- Department of Emergency Medicine
Medical College of Wisconsin
Hub for Collaborative Medicine
8701 Watertown Plank Rd.
Milwaukee, WI 53226
USA - 4149551175
Aasim I Padela
Medical College of Wisconsin, Emergency Medicine, Faculty Member
- Public Health, Islamic Studies, Islam, Health Policy, Medical Ethics, Bioethics, and 17 moreOrgan Donation and Transplantation, Health Care, Minority Health, Organization and delivery of healthcare, Global Health, Global Health Policy, Global Public Health, Global Health Diplomacy, Global Health Governance, Global Health and Foreign Policy, International And Humanitarian Medicine, Ethics, International Medicine, Religion, Human Rights, Islamic Law, and Islam and Human Rightsedit
- Dr. Aasim Padela is an internationally-recognized thought and research leader in the fields of Muslim health disparit... moreDr. Aasim Padela is an internationally-recognized thought and research leader in the fields of Muslim health disparities and Islamic Bioethics. In addition to leading the Initiative on Islam and Medicine, he maintains an active clinical, research, and bioethics practice at the Medical College of Wisconsin.
Dr. Padela holds an MD from Weill Cornell Medical College, completed residency in emergency medicine at the University of Rochester, and received an MSc in Healthcare Research from the University of Michigan. Prior to that, he received Bachelor’s degrees in Biomedical Engineering and Classical Arabic and Literature from the University of Rochester. His Islamic studies expertise comes from part-time seminary studies during secondary school, and tutorials with traditionally-trained Islamic authorities.
Dr. Padela is a clinician-researcher with scholarly foci at the intersections of healthcare, bioethics, and religion. His scholarship aims at improving health and healthcare through better accommodating religious values in healthcare delivery. Using Muslim Americans and Islam as a model, he studies how (i) religion impacts patient health behaviors and healthcare experiences, (ii) informs the professional identities and workplace experiences of clinicians, and (iii) furnishes bioethical guidance to patients, providers, policy-makers, and religious leaders. This knowledge is subsequently mobilized towards educational and policy interventions. His current projects span behaviors related to cancer screening, organ donation, end-of-life care, and the intersection of religion and science, and are funded by the Templeton Foundation, the American Cancer Society, the Health Research and Services Administration, and the Patient Centered Outcomes Research Institute.
He has authored over 100 peer-reviewed journal articles and book chapters, serves in an editorial capacity for the Encyclopedia of Islamic Bioethics, American Journal of Bioethics, BMC Medical Ethics, International Journal of Islam, BETIM Journal of Medical Humanities, and TAHFIM Journal of Islam and the Contemporary World. His work and expert commentary has been featured in the New York Times, USA Today, the Chicago Tribune, Washington Post, National Public Radio, BBC, and CNN.edit
Purpose To examine relationships between religiosity, workplace discrimination, religious accommodation, and related professional and psychological outcomes among US Muslim physicians. Method In 2021, the authors surveyed 264... more
Purpose
To examine relationships between religiosity, workplace discrimination, religious accommodation, and related professional and psychological outcomes among US Muslim physicians.
Method
In 2021, the authors surveyed 264 physicians from 3 U.S.-based Muslim clinician organizations. Religious commitment, as measured by multiple items, was evaluated as a possible predictor of workplace discrimination and accommodation; job turnover; career satisfaction; workplace motivation; and belonging, burnout, and depression. Bivariate regression models were used to identify possible significant relationships between predictor and outcome variables. Predictors with meaningful bivariate analyses were included in separate multivariate regression models for each outcome.
Results
Participants’ mean age was 39.5 years (standard deviation, 10.03). Most were male (160/246; 65%), U.S.-born (146/244; 60%), completed medical school in the United States (190/243; 78%), and wore a beard/hijab (135/235; 57%). Participants identified as African American (40/247; 16%), Arab (55/247; 22%), South Asian (82/247; 33%), and White (70/247; 28%). Multivariate models demonstrated that religious importance was positively associated with discrimination from patients (odds ratio [OR] = 3.78; P = .02) and depression (OR = 5.36; P = .002), and negatively associated with prayer accommodation at work (OR = .20; P = .001). Engaging in congregational religious activities was negatively associated with discrimination from patients (OR = .64; P = .006) and job turnover (OR = .63; P = .02) and positively associated with accommodations for prayer (OR = 1.42; P = .008) and general religious identity accommodation (OR = 1.47; P = .01). Additionally, participant race and ethnicity were variably associated with these outcomes.
Conclusions
This study demonstrates how religious identity may negatively associate with workplace experiences and well-being among U.S. Muslim physicians and highlights the buffering role of religious practice. It spotlights an urgent need for academic medical centers to ameliorate religious discrimination and implement workplace accommodation policies for Muslim physicians.
To examine relationships between religiosity, workplace discrimination, religious accommodation, and related professional and psychological outcomes among US Muslim physicians.
Method
In 2021, the authors surveyed 264 physicians from 3 U.S.-based Muslim clinician organizations. Religious commitment, as measured by multiple items, was evaluated as a possible predictor of workplace discrimination and accommodation; job turnover; career satisfaction; workplace motivation; and belonging, burnout, and depression. Bivariate regression models were used to identify possible significant relationships between predictor and outcome variables. Predictors with meaningful bivariate analyses were included in separate multivariate regression models for each outcome.
