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Demirkapu H, Edally W, De Vleminck A, Van den Block L, De Maesschalck S, Devroey D. Views on advance care planning of family members of older adults with Turkish and Moroccan backgrounds: An exploratory interview study. Palliat Med 2024:2692163241261207. [PMID: 38916263 DOI: 10.1177/02692163241261207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
BACKGROUND Significantly fewer individuals with migration backgrounds than native-born individuals undertake advance care planning. Older adults with Turkish and Moroccan backgrounds represent one of the largest ageing non-Western minority groups in Europe. Their relatives could play important roles in facilitating or hindering advance care planning, but their views remain underexplored. AIM To explore advance care planning knowledge, experience, views, facilitators and barriers among older Turkish and Moroccan adults' relatives in Belgium. DESIGN Qualitative thematic analysis of semi-structured interview data. SETTING/PARTICIPANTS Twenty-two relatives of older Turkish and Moroccan adults in Brussels, Mechelen and Antwerp, recruited via general practitioners. RESULTS Participants had limited advance care planning knowledge and had not discussed it with healthcare professionals. Some found discussing end-of-life preferences with relatives beneficial; others opposed the discussion of specific topics or felt discussions were unnecessary, as they felt responsible for caregiving and trusted by their relatives to make future decisions. Barriers included personal and relational characteristics, emotional difficulty and perceived non-urgency. Facilitators included information in older adults' native languages, general practitioners' cautious initiation and the involvement of several family members. CONCLUSIONS Relatives of older people with Turkish and Moroccan backgrounds are unfamiliar with advance care planning and have highly variable views on it. People should be given opportunities to discuss advance care planning in a culturally appropriate manner, and the diversity of perspectives regarding whether and how to engage in such planning should be recognised.ClinicalTrials.gov no. NCT05241301.
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Affiliation(s)
- Hakki Demirkapu
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Jette, Belgium
| | - Wael Edally
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Jette, Belgium
| | - Aline De Vleminck
- End-of-Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Jette and Ghent, Belgium
| | - Lieve Van den Block
- End-of-Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Jette and Ghent, Belgium
| | | | - Dirk Devroey
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Jette, Belgium
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Piracha NZ, Nickel LB, Quryshi A, Salah R, Padela AI. Muslims and End-of-Life Healthcare in Non-Muslim Majority Nations: A Systematic Literature Review. J Pain Symptom Manage 2024; 67:e299-e312. [PMID: 38218412 PMCID: PMC10939778 DOI: 10.1016/j.jpainsymman.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 12/08/2023] [Accepted: 01/03/2024] [Indexed: 01/15/2024]
Abstract
CONTEXT As Muslim populations in non-Muslim majority nations grow and age, they will increasingly require culturally appropriate healthcare. Delivering such care requires understanding their experiences with, as well as preferences regarding, end-of-life healthcare. OBJECTIVES To examine the experiences, needs, and challenges of Muslim patients and caregivers with end-of-life, hospice, and palliative care. METHODS A systematic literature review using five databases (MEDLINE, Scopus, Web of Science, CINAHL, Cochrane Library) and key terms related to Islam and end-of-life healthcare. Papers were limited to English-language empirical studies of adults in non-Muslim majority nations. After removing duplicates, titles, abstracts, and articles were screened for quality and reviewed by a multidisciplinary team. RESULTS From an initial list of 1867 articles, 29 articles met all inclusion criteria. Most studies focused on end-of-life healthcare not related to palliative or hospice services and examined Muslim patient and caregiver experiences rather than their needs or challenges. Content analysis revealed three themes: (1) the role of family in caregiving as a moral duty and as surrogate communicators; (2) gaps in knowledge among providers related to Muslim needs and gaps in patient/family knowledge about advance care planning; and (3) the influence of Islam on Muslim physicians' perspectives and practices. CONCLUSION There is scant research on Muslim patients' and caregivers' engagement with end-of-life healthcare in non-Muslim majority nations. Existing research documents knowledge gaps impeding both Muslim patient engagement with end-of-life care and the delivery of culturally appropriate healthcare.
