Authors
Laila Azam, PhD, MBA, MCW-Milwaukee; Arman Tahir, MD, Muslim Community Health Center; Ismail Quryshi, MD, FACP, HMDC, FAAHPM, CMD, Froedtert Hospital; Fozia Ahmed, BS, Muslim Community Health Center; Iqbal Ashraf, MS, Muslim Community Health Center; Abdul Hafeez, MD, Muslim Community Health Center; Ishma Rizvi, MPH, Muslim Community Health Center; Renee Foutz, MD, MCW-Milwaukee; Sondos Kholaki, MDiv, BCC, University of Southern California; Ramy Salah, MD; Colleen McCracken, MSN, RN, CMSRN, CHPN, OCN, NPD-BC, Froedtert Hospital; Aasim I. Padela, MD, MSc, FACEP, MCW-Milwaukee
Abstract
Background: Muslim Americans encounter unique challenges when navigating end-of-life (EOL) healthcare due to the need to reconcile complex U.S. legal requirements with Islamic ethical imperatives. Insufficient culturally/religiously tailored resources often result in decisional conflict, delayed planning, and heightened psychological distress for patients and families during critical care episodes.
Objective: This initiative sought to develop a comprehensive, evidence-informed resource that operationalizes Islamic bioethical principles alongside U.S. legal and clinical frameworks. The objective was to equip Muslim patients, caregivers, and healthcare professionals with a practical tool to support timely, values-congruent EOL decision-making.
Methods: Between 2022-2025, a multidisciplinary team conducted literature reviews, community-based surveys, and qualitative interviews with patients, caregivers, clinicians, and religious leaders. Findings were iteratively synthesized through workshops involving Islamic scholars, hospice and palliative care clinicians, and chaplains. The resulting resource integrates key concepts-including wilāya (guardianship), tawakkul (trust in God), and harm-reduction principles (minimizing potential physical, religious, or moral harm when ideal care cannot be achieved)-together with advance care planning tools (advance directives, power of attorney, DNR/DNI orders) to create an accessible, community-facing guide.
Results: The final product is a 30+ page guide written in plain language, featuring decision-making flowcharts, hospice care myth-busting tables, and structured conversation prompts for families and clinicians. The guide offers a structured pathway to reduce decisional conflict, clarify legal and religious responsibilities, and support religiously grounded EOL care planning.
Conclusion: This initiative demonstrates how community-engaged scholarship can bridge the gap between religious values and healthcare systems. By aligning Islamic bioethics with U.S. legal structures, the guide supports Muslims in approaching EOL care with peace, clarity, and trust in Allah's (God's) mercy, ultimately fostering religiously and ethically informed healthcare decisions.
view poster (PDF)