Results
Participants’ mean age was 39.5 years (standard deviation, 10.03). Most were male (160/246; 65%), U.S.-born (146/244; 60%), completed medical school in the United States (190/243; 78%), and wore a beard/hijab (135/235; 57%). Participants identified as African American (40/247; 16%), Arab (55/247; 22%), South Asian (82/247; 33%), and White (70/247; 28%). Multivariate models demonstrated that religious importance was positively associated with discrimination from patients (odds ratio [OR] = 3.78; P = .02) and depression (OR = 5.36; P = .002), and negatively associated with prayer accommodation at work (OR = .20; P = .001). Engaging in congregational religious activities was negatively associated with discrimination from patients (OR = .64; P = .006) and job turnover (OR = .63; P = .02) and positively associated with accommodations for prayer (OR = 1.42; P = .008) and general religious identity accommodation (OR = 1.47; P = .01). Additionally, participant race and ethnicity were variably associated with these outcomes.
Conclusions
This study demonstrates how religious identity may negatively associate with workplace experiences and well-being among U.S. Muslim physicians and highlights the buffering role of religious practice. It spotlights an urgent need for academic medical centers to ameliorate religious discrimination and implement workplace accommodation policies for Muslim physicians.
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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... more
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-oflife 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-oflife care and the delivery of culturally appropriate healthcare. J Pain Symptom Manage 2024;000:e1−e14.
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Objectives: As a result of recent biomedical advancements, organ donation continues to save and enhance countless lives globally. Yet, the gap between the organ supply and demand persists, leading to approximately 17 people dying each day... more
Objectives: As a result of recent biomedical advancements, organ donation continues to save and enhance countless lives globally. Yet, the gap between the organ supply and demand persists, leading to approximately 17 people dying each day waiting for an organ transplant and another person being added to the transplant waiting list every 9 minutes. This gap persists, in part, because of ethical and practical concerns arising from ambiguities surrounding death determination before donation and the dead donor rule. In this study, we discuss challenges related to defining death in the context of organ donation, critical and tolerant views on the dead donor rule, and possible avenues by which some of the ambiguities and ethical tensions related to organ donation may be resolved. Materials and Methods: We reviewed literature opinions and data pertaining to cultural and religious influences affecting societal attitudes toward death determination and organ donation and examined the future of deceased organ donation. Results: Cultural and religious influences affect societal attitudes toward death determination and organ donation. There is a plurality of views on the matter that may be assuaged to an extent by standardized death determination criterion that could be implemented globally or by identifying alternative therapies other than human organ transplant. Conclusions: The debate regarding death and the acceptability of dead donor organs for transplant does not have a straightforward solution, and efforts are needed to overcome social, cultural and religious objections.
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Regular mammogram screenings are effective for early breast cancer (BC) detection and decreased mortality rate. However, immigrant Muslim Arab women (IMAW) are less likely to adhere to these screenings although the rate of BC among IMAW... more
Regular mammogram screenings are effective for early breast cancer (BC) detection and decreased mortality rate. However, immigrant Muslim Arab women (IMAW) are less likely to adhere to these screenings although the rate of BC among IMAW is high. Recent studies have explored low mammogram screening rates among immigrant Muslim and/or Arab women from a limited perspective, overlooking the fact that husbands have an influence in IMAW’s health behaviors toward cancer screenings. Thus, this mixed-method approaches were employed to (a) explore the association between spousal support and IMAW’s health beliefs toward mammograms and their utilization, (b) to understand IMAW’s experiences of spousal influence related to their mammogram use and health beliefs. The quantitative portion of the study, recruitment and data collection were conducted via online surveys in Arabic and English. Logistic regressions were used to explore relationships between perceived spousal support and IMAW’s mammogram utilization and health beliefs. The qualitative portion of the study was conducted on a purposive sample of IMAW. A semi-structured interview guide in Arabic and English was used during one-on-one interviews. Arabic interviews were translated into English and transcribed by professionals. Interviews were analyzed by thematic analysis according to Braun and Clarke (2008). A total of 184 IMAW completed the survey with mean age of 50.4 (SD = 5.58, range = 45–60). Results revealed low mammogram screening rate among IMAW. Only 32.6% adhered to mammograms. Spousal support was positively associated with ever having obtained a mammogram and IMAW’s adherence to mammogram. The 20 qualitative interviews, 16 in Arabic and four in English, produced rich description supporting results from the survey which includes, (a) types of spousal support, (b) impact of spousal support on participants’ mammogram utilization and experience, and (3) impact of spousal support on participants’ health beliefs toward mammograms. Findings from surveys and interviews show that a husband’s support is positively associated with IMAW’s mammogram utilization and health beliefs. Suggesting a new approach to integrate husbands in culturally appropriate interventions to increase mammogram screening rates among IMAW.