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Affiliation(s)
- Natasha Z Piracha
- Division of Critical Care and Hospital Medicine, Department of Pediatrics (N.Z.P.), Columbia University Vagelos College of Physicians and Surgeons and New York-Presbyterian, New York, New York, USA; Adult Palliative Care Service, Department of Medicine (N.Z.P.), Columbia University Vagelos College of Physicians and Surgeons and New York-Presbyterian, New York, New York, USA
| | - Lauren B Nickel
- Department of Emergency Medicine (L.B.N., A.Q., A.I.P.), Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
| | - Afiya Quryshi
- Department of Emergency Medicine (L.B.N., A.Q., A.I.P.), Medical College of Wisconsin, Milwaukee, Wisconsin, USA; Harvard University (A.Q.), Cambridge, Massachusetts, USA
| | - Ramy Salah
- Department of Palliative Medicine (R.S.), Palo Alto Medical Foundation, San Mateo, California, USA
| | - Aasim I Padela
- Department of Emergency Medicine (L.B.N., A.Q., A.I.P.), Medical College of Wisconsin, Milwaukee, Wisconsin, USA; Initiative on Islam and Medicine (A.I.P.), Glendale Heights, Illinois, USA
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Muishout G, Topcu N, de la Croix A, Wiegers G, van Laarhoven HW. Turkish imams and their role in decision-making in palliative care: A Directed Content and Narrative analysis. Palliat Med 2022; 36:1006-1017. [PMID: 35848214 PMCID: PMC9174576 DOI: 10.1177/02692163221095200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
BACKGROUND Muslims are the largest religious minority in Europe. When confronted with life-threatening illness, they turn to their local imams for religious guidance. AIM To gain knowledge about how imams shape their roles in decision-making in palliative care. DESIGN Direct Content Analysis through a typology of imam roles. To explore motives, this was complemented by Narrative Analysis. SETTING/PARTICIPANTS Ten Turkish imams working in the Netherlands, with experience in guiding congregants in palliative care. RESULTS The roles of Jurist, Exegete, Missionary, Advisor and Ritual Guide were identified. Three narratives emerged: Hope can work miracles, Responsibility needs to be shared, and Mask your grief. Participants urged patients not to consent to withholding or terminating treatment but to search for a cure, since this might be rewarded with miraculous healing. When giving consent seemed unavoidable, the fear of being held responsible by God for wrongful death was often managed by requesting fatwa from committees of religious experts. Relatives were urged to hide their grief from dying patients so they would not lose hope in God. CONCLUSION Imams urge patients' relatives to show faith in God by seeking maximum treatment. This attitude is motivated by the fear that all Muslims involved will be held accountable by God for questioning His omnipotence to heal. Therefore, doctors may be urged to offer treatment that contradicts medical standards for good palliative care. To bridge this gap, tailor-made palliative care should be developed in collaboration with imams. Future research might include imams of other Muslim organizations.
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Affiliation(s)
- George Muishout
- Department of History, European Studies and Religious Studies, Amsterdam School for Historical Studies, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Anne de la Croix
- Research in Education, Amsterdam UMC, Faculty of Medicine, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Gerard Wiegers
- Department of History, European Studies and Religious Studies, Amsterdam School for Historical Studies, University of Amsterdam, Amsterdam, The Netherlands
| | - Hanneke Wm van Laarhoven
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Abstract
What, precisely, are we seeking to achieve in offering 'life-saving' treatment to patients with cancer? Research funding agencies and pharmaceutical industry media releases, and government cancer screening programs all promise that their cancer programs save lives. But everybody dies. The nature of life and death from cancer is explored philosophically in this essay, with particular reference to the quality of life, and its meaning, during the period of prolongation of survival by 'life-saving' cancer care.
