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Irfan B, Ankouni G, Reader J, Seraji-Bozorgzad N, Giordani B, Bakulski K, Bhaumik A, Hampstead BM, Rahman-Filipiak A. Alzheimer's Disease and Related Dementias in Muslim Women: Recommendations for Culturally Sensitive Care. J Alzheimers Dis 2024; 99:857-867. [PMID: 38759011 PMCID: PMC11191545 DOI: 10.3233/jad-240064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2024] [Indexed: 05/19/2024]
Abstract
Alzheimer's disease and related dementias (ADRD) present significant challenges including cognitive and functional loss, behavioral disruption, emotional distress, and significant financial burden. These stressors are amplified in minority groups, who experience higher rates of ADRD but less frequent and later diagnosis. There is therefore a critical need to identify tangible approaches to culturally informed dementia assessment and care for patients from diverse communities. Muslim patients and particularly Muslim women are among the populations most understudied in the ADRD space. Muslim patients may hold unique religious, spiritual, and cultural beliefs and practices that can impact care-seeking for dementia symptoms, diagnostic accuracy, and treatment uptake. This paper outlines culturally informed approaches to assessing and treating Muslim women and families at each stage of ADRD care, though many recommendations extend to the broader Muslim community and others of diverse racial-ethnic backgrounds. We provide concrete suggestions for building rapport within and leveraging common family structures, respecting principles of modesty and privacy for all women including those who observe hijab or niqab, and communicating dementia diagnosis and care in the context of spiritual and ethical beliefs. While not intended as a comprehensive and prescriptive guide, this review provides important points of consideration and discussion with patients of Muslim backgrounds.
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Affiliation(s)
- Bilal Irfan
- Michigan Alzheimer’s Disease Research Center, Ann Arbor, MI, USA
- Department of Neurology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Ghadeer Ankouni
- Michigan Alzheimer’s Disease Research Center, Ann Arbor, MI, USA
- Department of Neurology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Jonathan Reader
- Michigan Alzheimer’s Disease Research Center, Ann Arbor, MI, USA
- Department of Neurology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Navid Seraji-Bozorgzad
- Michigan Alzheimer’s Disease Research Center, Ann Arbor, MI, USA
- Department of Neurology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Bruno Giordani
- Michigan Alzheimer’s Disease Research Center, Ann Arbor, MI, USA
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Kelly Bakulski
- Michigan Alzheimer’s Disease Research Center, Ann Arbor, MI, USA
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Arijit Bhaumik
- Michigan Alzheimer’s Disease Research Center, Ann Arbor, MI, USA
- Department of Neurology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Benjamin M. Hampstead
- Michigan Alzheimer’s Disease Research Center, Ann Arbor, MI, USA
- Research Program on Cognition & Neuromodulation Based Interventions, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
- Mental Health Service, Veterans Affairs Ann Arbor Health Systems, Ann Arbor, MI, USA
| | - Annalise Rahman-Filipiak
- Michigan Alzheimer’s Disease Research Center, Ann Arbor, MI, USA
- Research Program on Cognition & Neuromodulation Based Interventions, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
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Alhasan K, Aljamaan F, Ajlan A, Aleid H, Al Ghoufi T, Alabbad SI, AlDhaferi RF, Almaiman W, Ali T, Hakami AA, Hakami RA, Alqarni BS, Alrashed AS, Alsharidi TR, Almousa HA, Altamimi I, Alhaboob A, Jamal A, Shalaby MA, Kari JA, Raina R, Broering DC, Temsah MH. Awareness, Attitudes, and Willingness: A Cross-Sectional Study of Organ Donation in Saudi Arabia. Healthcare (Basel) 2023; 11:3126. [PMID: 38132016 PMCID: PMC10742515 DOI: 10.3390/healthcare11243126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/12/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Organ transplantation is inherently dependent on the availability of organ donors. There is a noticeable paucity of literature addressing the rates of organ donation registration and the awareness of Islamic regulations (Fatwa) regarding organ donation within Saudi Arabia. Our