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From restrictions on public gatherings and travel, to masking regulations and the closure of businesses, policymakers craft various social policies and legal mandates to mitigate COVID-19 disease spread and impact. Religious practices... more
From restrictions on public gatherings and travel, to masking regulations and the closure of businesses, policymakers craft various social policies and legal mandates to mitigate COVID-19 disease spread and impact. Religious practices have also been subject to constraints, insofar as they contribute to social life and inform COVID-19-related behaviors. From Friday prayers and burial rites to vaccines and healthcare, Muslims have sought guidance about how to maintain religious identity in the face of the constraints on social activities. As such, this chapter examines how public health and religion-related values intersected in the Islamic bioethical guidance offered by the US-based National Muslim Task Force on COVID-19. It begins by describing the context, personnel, and procedures by which the Fiqh Committee of the National Muslim Task Force on COVID-19 came to be and deliberated. Next, it analyzes the ways in biomedical data, state authority mandates, and Islamic ethico-legal imperatives integrated to furnish guidance on congregational prayer services and vaccine uptake to mosque leaders and community members. This section also describes contentions over the applicability of maṣlaḥa (public interest), ḍarūra (dire necessity), ḥifz al-nafs (preservation of life), and ḥifz al-dīn (preservation of religion) in the COVID-19 context. The final section reflects on the discursive gaps between policymakers, religious scholars, and public health professionals, and the need for multidisciplinary engagement in Islamic bioethical deliberation.
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Artificial womb technology for extracorporeal gestation of human offspring (ectogenesis or ectogestation) has profound ethical, sociological and religious implications for Muslim communities. In this article we examine the usage of the... more
Artificial womb technology for extracorporeal gestation of human offspring (ectogenesis or ectogestation) has profound ethical, sociological and religious implications for Muslim communities. In this article we examine the usage of the technology through the lens of Islamic ethico-legal frameworks specifically the legal maxims (al-Qawaid al-Fiqhiyyah) and higher objectives of Islamic law (Maqaṣid al-Shariah). Our analysis suggests that its application may be contingently permissible (halal) in situations of dire need such as sustaining life and development of extremely premature newborns, for advancing fetal medicine and avoiding maternal co-morbidities during fetal treatment, and for enabling motherhood for women without functional wombs, or who face grave medical risks in pregnancy. However, its application may be proscribed (haram) for enabling healthy women to avoid pregnancy and childbirth, or to achieve parenthood equity. Specification of these views to particular policy, legal contexts and Fatwa will require multidisciplinary Shariah-based bioethical deliberations between jurists, policymakers, and scientists.
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x and processes of American healthcare system, e.g. prioritizing efficiency and individual autonomy [3-5]. Specifically, Muslim Americans, a large a growing sector of the population, need a greater understanding about which EOLHC... more
x and processes of American healthcare system, e.g. prioritizing efficiency and individual autonomy [3-5]. Specifically, Muslim Americans, a large a growing sector of the population, need a greater understanding about which EOLHC treatment options are consistent with their beliefs [3-5]. Muslim Americans number between 3 and 5 million persons, and comprise primarily of Arabs, South Asians, and African Americans [6-8]. Nearly 65% of Muslims are immigrants, and 14% are over the age of 55. The Muslim population continues to grow by an average of 100,000 people per year in the US, along with an increase in older Muslim adults, due to the aging of the middle-aged group whose parents previously migrated to the US from abroad [7, 9]. Shared religious beliefs, values, and identity shape this community's health and healthcare seeking behaviors across racial/ethnic and sociodemographic lines [10, 11]. Islamic beliefs inform Muslim Americans conceptions of health, healing, illness and cure [12, 13], and Islamic law and ethics influence choices regarding treatment options
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Background and Objectives: Advance Care Planning (ACP) is a critical tool in advancing patient self-determination in health care delivery. Despite increasing research into racial/ethnic minorities' engagement with ACP in the US, studies... more
Background and Objectives: Advance Care Planning (ACP) is a critical tool in advancing patient self-determination in health care delivery. Despite increasing research into racial/ethnic minorities' engagement with ACP in the US, studies on Muslim Americans are relatively scarce. We aimed to examine levels of ACP engagement among Muslim adults and measure associations between socio-demographic and religiosity characteristics and ACP engagement. Methodology: This was a survey study among Muslims attending mosque seminars in Chicago and Washington DC. Religiosity characteristics were assessed using a modified version of the Duke University Religion Index (DUREL) and the Psychological Measure of Islamic Religiousness (PMIR). ACP engagement was measured by the 4-item ACP Engagement Survey (4-ACPES) and 2 additional items covering ACP religious dimensions. Statistical analyses were performed using SPSS 28.0. Results: Out of 152 respondents, 56.2% to 72.6% were in the pre-contemplation stage of ACP across the 6 ACP items. Bivariate analyses showed that ACP engagement was correlated with participant age, ethnicity, duration of stay in the US and country of birth. Multivariable analyses demonstrated no association between religiosity characteristics and ACP engagement; independent predictors of ACP engagement were race/ ethnicity (being South Asian), country of birth (born outside the US) and duration of stay in the US (longer years). Discussion/ Conclusion: Our study suggests that American Muslims are largely unprepared to engage with ACP. Moreover, religiosity does not predict ACP engagement. We call for greater community outreach and educational programs that instill awareness and knowledge on the importance of ACP, and provide resources for tailored religiously-oriented conversations that assist individuals with ACP.