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Affiliation(s)
- J Harvey Turner
- Department of Nuclear Medicine, The University of Western Australia, Fiona Stanley Fremantle Hospitals Group, Murdoch, Australia
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Mentzelopoulos SD, Couper K, Van de Voorde P, Druwé P, Blom M, Perkins GD, Lulic I, Djakow J, Raffay V, Lilja G, Bossaert L. [Ethics of resuscitation and end of life decisions]. Notf Rett Med 2021; 24:720-749. [PMID: 34093076 PMCID: PMC8170633 DOI: 10.1007/s10049-021-00888-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 12/14/2022]
Abstract
These European Resuscitation Council Ethics guidelines provide evidence-based recommendations for the ethical, routine practice of resuscitation and end-of-life care of adults and children. The guideline primarily focus on major ethical practice interventions (i.e. advance directives, advance care planning, and shared decision making), decision making regarding resuscitation, education, and research. These areas are tightly related to the application of the principles of bioethics in the practice of resuscitation and end-of-life care.
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Affiliation(s)
- Spyros D. Mentzelopoulos
- Evaggelismos Allgemeines Krankenhaus, Abteilung für Intensivmedizin, Medizinische Fakultät der Nationalen und Kapodistrischen Universität Athen, 45–47 Ipsilandou Street, 10675 Athen, Griechenland
| | - Keith Couper
- Universitätskliniken Birmingham NHS Foundation Trust, UK Critical Care Unit, Birmingham, Großbritannien
- Medizinische Fakultät Warwick, Universität Warwick, Coventry, Großbritannien
| | - Patrick Van de Voorde
- Universitätsklinikum und Universität Gent, Gent, Belgien
- staatliches Gesundheitsministerium, Brüssel, Belgien
| | - Patrick Druwé
- Abteilung für Intensivmedizin, Universitätsklinikum Gent, Gent, Belgien
| | - Marieke Blom
- Medizinisches Zentrum der Universität Amsterdam, Amsterdam, Niederlande
| | - Gavin D. Perkins
- Medizinische Fakultät Warwick, Universität Warwick, Coventry, Großbritannien
| | | | - Jana Djakow
- Intensivstation für Kinder, NH Hospital, Hořovice, Tschechien
- Abteilung für Kinderanästhesiologie und Intensivmedizin, Universitätsklinikum und Medizinische Fakultät der Masaryk-Universität, Brno, Tschechien
| | - Violetta Raffay
- School of Medicine, Europäische Universität Zypern, Nikosia, Zypern
- Serbischer Wiederbelebungsrat, Novi Sad, Serbien
| | - Gisela Lilja
- Universitätsklinikum Skane, Abteilung für klinische Wissenschaften Lund, Neurologie, Universität Lund, Lund, Schweden
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Sharif Nia H, Lehto RH, Seyedfatemi N, Mohammadinezhad M. A path analysis model of spiritual well-being and quality of life in Iranian cancer patients: a mediating role of hope. Support Care Cancer 2021; 29:6013-6019. [PMID: 33782763 DOI: 10.1007/s00520-021-06172-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 03/18/2021] [Indexed: 11/12/2022]
Abstract
PURPOSE Maintenance of quality of life (QOL) is vital for adaptation to life-threatening and chronic illnesses such as cancer. Therefore, the evaluation and strengthening of personal psychological resources that support QOL for patients with cancer is paramount. This study investigated the potential mediating role of hope in the relationship between spiritual well-being and QOL in Iranian cancer patients. METHODS A correlational predictive design was used with 200 patients with varying types and stage of cancer. Demographic and health characteristic surveys, spiritual well-being (SWB), adult hope, and EORTC QLQ-c30 scales were used for measuring the study constructs. Path analysis modeling was used to determine mediation relationships. RESULTS Patients' QOL was affected by SWB and hope. Religious (β = 0.205, p = 0.002) and existential (β = 0.286, p < 0.001) SWB dimensions and hope (β = 0.263, p < 0.001) improved QOL scores. The presence of hope partially mediated the relationship between SWB and QOL. CONCLUSION Quality of life was directly affected by SWB and was further improved by the presence of hope. The study suggests that maintenance of hope is essential to QOL in Iranian patients with cancer.
