The process of dying is never easy for the patient or their relations, no matter what the ethnic or faith group. However, in this area, particular care needs to be taken to prevent additional pain, grief or even offence to those involved.
The basis of the Islamic faith is the total submission of the self to the will of Allah. Only Allah can decide when someone is to die, and medical support must be given for as long as possible. Causing or hastening death is forbidden in the Qur'an; this applies to the giving of treatment and medication as well as withholding it. For example, a Muslim patient has a duty to seek out medical care if they fall ill, but they do not have a duty to accept experimental treatment for terminal conditions.
For this reason, families of Islamic patients may be distressed by the idea of a 'do not resuscitate' policy, as it implies that not everything is being done to sustain the life of their relative. Wherever possible, seek advice from the local imam.
Ideally a Muslim would like to die at home, surrounded by their family and community. Wherever possible, allow a patient to return home to be cared for until their death. Arranging a daily visit from a health professional in order to spot any medical needs will obviously facilitate this situation.
Whether at home or in a hospital, as a patient approaches death they will expect to have their family and friends gathered around them for a final farewell. This is an important event in the Muslim community, allowing a dying Muslim to talk to his family and to put right anything he feels is wrong in his relationships with family, friends and community before he dies. Visiting the sick is a sacred duty according to Islam, as well as a last opportunity to show respect to a fellow Muslim and their family.
The Muslim in hospital may have more visitors than the healthcare team are expecting; figures of more than fifty visitors a day are not uncommon. With this in mind, it may be best to move the dying Muslim to a side room in order to accommodate visitors, and arrange a visiting schedule or rota with the family to make sure that the patient and staff are not overwhelmed.
Many of these visitors will want to assist in the care of the patient. Staff may need to make clear to family (and so to visitors) exactly what visitors are able to do for their friend, and what healthcare staff will need to do.
Passages from the Qur'an will be read to the patient and the shahadah recited. Prayers for forgiveness for any past sins will also be said.
As the patient approaches the end, they or their family may wish the bed to be turned so that the feet face towards Makkah (Mecca) in the south east. As they and any surrounding visitors say the shahadah, their prayers will go straight to Makkah to be heard.
The last thing a Muslim will say before they die is the shahadah 'There is no God but Allah and Muhammad is His messenger' so that they die with holy words on their lips.
At the point of death, the surrounding family will repeat the phrase 'To Allah we belong and to Allah we return' to speed the departing soul to Allah.
Dying is a natural process and a Muslim will try to accept it; only Allah knows when death will happen, and so a Muslim patient will try to be prepared for it at any time. However, healthcare staff can do a great deal to help the family and friends of a dying Muslim, by assuring them that their traditions and needs will be listened to.
It is important that no direct contact occurs between a non-Muslim and a Muslim patient, especially if the staff member is of the opposite gender, and so it is important to wear gloves at all times when touching patients.
Muslims believe that a person who is diagnosed as brain dead does not need to be kept on life support. However, if after the removal of the life support, the body is still breathing or the heart is still beating, the issue of whether the body is dead will become complicated. Islam has a condition known as 'movement of the slain', where a person may be termed dead even though they are still moving; this condition applies to a patient who has been declared brain dead, but whom is still apparently breathing, albeit with the aid of ventilation. It is a good idea to consult with an imam in such cases.
All possible efforts must be made to save a life, and this includes resuscitation. The family of a patient might be deeply distressed by discussion of 'do not resuscitate'
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