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Physicians from marginalized racial, ethnic, sexual, and gender backgrounds often encounter adversity, ranging from overt discrimination to subtle microaggressions, which impacts their professional careers. Consequently, concerted efforts... more
Physicians from marginalized racial, ethnic, sexual, and gender backgrounds often encounter adversity, ranging from overt discrimination to subtle microaggressions, which impacts their professional careers. Consequently, concerted efforts to promote workforce diversity in healthcare have begun to tackle these issues. In this study, we further these efforts by uplifting the voices of a minority religious community, Muslim physicians, and their experiences in the medical profession. Using a community-engaged research approach, we recruited 18 physicians from 3 national Muslim clinician organizations who had worked at a university hospital within the last 20 years to participate in semi-structured interviews focused on how their religious identity intersects with experiences of discrimination and accommodation. Deploying a phenomenological framework, we identified four emergent themes that cut across the 18 interviews. The physicians’ experiences demonstrated that they i) shouldered extra labor to uphold their religious identity, (ii) denied their personal experiences of religious discrimination, (iii) feared religious discrimination, and (iv) mislabeled their personal management of religious practices as institutional accommodations. These experiences suggest that the additional responsibilities and burdens that saddle underrepresented racial and ethnic identities in medicine – dubbed “the minority tax” – extend to this religious minority group. They also highlight a unique set of psychological and professional costs associated with carrying a Muslim identity in the physician workforce. Our findings underscore the need for healthcare systems to take bold action in creating non-discriminatory, inclusive, and equitable working environments that attend to the religious identities of diverse physicians.
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Background Career satisfaction and burnout among physicians are important to study because they impact healthcare quality, outcomes, and physicians' well-being. Relationships between religiosity and these constructs are underexplored, and... more
Background Career satisfaction and burnout among physicians are important to study because they impact healthcare quality, outcomes, and physicians' well-being. Relationships between religiosity and these constructs are underexplored, and Muslim American physicians are an understudied population.
Methods To explore relationships between career satisfaction, burnout, and callousness and Muslim physician characteristics, a questionnaire including measures of religiosity, career satisfaction, burnout, callousness, and sociodemographic characteristics was mailed to a random sample of Islamic Medical Association of North America members. Statistical relationships were explored using chi-squared tests and logistic regression models.
Results There were 255 respondents (41% response rate) with a mean age of 52 years. Most (70%) were male, South Asian (70%), and immigrated to the United States as adults (65%). Nearly all (89%) considered Islam the most or very important part of their life, and 85% reported being somewhat or very satisfied with their career. Multivariate models revealed that workplace accommodation of religious identity is the strongest predictor of career satisfaction (odds ratio [OR]: 2.69, p = 0.015) and that respondents who considered religious practice to be the most important part of their lives had higher odds of being satisfied with their career (OR: 2.21, p = 0.049) and lower odds of burnout (OR: 0.51, p = 0.016). Participants who felt that their religion negatively influenced their relationships with colleagues had higher odds of callousness (OR: 2.25, p = 0.003).
Conclusions For Muslim physicians, holding their religion to be the most important part of their life positively associates with career satisfaction and lower odds of burnout and callousness. Critically, perceptions that one's workplace accommodates a physician's religious identity associate strongly with career satisfaction. In this era of attention to physician well-being, the importance of religiosity and religious identity accommodations to positive career outcomes deserves focused policy attention.
Methods To explore relationships between career satisfaction, burnout, and callousness and Muslim physician characteristics, a questionnaire including measures of religiosity, career satisfaction, burnout, callousness, and sociodemographic characteristics was mailed to a random sample of Islamic Medical Association of North America members. Statistical relationships were explored using chi-squared tests and logistic regression models.
Results There were 255 respondents (41% response rate) with a mean age of 52 years. Most (70%) were male, South Asian (70%), and immigrated to the United States as adults (65%). Nearly all (89%) considered Islam the most or very important part of their life, and 85% reported being somewhat or very satisfied with their career. Multivariate models revealed that workplace accommodation of religious identity is the strongest predictor of career satisfaction (odds ratio [OR]: 2.69, p = 0.015) and that respondents who considered religious practice to be the most important part of their lives had higher odds of being satisfied with their career (OR: 2.21, p = 0.049) and lower odds of burnout (OR: 0.51, p = 0.016). Participants who felt that their religion negatively influenced their relationships with colleagues had higher odds of callousness (OR: 2.25, p = 0.003).
Conclusions For Muslim physicians, holding their religion to be the most important part of their life positively associates with career satisfaction and lower odds of burnout and callousness. Critically, perceptions that one's workplace accommodates a physician's religious identity associate strongly with career satisfaction. In this era of attention to physician well-being, the importance of religiosity and religious identity accommodations to positive career outcomes deserves focused policy attention.