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Affiliation(s)
- Hamid Sharif Nia
- School of Nursing and Midwifery Amol, Mazandaran University of Medical Sciences, Sari, Iran
| | - Rebecca H Lehto
- College of Nursing, Michigan State University, East Lansing, MI, USA
| | - Naiemeh Seyedfatemi
- Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran
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Mentzelopoulos SD, Couper K, Voorde PVD, Druwé P, Blom M, Perkins GD, Lulic I, Djakow J, Raffay V, Lilja G, Bossaert L. European Resuscitation Council Guidelines 2021: Ethics of resuscitation and end of life decisions. Resuscitation 2021; 161:408-432. [PMID: 33773832 DOI: 10.1016/j.resuscitation.2021.02.017] [Citation(s) in RCA: 110] [Impact Index Per Article: 36.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
These European Resuscitation Council Ethics guidelines provide evidence-based recommendations for the ethical, routine practice of resuscitation and end-of-life care of adults and children. The guideline primarily focus on major ethical practice interventions (i.e. advance directives, advance care planning, and shared decision making), decision making regarding resuscitation, education, and research. These areas are tightly related to the application of the principles of bioethics in the practice of resuscitation and end-of-life care.
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Affiliation(s)
| | - Keith Couper
- UK Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; Warwick Medical School, University of Warwick, Coventry, UK
| | - Patrick Van de Voorde
- University Hospital and University Ghent, Belgium; Federal Department Health, Belgium
| | - Patrick Druwé
- Ghent University Hospital, Department of Intensive Care Medicine, Ghent, Belgium
| | - Marieke Blom
- Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Gavin D Perkins
- UK Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | | | - Jana Djakow
- Paediatric Intensive Care Unit, NH Hospital, Hořovice, Czech Republic; Department of Paediatric Anaesthesiology and Intensive Care Medicine, University Hospital and Medical Faculty of Masaryk University, Brno, Czech Republic
| | - Violetta Raffay
- European University Cyprus, School of Medicine, Nicosia, Cyprus; Serbian Resuscitation Council, Novi Sad, Serbia
| | - Gisela Lilja
- Lund University, Skane University Hospital, Department of Clinical Sciences Lund, Neurology, Lund, Sweden
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Van Keer RL, Deschepper R, Huyghens L, Bilsen J. Withholding/Withdrawing Life-Sustaining Treatment in a Multiethnic Critical Care Setting: An Ethnographic Study. J Palliat Med 2020; 24:338-346. [PMID: 32721261 DOI: 10.1089/jpm.2019.0653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Critical care physicians often have to make challenging decisions to withhold/withdraw life-sustaining treatments. As a result of society's increasingly cultural diversity such decision making often involves patients from ethnic minority groups, which might pose extra challenges. Objective: To investigate withholding/withdrawing life-sustaining treatments with patients from ethnic minority groups and their families during critical care. Design: Ethnographic fieldwork (observations, in-depth interviews and reading patients' medical files). Setting/Subjects: Eighteen patients from ethnic minority groups, their relatives, physicians and nurses were studied in one intensive care unit of a multi-ethnic urban hospital (Belgium). Results: During decision making physicians had a very central role. The contribution of patients and nurses was limited, while families' input was more noticeable. Decision making was hampered by communication difficulties between: (1) staff and relative(s), (2) relatives, and (3) patient and relative(s). Different approaches were used by physicians to overcome difficulties, which often reflected their tendency to control decision making, for example, stressing their central role. At times their approaches reflected their inability to align families' wishes with their own, for example, when making decisions without explicitly informing relatives. Conclusions: Withholding/withdrawing life-sustaining treatments in a multi-ethnic critic care context has a number of alarming difficulties, such as how to take families' input correctly into account. It is important that decision making happens in a cultural sensitive way and with involvement tailored to patients' and relatives' needs and in close consultation with interprofessional health care workers/other services.