study aimed to evaluate the level of organ donation registration, awareness of Islamic regulations, and knowledge of the Saudi Center for Organ Transplantation (SCOT) within the Saudi society. METHODS We conducted a cross-sectional survey from 30 March to 9 April 2023. This survey aimed to assess the awareness of Islamic (Fatwa) guidance on organ donation, the role of SCOT, and the rate of organ donation registration facilitated through the Tawakkalna app, the official health passport application in Saudi Arabia. RESULTS Out of 2329 respondents, 21% had registered as potential deceased organ donors, despite 87% acknowledging the importance of organ donation. Awareness of the Islamic Fatwa regarding organ donation was reported by 54.7% of respondents, and 37% recognized the Fatwa's acceptance of brain death criteria. The likelihood of registration as organ donors was higher among Saudi citizens under 45 years of age, females, healthcare workers (HCWs), individuals with higher education, relatives of patients awaiting organ donations, those informed about the Islamic Fatwas, and those willing to donate organs to friends. Conversely, being over the age of 25, Saudi nationality, employment as an HCW, awareness of SCOT, and prior organ donation registration were predictive of a heightened awareness of Islamic Fatwas. However, perceiving the importance of organ donation correlated with a lower awareness of the Fatwas. Significant positive correlations were found between awareness of SCOT, awareness of Fatwas, and registration for organ donation. CONCLUSIONS While the Saudi population exhibits a high regard for the importance of organ donation, this recognition is not adequately translated into registration rates. The discrepancy may be attributable to limited awareness of SCOT and the relevant Islamic Fatwas. It is imperative to initiate organ donation awareness campaigns that focus on religious authorization to boost organ donation rates and rectify prevalent misconceptions.
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Affiliation(s)
- Khalid Alhasan
- College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia
- Kidney and Pancreas Health Center, Organ Transplant Center of Excellence, King Faisal Specialist Hospital and Research Center, Riyadh 11564, Saudi Arabia
- Pediatric Department, King Saud University Medical City, King Saud University, Riyadh 11362, Saudi Arabia
| | - Fadi Aljamaan
- College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia
- Critical Care Department, King Saud University Medical City, King Saud University, Riyadh 11362, Saudi Arabia
| | - Aziza Ajlan
- Transplant Clinical Pharmacy Section, Organ Transplant Center of Excellence, King Faisal Specialist Hospital and Research Center, Riyadh 11564, Saudi Arabia
| | - Hassan Aleid
- Kidney and Pancreas Health Center, Organ Transplant Center of Excellence, King Faisal Specialist Hospital and Research Center, Riyadh 11564, Saudi Arabia
| | - Talal Al Ghoufi
- Saudi Center of Organ Transplantation, Riyadh 12823, Saudi Arabia
| | - Saleh I. Alabbad
- Kidney and Pancreas Health Center, Organ Transplant Center of Excellence, King Faisal Specialist Hospital and Research Center, Riyadh 11564, Saudi Arabia
| | - Rezqah F. AlDhaferi
- Kidney and Pancreas Health Center, Organ Transplant Center of Excellence, King Faisal Specialist Hospital and Research Center, Riyadh 11564, Saudi Arabia
| | - Weiam Almaiman
- Kidney and Pancreas Health Center, Organ Transplant Center of Excellence, King Faisal Specialist Hospital and Research Center, Riyadh 11564, Saudi Arabia
| | - Tariq Ali
- Kidney and Pancreas Health Center, Organ Transplant Center of Excellence, King Faisal Specialist Hospital and Research Center, Riyadh 11564, Saudi Arabia
| | | | | | - Baraah S. Alqarni
- Pediatric Department, King Saud University Medical City, King Saud University, Riyadh 11362, Saudi Arabia
| | - Alhanouf S. Alrashed
- Pediatric Department, King Saud University Medical City, King Saud University, Riyadh 11362, Saudi Arabia
| | | | - Hamad A. Almousa
- College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia
| | - Ibraheem Altamimi
- College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia
| | - Ali Alhaboob
- College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia
- Pediatric Department, King Saud University Medical City, King Saud University, Riyadh 11362, Saudi Arabia
| | - Amr Jamal
- College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia