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The past two decades have witnessed a substantial interest in Islamic bioethics research and writing. As more papers are published and a greater number of conferences are held, it is important to reflect on the concepts and concerns that... more
The past two decades have witnessed a substantial interest in Islamic bioethics research and writing. As more papers are published and a greater number of conferences are held, it is important to reflect on the concepts and concerns that frame the emerging discourse and its nascent academic literature. Accordingly, this paper begins by reflecting on the term Islamic bioethics and the motivations that spur Islamic bioethical deliberation. In so doing, it calls for paying attention to the normative and methodological implications of uniting the disparate discourses represented by the conjunctive term. To further assist consumers in distinguishing various types of Islamic bioethics research and writing, three general categories of scholarly work-Islamic bioethics, Muslim bioethics, and applied Islamic bioethics-are introduced. Next, the paper outlines
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Background: Regular mammogram screenings contribute to a decreased breast cancer (BC) mortality rate. Women from ethnic minorities in the United States, however, often underutilize mammogram screenings; in particular, immigrant Muslim... more
Background: Regular mammogram screenings contribute to a decreased breast cancer (BC) mortality rate. Women from ethnic minorities in the United States, however, often underutilize mammogram screenings; in particular, immigrant Muslim Arab (IMAW) women have low mammogram screening rates. Objective: To explore the associations between mammogram utilization and (a) health and religious beliefs, (b) level of knowledge about mammograms, (c) health care provider (HCP) recommendations, and (d) spousal support. Methods: A cross-sectional study employed online data collection. An Arabic or English survey was completed by women who were 45 or older and married, had immigrated from Arab countries, and had no history of breast cancer. Logistic regression was conducted for data analyses. Results: Of the 184 Immigrant Muslim Arab survey participants, 86.6% reported having had at least one mammogram in their lifetime, and 32.6% adhered to mammograms. Ever having obtained a mammogram and adherence to mammograms were negatively associated with perceived mammogram barriers and positively associated with (a) spousal support, (b) level of mammogram knowledge, and (c) perceived self-confidence. Receiving (HCP) recommendation increased the likelihood of ever having obtained a mammogram. Finally, participants who reported higher levels of perceived mammogram benefits were more likely to have obtained a mammogram within the last 2 years compared to their counterparts. Conclusions: IMAW have demonstrated low mammogram adherence rate. Implications: Nursing clinicians and scholars must play a role in designing and implementing interventions to promote women adherence to mammograms. Involving husbands in these interventions may improve immigrant Muslim Arab women's mammogram adherence rates.
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Objective To assess Muslim physician experiences with religious discrimination and identify strategies for better accommodating Muslim identity in health care. Data Sources and Study Setting Interviews were conducted with Muslim... more
Objective
To assess Muslim physician experiences with religious discrimination and identify strategies for better accommodating Muslim identity in health care.
Data Sources and Study Setting
Interviews were conducted with Muslim physicians from three US-based Muslim clinician organizations between June and August 2021.
Study Design
In-depth, semi-structured qualitative interviews used a phenomenological approach to describe experiences of religious discrimination and accommodation. A team-based framework approach to coding was used to inductively generate themes from interview data.
Data Collection/Extraction Methods
Physicians from the Islamic Medical Association of North America, American Muslim Health Professionals, and the US Muslim Physicians group were invited to participate using closed organizational listservs. Inclusion criteria sought English-speaking, self-identifying Muslims with current or past affiliation with a university hospital in the United States. Potential participants were segmented into groups based on responses to questions about perceived religious discrimination and accommodation. Purposive sampling was used to iteratively approach participants within these groups in order to capture a diverse respondent pool. Interviews stopped after thematic saturation was reached.
Principal Findings
Eighteen physicians (11 women and 7 men; mean age: 41.5 [standard deviation = 12.91] years) were interviewed. Nearly all (n = 16) held Islam to be important in their lives. Three overarching themes, with several subthemes, emerged. Participants (1) struggled to maintain religious practices and observances due to unaccommodating organizational structures; (2) experienced religious discrimination, which, in turn, impacted their professional trajectories and, at times, their personal well-being; and (3) believed that institutions could implement specific educational and policy interventions to advance the religious accommodation of Muslims in health care.
Conclusions
Muslim physicians frequently encounter religious discrimination, yet there are concrete ways in which health care workplaces can better accommodate their religious needs and combat discrimination. To improve workforce diversity, equity, and inclusion, educational forums and policies that support the religious practices of physicians need to be established.
To assess Muslim physician experiences with religious discrimination and identify strategies for better accommodating Muslim identity in health care.
Data Sources and Study Setting
Interviews were conducted with Muslim physicians from three US-based Muslim clinician organizations between June and August 2021.
Study Design
In-depth, semi-structured qualitative interviews used a phenomenological approach to describe experiences of religious discrimination and accommodation. A team-based framework approach to coding was used to inductively generate themes from interview data.
Data Collection/Extraction Methods
Physicians from the Islamic Medical Association of North America, American Muslim Health Professionals, and the US Muslim Physicians group were invited to participate using closed organizational listservs. Inclusion criteria sought English-speaking, self-identifying Muslims with current or past affiliation with a university hospital in the United States. Potential participants were segmented into groups based on responses to questions about perceived religious discrimination and accommodation. Purposive sampling was used to iteratively approach participants within these groups in order to capture a diverse respondent pool. Interviews stopped after thematic saturation was reached.
Principal Findings
Eighteen physicians (11 women and 7 men; mean age: 41.5 [standard deviation = 12.91] years) were interviewed. Nearly all (n = 16) held Islam to be important in their lives. Three overarching themes, with several subthemes, emerged. Participants (1) struggled to maintain religious practices and observances due to unaccommodating organizational structures; (2) experienced religious discrimination, which, in turn, impacted their professional trajectories and, at times, their personal well-being; and (3) believed that institutions could implement specific educational and policy interventions to advance the religious accommodation of Muslims in health care.