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Affiliation(s)
- Rose-Lima Van Keer
- Mental Health and Wellbeing Research Group (MENT), Department of Public Health, Vrije Universiteit Brussel, Brussels, Belgium
| | - Reginald Deschepper
- Mental Health and Wellbeing Research Group (MENT), Department of Public Health, Vrije Universiteit Brussel, Brussels, Belgium
| | - Luc Huyghens
- Critical Care Department, Vrije Universiteit Brussel, Brussels, Belgium.,Service of Intensive Care Medicine, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Johan Bilsen
- Mental Health and Wellbeing Research Group (MENT), Department of Public Health, Vrije Universiteit Brussel, Brussels, Belgium
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9
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Factors affecting the attitudes and opinions of ICU physicians regarding end-of-life decisions for their patients and themselves: A survey study from Turkey. PLoS One 2020; 15:e0232743. [PMID: 32433670 PMCID: PMC7239490 DOI: 10.1371/journal.pone.0232743] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 04/21/2020] [Indexed: 01/05/2023] Open
Abstract
Introduction Turkey is constitutionally secular with a Muslim majority. There is no legal basis for limiting life-support at the end-of-life (EOL) in Turkey. We aimed to investigate the opinions and attitudes of intensive care unit (ICU) physicians regarding EOL decisions, for both their patients and themselves, and to evaluate if the physicians’ demographic and professional variables predicted the attitudes of physicians toward EOL decisions. Methods An online survey was distributed to national critical care societies’ members. Physicians’ opinions were sought concerning legalization of EOL decisions for terminally ill patients or by patient-request regardless of prognosis. Participants physicians’ views on who should make EOL decisions and when they should occur were determined. Participants were also asked if they would prefer cardiopulmonary resuscitation (CPR) and/or intubation/mechanical ventilation (MV) personally if they had terminal cancer. Results A total of 613 physicians responded. Religious beliefs had no effect on the physicians’ acceptance of do-not-resuscitate (DNR) / do-not-intubate (DNI) orders for terminally ill patients, but atheism, was found to be an independent predictor of approval of DNR/DNI in cases of patient request (p<0.05). While medical experience (≥6 years in the ICU) was the independent predictor for the physicians’ approval of DNI decisions on patient demand, the volume of terminal patients in ICUs (between 10–50% per year) where they worked was an independent predictor of physicians’ approval of DNI for terminal patients. When asked to choose personal options in an EOL scenario (including full code, only DNR, only DNI, both DNR and DNI, and undecided), younger physicians (30–39 years) were more likely to prefer the "only DNR" option compared with physicians aged 40–49 years (p<0.05) for themselves and age 30–39 was an independent predictor of individual preference for "only DNR” at the hypothetical EOL. Physicians from an ICU with <10% terminally ill patients were less likely to prefer "DNR" or "DNR and DNI" options for themselves at EOL compared with physicians who worked in ICUs with a higher (>50%) terminally ill patient ratio (p<0.05). Conclusion Most ICU physicians did not want legalization of DNR and DNI orders, based solely on patient request. Even if EOL decision-making were legal in Turkey, this attitude may conflict with patient autonomy. The proportion of terminally ill patients in the ICU appears to affect physicians’ attitudes to EOL decisions, both for their patients and by personal preference, an association which has not been previously reported.
