. Diamond. 2021. What should clinicians do when a patient’s autonomy undermines her being treated equitably? AMA Journal of Ethics. https://doi.org/10.1001/amajethics.2021.97.
Albar, Mohammad Ali, and Hassan Chamsi-Pasha. 2017. The Physician-Patient Relationship in an Islamic Context. In Islamic bioethics: Current issues and challenges Eds. Bagheri, Alireza and Alali, Khalid. https://doi.org/10.1142/9781783267507_0005.
Radha Krishna, Lalit Kumar, Deborah S. Watkinson, and Ng Lee Beng. 2015. Limits to relational autonomy—The Singaporean experience. Nursing ethics. https://doi.org/10.1177/0969733014533239.
Sachedina, Abdulaziz. 2005. End-of-life: the Islamic view. The Lancet. https://doi.org/10.1016/S0140-6736(05)67183-8.
Lipson, Juliene G., and Afaf Meleis. 1983. Issues in health care of Middle Eastern patients. Western Journal of Medicine 139(6): 854–861.
Acknowledgements
The authors wish to thank the University of Michigan-Dearborn’s Summer Undergraduate Research Experience (SURE) program for funding the initial stages of this research collaboration and Jaye Starr, Spiritual Care Chaplain at Michigan Medicine, as well as two anonymous reviewers for their helpful comments on an earlier version of this manuscript.
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Sajber, K., Khaleefah, S. Culturally competent respect for the autonomy of Muslim patients: fostering patient agency by respecting justice. Theor Med Bioeth 45, 133–149 (2024). https://doi.org/10.1007/s11017-023-09655-x
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DOI: https://doi.org/10.1007/s11017-023-09655-x