Conclusions
Muslim physicians frequently encounter religious discrimination, yet there are concrete ways in which health care workplaces can better accommodate their religious needs and combat discrimination. To improve workforce diversity, equity, and inclusion, educational forums and policies that support the religious practices of physicians need to be established.
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Research Interests:
Minority groups based on immigration status, gender, or religion often face discrimination in healthcare settings. Muslim women, especially those who wear hijab, are more likely to experience stereotyping and discrimination in and outside... more
Minority groups based on immigration status, gender, or religion often face discrimination in healthcare settings. Muslim women, especially those who wear hijab, are more likely to experience stereotyping and discrimination in and outside of healthcare, but little is known about the sociodemographic predictors of this discrimination. We examined sociodemographic factors and religiosity as predictors of discrimination in medical settings among Muslim American women. Muslim women (n = 254) were recruited from Muslim organizations in Chicago to self-administer a survey on perceived discrimination, religiosity, and sociodemographic characteristics. Many participants reported that they were treated with less courtesy than non-Muslims (25.4%) and that a doctor or nurse did not listen to them (29.8%) or acted as though they were not smart (24.3%). A multivariable regression model revealed that self-rated religiosity was negatively associated with discrimination. Race/ ethnicity trended towards predicting perceived discrimination such that Arabs and South Asians reported less discrimination than African Americans. The current study sheds light on the important role of religiosity in shaping Muslim women's experiences in medical settings and points to the buffering effect of religiosity and the additive consequences of racial/ethnic identity in experiences of religious discrimination.
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BACKGROUND: Discrimination negatively impacts physician career trajectories and well-being. OBJECTIVE: Quantify perceived religious discrimination among US Muslim physicians and compare trends over time. DESIGN/PARTICIPANTS/MAIN MEASURES:... more
BACKGROUND: Discrimination negatively impacts physician career trajectories and well-being. OBJECTIVE: Quantify perceived religious discrimination among US Muslim physicians and compare trends over time. DESIGN/PARTICIPANTS/MAIN MEASURES: Two national surveys tabulated discrimination. The 2013 survey involved a mailed questionnaire to a random sample of 746 Islamic Medical Association of North America (IMANA) members, while the 2021 survey was administered online to subscribers of IMANA, American Muslim Health Professionals, and the US Muslim Physician network. Eligible participants had to be practicing US Muslim physicians, and English-proficient (the 2021 sample was further restricted to physicians in academic medicine). Questionnaires assessed experiences of religious discrimination and accommodation. KEY RESULTS: In 2013, the 255 participants had a mean age of 52 years, were mostly male (70%), Sunni (91%), South Asian (70%), and adult immigrants (65%). In 2021, the 264 participants had a mean age of 39.5 years, were mostly male (65%) and Sunni (75%). In contrast to 2013, the majority were born in the USA (59%; p<0.01), and respondents were more diverse with 33% South Asians, 22% Arabs, and 16% African Americans. Greater proportions of the 2021 sample reported facing religious discrimination frequently in their career (24 to 53%; p<0.01), experiencing job turnover (7 to 32%; p<0.01), and having patients refuse their care (9 to 33%; p<0.01). A higher proportion of South Asians, Arabs, and participants under the age of 40 reported discrimination and job turnover in 2021 when compared to 2013. Higher proportions of South Asians and Whites reported being passed over for professional advancement and having patients refuse their care in 2021 relative to 2013. CONCLUSIONS: Many American Muslim clinicians encounter religious discrimination at the workplace, and these experiences appear to be on the rise. Healthcare workforce diversity, inclusion, and equity programming should include a focus on accommodating the religious identities of physicians.
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Background: More than 100,000 Americans with failing organs await transplantation, mostly from dead donors. Yet only a fraction of patients declared dead by neurological criteria (DNC) become organ donors. Discussion: Emergency physicians... more
Background: More than 100,000 Americans with failing organs await transplantation, mostly from dead donors. Yet only a fraction of patients declared dead by neurological criteria (DNC) become organ donors. Discussion: Emergency physicians (EPs) can improve solid organ donation in the following ways: providing perimortem critical care support to potential organ donors, promptly notifying organ procurement organizations (OPOs), asking neurocritical care specialists to evaluate selected emergency department patients for death based on established neurologic criteria, participating in research to advance these developments, implementing automatic OPO notification technologies, and educating the professional and lay communities about organ donation and transplantation, including exploration of opt-out (presumed consent) organ recovery policies. Conclusion: With future improvements in organ preservation and DNC assessment, EPs may become even more involved in the donation process. EPs should support and engage in efforts to promote organ donation and transplantation.