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Bennardi M, Diviani N, Gamondi C, Stüssi G, Saletti P, Cinesi I, Rubinelli S. Palliative care utilization in oncology and hemato-oncology: a systematic review of cognitive barriers and facilitators from the perspective of healthcare professionals, adult patients, and their families. BMC Palliat Care 2020; 19:47. [PMID: 32284064 PMCID: PMC7155286 DOI: 10.1186/s12904-020-00556-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 03/25/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Despite the high potential to improve the quality of life of patients and families, palliative care services face significant obstacles to their use. In countries with high-resource health systems, the nonfinancial and nonstructural obstacles to palliative care services are particularly prominent. These are the cognitive barriers -knowledge and communication barriers- to the use of palliative care. To date no systematic review has given the deserved attention to the cognitive barriers and facilitators to palliative care services utilization. This study aims to synthesize knowledge on cognitive barriers and facilitators to palliative care use in oncology and hemato-oncology from the experiences of health professionals, patients, and their families. METHODS A systematic review was conducted. PubMed, PsycINFO, International Association for Hospice and Palliative Care/Cumulative Index of Nursing and Allied Health Literature (IAHPC/CINAHL), and Communication & Mass Media Complete (CMMC) were systematically searched for the main core concepts: palliative care, barriers, facilitators, perspectives, points of view, and related terms and synonyms. After screening of titles, abstracts, and full-texts, 52 studies were included in the qualitative thematic analysis. RESULTS Four themes were identified: awareness of palliative care, collaboration and communication in palliative care-related settings, attitudes and beliefs towards palliative care, and emotions involved in disease pathways. The results showed that cognitive barriers and facilitators are involved in the educational, social, emotional, and cultural dimensions of palliative care provision and utilization. In particular, these barriers and facilitators exist both at the healthcare professional level (e.g. a barrier is lack of understanding of palliative care applicability, and a facilitator is strategic visibility of the palliative care team in patient floors and hospital-wide events) and at the patient and families level (e.g. a barrier is having misconceptions about palliative care, and a facilitator is patients' openness to their own needs). CONCLUSIONS To optimize palliative care services utilization, awareness of palliative care, and healthcare professionals' communication and emotion management skills should be enhanced. Additionally, a cultural shift, concerning attitudes and beliefs towards palliative care, should be encouraged.
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Affiliation(s)
- Marco Bennardi
- Swiss Paraplegic Research, Person-centered Healthcare & Health Communication; University of Lucerne, Department of Health Sciences and Medicine, Guido A. Zäch Strasse 4, 6207, Nottwil, Switzerland.
| | - Nicola Diviani
- Swiss Paraplegic Research, Person-centered Healthcare & Health Communication; University of Lucerne, Department of Health Sciences and Medicine, Guido A. Zäch Strasse 4, 6207, Nottwil, Switzerland
| | - Claudia Gamondi
- Oncology Institute of Southern Switzerland, Palliative Care, Ospedale San Giovanni, 6500, Bellinzona, Switzerland
| | - Georg Stüssi
- Oncology Institute of Southern Switzerland, Hematology, Ospedale San Giovanni, 6500, Bellinzona, Switzerland
| | - Piercarlo Saletti
- Oncology Institute of Southern Switzerland, Medical Oncology, Ospedale Regionale Lugano, 6962, Viganello, Switzerland
| | - Ivan Cinesi
- Palliative TI - Associazione Cure Palliative Ticino, Via San Leonardo, 6599, Cadenazzo, Switzerland
| | - Sara Rubinelli
- Swiss Paraplegic Research, Person-centered Healthcare & Health Communication; University of Lucerne, Department of Health Sciences and Medicine, Guido A. Zäch Strasse 4, 6207, Nottwil, Switzerland
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Ahaddour C, Van den Branden S, Broeckaert B. "What Goes Around Comes Around": Attitudes and Practices Regarding Ageing and Care for the Elderly Among Moroccan Muslim Women Living in Antwerp (Belgium). JOURNAL OF RELIGION AND HEALTH 2020; 59:986-1012. [PMID: 29362969 DOI: 10.1007/s10943-018-0562-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The aim of this article is threefold. First, we seek to elicit the attitudes and practices of middle-aged and elderly Moroccan Muslim women towards ageing and care for the elderly. Second, we aim to identify possible differences between middle-aged and elderly women's attitudes and practices. Third, we seek to explore which role religion plays in their attitudes and practices. Qualitative empirical research was conducted with a sample of middle-aged and elderly Moroccan Muslim women living in Antwerp (Belgium) (n = 30) and with experts in the field (n = 15). Our study unveils that ageing and care for the elderly are clearly understood from a religious framework. More specifically, theological and eschatological considerations take up a central position. Access to and utilization of professional elderly care is hampered by several barriers (e.g. religious, cultural and financial). We found a more open attitude towards professional elderly care among middle-aged women than among elderly women.