- Family and Community Medicine Department, King Saud University, Riyadh 11362, Saudi Arabia
- Evidence-Based Healthcare and Knowledge Translation Research Chair, King Saud University, Riyadh 11421, Saudi Arabia
| | - Mohamed A. Shalaby
- Evidence-Based Healthcare and Knowledge Translation Research Chair, King Saud University, Riyadh 11421, Saudi Arabia
- Pediatric Nephrology Unit, Faculty of Medicine and Pediatric Nephrology Center of Excellence, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Jameela A. Kari
- Evidence-Based Healthcare and Knowledge Translation Research Chair, King Saud University, Riyadh 11421, Saudi Arabia
- Pediatric Nephrology Unit, Faculty of Medicine and Pediatric Nephrology Center of Excellence, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Rupesh Raina
- Akron Nephrology Associates, Department of Nephrology, Cleveland Clinic Akron General Medical Center, Akron, OH 44302, USA
| | - Dieter C. Broering
- Kidney and Pancreas Health Center, Organ Transplant Center of Excellence, King Faisal Specialist Hospital and Research Center, Riyadh 11564, Saudi Arabia
| | - Mohamad-Hani Temsah
- College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia
- Pediatric Department, King Saud University Medical City, King Saud University, Riyadh 11362, Saudi Arabia
- Evidence-Based Healthcare and Knowledge Translation Research Chair, King Saud University, Riyadh 11421, Saudi Arabia
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Siraj MS. How a compensated kidney donation program facilitates the sale of human organs in a regulated market: the implications of Islam on organ donation and sale. Philos Ethics Humanit Med 2022; 17:10. [PMID: 35897010 PMCID: PMC9331153 DOI: 10.1186/s13010-022-00122-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 07/05/2022] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND Advocates for a regulated system to facilitate kidney donation between unrelated donor-recipient pairs argue that monetary compensation encourages people to donate vital organs that save the lives of patients with end-stage organ failure. Scholars support compensating donors as a form of reciprocity. This study aims to assess the compensation system for the unrelated kidney donation program in the Islamic Republic of Iran, with a particular focus on the implications of Islam on organ donation and organ sales. METHODS This study reviews secondary documents for philosophical argumentation and ethical analysis of human organ donation and sale for transplantation. RESULTS AND DISCUSSION According to Islamic law, organ donation is an act of sadaqatul jariyah, and individuals are permitted to donate organs with the intention of saving lives. The commercialization of humans as organ sellers and buyers is contrary to the Islamic legal maxim eethaar, undermining donors of 'selfless' or 'altruistic' motivations. Such an act should be considered immoral, and the practice should not be introduced into other countries for the sake of protecting human dignity, integrity, solidarity, and respect. I, therefore, argue that Iran's unrelated kidney donation program not only disregards the position of the Islamic religion with respect to the provision or receipt of monetary benefits for human kidneys for transplantation but that it also misinterprets the Islamic legal proscription of the sale of human organs. I also argue that the implementation of Iran's unrelated kidney donor transplantation program is unethical and immoral in that potential donors and recipients engage in a bargaining process akin to that which sellers and buyers regularly face in regulated commodity exchange markets. Conversely, I suggest that a modest fixed monetary remuneration as a gift be provided to a donor as a reward for their altruistic organ donation, which is permissible by Islamic scholars. This may remove the need to bargain for increased or decreased values of payment in exchange for the organ, as well as the transactional nature of 'buyer and seller', ensuring the philosophy of 'donor and recipient' is maintained. CONCLUSIONS Offering a fixed modest monetary incentive to organ donors would serve to increase organ supply while protecting donors' health and reducing human suffering without legalizing the human organ trade.
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Affiliation(s)
- Md Sanwar Siraj
- Department of Government and Politics, Jahangirnagar University, Savar, Dhaka, Bangladesh.
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