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The popular narrative about Muslims and organ donation, especially about Muslims in the diaspora, is that Muslims have unfavorable sentiments about organ donation. Furthermore, this skepticism is associated with Islam in the sense that... more
The popular narrative about Muslims and organ donation, especially about Muslims in the diaspora, is that Muslims have unfavorable sentiments about organ donation. Furthermore, this skepticism is associated with Islam in the sense that pious Muslims are regarded to be more averse to organ donation, and Islamic edicts that judge organ donation to be religiously forbidden are thought to be erroneous. Based on this narrative, public health leaders encourage organ donation by teaching Muslims about the social advantages of organ donation and linking these advantages to religious edicts that consider organ donation to be lawful. We examined the factual and moral foundations of this narrative of Muslims, Islam, and organ donation. Our analysis demonstrated that the narrative is undermined by methodological flaws in existing empirical research and misconceptions of Islamic normativity. We contend that Muslim concerns about organ donation extend beyond whether it is religiously allowed and that contextual circumstances produce diverse and equally acceptable Islamic viewpoints on organ donation. As a result, we advocate that educational initiatives aid informed decision-making by debunking misunderstandings about organ donation and promoting plurality of Islamic ethicolegal positions on the practice.
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Introduction:Detailed studies on the associations between religious beliefs and organ donation attitudes among religious minorities remain wanting. Although Muslims appear to have low rates of support for donation, how these behaviors... more
Introduction:Detailed studies on the associations between religious beliefs and organ donation attitudes among religious minorities remain wanting. Although Muslims appear to have low rates of support for donation, how these behaviors relate to religious frameworks requires further investigation.Methods:We sought to explore the relationship between religious beliefs (Islam) and organ donation attitudes through focus groups with 43 Muslim women from 5 Chicago-area mosques. Purposive selection of mosques generated near-equal representation of Arabs, South Asians, and African Americans, as well as diversity in education and income. Using the theory of planned behavior as our conceptual framework, we expanded the traditional normative domain to include religiously informed beliefs.Findings:We found that the relationship between religious beliefs and Muslim attitudes toward organ donation is more complex than commonly perceived. Regarding the Islamic ethicolegal permissibility of organ d...
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Background: American Muslims tend to hold more negative attitudes towards organ donation than other American populations, and these attitudes are contributed to by gaps in biomedical and religious knowledge. As a result, there is... more
Background: American Muslims tend to hold more negative attitudes towards organ donation than other American populations, and these attitudes are contributed to by gaps in biomedical and religious knowledge. As a result, there is significant need for religiously-tailored health education on organ donation within this community. Thus our study sought to test the effectiveness of a mosque-based, religiously-tailored health education program that addressed biomedical and religious knowledge gaps regarding living organ donation amongst Muslim Americans. Methods: A randomized, controlled, cross-over trial of religiously-tailored educational workshops held at four mosques in Washington D.C. and Chicagoland. Mosques are randomized into early and late intervention arms and participants are recruited at worship services and other mosque events. The primary study outcomes are changes in biomedical and religious knowledge regarding living organ donation. Secondary outcomes include change in pr...
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Donation after circulatory determination of death (DCDD) and xenotransplantation are advanced as possible solutions to the growing gap between the number of individuals in need of organ transplantation and the pool of donors.... more
Donation after circulatory determination of death (DCDD) and xenotransplantation are advanced as possible solutions to the growing gap between the number of individuals in need of organ transplantation and the pool of donors. Investigating how various publics, including religious leaders, might view these "therapies" is essential for broad public and professional support and will be needed in order to make these solutions viable. This study, therefore, presents normative Islamic bioethical perspectives on donation after circulatory determination of death and xenotransplantation. First, we will discuss foundational Islamic ethico-legal debates regarding organ donation. These debates can be grouped into three broad positions, those who consider organ donation categorically impermissible as a violation of human dignity (ḥurma and karāma), those who agree that organ donation is impermissible in principle, but allow it conditionally on the basis of dire necessity (ḍarūra), and ...
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Healthcare practitioners are increasingly aware that patients may utilize faith-based healing practices in place of conventional medicine based on their spiritual and/or religious understandings of health and illness. Therefore,... more
Healthcare practitioners are increasingly aware that patients may utilize faith-based healing practices in place of conventional medicine based on their spiritual and/or religious understandings of health and illness. Therefore, elucidating the ontological understandings of patients utilizing such religion-based treatments may clarify why patients and clinicians have differing understandings of 'who' heals and 'what' are means for healing. This paper describes an Islamic ontological schema that includes the following realms: Divine existence; spirits/celestial beings; non-physical forms/similitudes; and physical bodies. Ontological schema-based means of healing include conventional medicine, religion-based means (e.g., supplication, charity, prescribed incantations/amulets), and active adoption of Islamic virtues (e.g., reliance on God [tawakkul] and patience [sabr]). An ontological schema-based description of causes and means of healing can service a more holistic m...