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Affiliation(s)
- Chaïma Ahaddour
- Research Unit of Theological and Comparative Ethics, Faculty of Theology and Religious Studies, KU Leuven, Sint-Michielsstraat 6, Box 3101, 3000, Louvain, Belgium.
| | - Stef Van den Branden
- Research Unit of Theological and Comparative Ethics, Faculty of Theology and Religious Studies, KU Leuven, Sint-Michielsstraat 6, Box 3101, 3000, Louvain, Belgium
| | - Bert Broeckaert
- Research Unit of Theological and Comparative Ethics, Faculty of Theology and Religious Studies, KU Leuven, Sint-Michielsstraat 6, Box 3101, 3000, Louvain, Belgium
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12
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Duivenbode R, Hall S, Padela AI. Assessing Relationships Between Muslim Physicians’ Religiosity and End-of-Life Health-Care Attitudes and Treatment Recommendations: An Exploratory National Survey. Am J Hosp Palliat Care 2019; 36:780-788. [DOI: 10.1177/1049909119833335] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background: Research demonstrates that the attitudes of religious physicians toward end-of-life care treatment can differ substantially from their nonreligious colleagues. While there are various religious perspectives regarding treatment near the end of life, the attitudes of Muslim physicians in this area are largely unknown. Objective: This article attempts to fill in this gap by presenting American Muslim physician attitudes toward end-of-life care decision-making and by examining associations between physician religiosity and these attitudes. Methods: A randomized national sample of 626 Muslim physicians completed a mailed questionnaire assessing religiosity and end-of-life care attitudes. Religiosity, religious practice, and bioethics resource utilization were analyzed as predictors of quality-of-life considerations, attitudes regarding withholding and withdrawing life-sustaining treatment, and end-of-life treatment recommendations at the bivariate and multivariable level. Results: Two-hundred fifty-five (41% response rate) respondents completed surveys. Most physicians reported that religion was either very or the most important part of their life (89%). Physicians who reported consulting Islamic bioethics literature more often had higher odds of recommending active treatment over hospice care in an end-of-life case vignette. Physicians who were more religious had higher odds of viewing withdrawal of life-sustaining treatment more ethically and psychologically challenging than withholding it and had lower odds of agreeing that one should always comply with a competent patient’s request to withdraw life-sustaining treatment. Discussion: Religiosity appears to impact Muslim physician attitudes toward various aspects of end-of-life health-care decision-making. Greater research is needed to evaluate how this relationship manifests itself in patient care conversations and shared clinical decision-making in the hospital.
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Affiliation(s)
- Rosie Duivenbode
- Initiative on Islam and Medicine, The University of Chicago, Chicago, IL, USA
| | - Stephen Hall
- Initiative on Islam and Medicine, The University of Chicago, Chicago, IL, USA
- Department of Medicine, Section of Emergency Medicine, The University of Chicago, Chicago, IL, USA
| | - Aasim I. Padela
- Initiative on Islam and Medicine, The University of Chicago, Chicago, IL, USA
- Department of Medicine, Section of Emergency Medicine, The University of Chicago, Chicago, IL, USA
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13
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Differenz – Macht – Ethik. Ethik Med 2018. [DOI: 10.1007/s00481-018-0490-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Muslim physicians and palliative care: attitudes towards the use of palliative sedation. Support Care Cancer 2018; 26:3701-3710. [PMID: 29736869 PMCID: PMC6182360 DOI: 10.1007/s00520-018-4229-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 04/26/2018] [Indexed: 11/20/2022]
Abstract
Background Muslim norms concerning palliative sedation can differ from secular and non-Muslim perceptions. Muslim physicians working in a Western environment are expected to administer palliative sedation when medically indicated. Therefore, they can experience tension between religious and medical norms. Objective To gain insight into the professional experiences of Muslim physicians with palliative sedation in terms of religious and professional norms. Design Interpretative phenomenological study using semi-structured interviews to take a closer look at the experiences of Muslim physicians with palliative sedation. Data were recorded, transcribed and analysed by means of interpretative phenomenological analysis (IPA). Participants Ten Muslim physicians, working in the Netherlands, with professional experience of palliative sedation. Results Two main themes were identified: professional self-concept and attitudes towards death and dying. Participants emphasized their professional responsibility when making treatment decisions, even when these contravened the prevalent views of Islamic scholars. Almost all of them expressed the moral obligation to fight their patients’ pain in the final stage of life. Absence of acceleration of death was considered a prerequisite for using palliative sedation by most participants. Conclusions Although the application of palliative sedation caused friction with their personal religious conceptions on a good death, participants followed a comfort-oriented care approach corresponding to professional medical standards. All of them adopted efficient strategies for handling of palliative sedation morally and professionally. The results of this research can contribute to and provide a basis for the emergence of new, applied Islamic ethics regarding palliative sedation.
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Ahaddour C, Broeckaert B, Van den Branden S. "Every soul shall taste death." Attitudes and beliefs of Moroccan muslim women living in Antwerp (Belgium) toward dying, death, and the afterlife. DEATH STUDIES 2018; 43:41-55. [PMID: 29482464 DOI: 10.1080/07481187.2018.1437096] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This study aims to elicit the beliefs and attitudes of middle-aged and elderly Moroccan Muslim women toward dying, death, and the afterlife; to identify whether differences are observable between middle-aged and elderly participants and to document how the actual attitudes of our participants relate to normative Islamic literature. Interviews were conducted with middle-aged and elderly Moroccan women living in Belgium (n = 30) and with experts in the field (n = 15). This study reveals that the belief in an omnipotent and omniscient God and in an afterlife strongly marks the attitudes of first- and second-generation Muslims in Belgium toward life and death.
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Affiliation(s)
- Chaïma Ahaddour
- a Faculty of Theology and Religious Studies , KU Leuven (Research Unit of Theological and Comparative Ethics) , Leuven , Belgium
| | - Bert Broeckaert
- b Comparative Ethics and Medical Ethics, Faculty of Theology and Religious Studies , KU Leuven (Research Unit of Theological and Comparative Ethics) , Leuven , Belgium
| | - Stef Van den Branden
- a Faculty of Theology and Religious Studies , KU Leuven (Research Unit of Theological and Comparative Ethics) , Leuven , Belgium
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Pawlikowski J. Consequences of the Complexity and Variety of Beliefs About Miracles. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2018; 18:71-72. [PMID: 29697333 DOI: 10.1080/15265161.2018.1434573] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Jakub Pawlikowski
- a Medical University of Lublin and Harvard T.H. Chan School of Public Health
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Ahaddour C, Van den Branden S, Broeckaert B. "God is the giver and taker of life": Muslim beliefs and attitudes regarding assisted suicide and euthanasia. AJOB Empir Bioeth 2018; 9:1-11. [PMID: 29267141 DOI: 10.1080/23294515.2017.1420708] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In the context of the Belgian debates on end-of-life care, the views of Muslims remain understudied. The aim of this article is twofold. First, we seek to document the relation between contemporary normative Muslim ideas on assisted suicide and voluntary euthanasia on the one hand and real-world views and attitudes of Muslims living in Belgium on the other hand. Second, we aim to identify whether a shift is observable in the views and attitudes regarding active termination of life between first- and second-generation Muslims. We have observed that when dealing with these bioethical issues, both first- and second-generation Muslims adopt a theological line of reasoning similar to the one that can be found in normative Islamic views. We have found an absolute rejection of every act that deliberately terminates life, based upon the unconditional belief in an afterlife and in God's sovereign power over life and death.
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Affiliation(s)
- Chaïma Ahaddour
- a Faculty of Theology and Religious Studies, KU Leuven (Research Unit of Theological and Comparative Ethics) , Leuven , Belgium
| | - Stef Van den Branden
- a Faculty of Theology and Religious Studies, KU Leuven (Research Unit of Theological and Comparative Ethics) , Leuven , Belgium
| | - Bert Broeckaert
- a Faculty of Theology and Religious Studies, KU Leuven (Research Unit of Theological and Comparative Ethics) , Leuven , Belgium
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