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Research Interests: Health Care, Global Health, Cancer, Developing Countries, Public Health, and 14 moreHealth Policy, Global Health Policy, Medicine, Healthcare, Policy making, Humans, Female, Womens and Gender Studies, Trojan Horse, Womens Health, Public Policy, Socioeconomic Factors, The Lancet, and Medical and Health Sciences
Research Interests: Psychology, Islamic Law, Philosophy, Medical Law, Decision Making, and 13 morePhilosophy of Medicine, Personhood, Religion and medicine, Islam, Medicine, Clinical Ethics, Humans, End of life care, Islamic bioethics, Public health systems and services research, Morals, Terminal care, and Ethical Analysis
Research Interests: Health Behavior, Religion and medicine, Islam, Medicine, Community Based Participatory Research, and 15 moreChicago, Humans, Needs Assessment, Minority Groups, United States, Female, Aged, Middle Aged, Adult, Health surveys, Delayed Diagnosis, attitude to health, cultural characteristics, Delivery of Health Care, and Medical and Health Sciences
ABSTRACT Background: Invidious discrimination is unreasonable and unethical. When directed against patients, such discrimination violates the respect for persons at the heart of bioethics. Might such discrimination also be directed at... more
ABSTRACT Background: Invidious discrimination is unreasonable and unethical. When directed against patients, such discrimination violates the respect for persons at the heart of bioethics. Might such discrimination also be directed at times toward physicians themselves? Studies of workplace discrimination have largely focused on race and gender, with few examining whether religious identity attracts discrimination. Muslim physicians from diverse backgrounds comprise 5% of the U.S. physician workforce and, given the sociopolitical climate, may face anti-Muslim discrimination in the workplace. We assessed the prevalence of perceived religious discrimination and its association with measures of religiosity through a national survey of American Muslim physicians. Methods: A questionnaire including measures of religiosity, perceived religious discrimination, religious accommodation at the workplace, and discrimination-related job turnover was mailed to 626 Islamic Medical Association of North America members at random in 2013. Results: Two hundred fifty-five physicians responded (41% response rate). Most were male (70%), South Asian (70%), and adult immigrants to the United States (65%). Nearly all (89%) considered Islam as the most or a very important part of their life, and most (63%) prayed five times daily; 24% reported experiencing religious discrimination frequently over their career, and 14% currently experience religious discrimination at work. After adjusting for personal and practice characteristics, respondents for whom religion was most important had greater odds of experiencing religious discrimination at their current workplace (OR 3.9, p < .01). Sixteen respondents reported job turnover due to religious discrimination, of whom 12 rated religion as the most important part of their life. Conclusions: A significant minority of Muslim clinicians experience religious discrimination at work, and particularly those for whom their religion is most important. Further research is needed to undergird data-driven programs and policies that might reduce invidious, religion-directed discrimination in the health care workplace.
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Welcome to Beyond the Manuscript. In each volume of the Journal, the editors select one article for our Beyond the Manuscript post-study interview with the authors. Beyond the Manuscript provides the authors the opportunity to tell... more
Welcome to Beyond the Manuscript. In each volume of the Journal, the editors select one article for our Beyond the Manuscript post-study interview with the authors. Beyond the Manuscript provides the authors the opportunity to tell listeners what they would want to know about the project beyond what went into the final manuscript. The associate editors who handled the articles conduct our Beyond the Manuscript interviews. In this edition of Beyond the Manuscript Associate Editor Hae-Ra Han interviews Amal Killawi and Aasim Padela, authors of “Using CBPR for Health Research in American Muslim Mosque Communities: Lessons Learned.”
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Islamic ethico-legal assessments of brain death are varied and controversial. Some Islamic ethico-legal bodies have concluded that brain death is equivalent to cardiopulmonary death; others regard it as an intermediate state between life... more
Islamic ethico-legal assessments of brain death are varied and controversial. Some Islamic ethico-legal bodies have concluded that brain death is equivalent to cardiopulmonary death; others regard it as an intermediate state between life and death, and a few opine that it does not meet the standards for legal death according to Islamic law. Yet this translation of the concept of brain death into the Islamic ethico-legal domain has generated multiple ethical complexities that receive insufficient attention within the extant medical and fiqh literature. How do Islamic legists understand brain death as a clinical phenomenon? How does the Islamic ethico-legal system treat medical uncertainty? What Islamic ethico-legal principles should apply to bioethical questions about life and death? In this paper, we analyze the arguments for, and against, the acceptance of brain death within the context of the deliberation of a representative juridical council. In our discussion we focus on areas i...
Research Interests: Law, Bioethics, Islam, Brain Death, Deliberation, and 3 moreHumans, Medicine Law, and Bioethical Issues
American Muslims represent a growing and diverse community. Efforts at promoting cultural competence, enhancing cross-cultural communication skills, and improving community health must account for the religio-cultural frame through which... more
American Muslims represent a growing and diverse community. Efforts at promoting cultural competence, enhancing cross-cultural communication skills, and improving community health must account for the religio-cultural frame through which American Muslims view healing. Using a community-based participatory research model, we conducted 13 focus groups at area mosques in southeast Michigan to explore American Muslim views on healing and to identify the primary agents, and their roles, within the healing process. Participants shared a God-centric view of healing. Healing was accessed through direct means such as supplication and recitation of the Qur’an, or indirectly through human agents including imams, health care practitioners, family, friends, and community. Human agents served integral roles, influencing spiritual, psychological, and physical health. Additional research into how religiosity, health care systems, and community factors influence health-care-seeking behaviors is warr...
Research Interests: Perception, Participatory Action Research, Cultural Competency, Cultural Competence, American Muslims, and 15 moreHealth, Islam, Adolescent, Medicine, Community Based Participatory Research, Humans, Female, Male, Focus Group, Muslims, Healing, Aged, Middle Aged, Adult, and Medical and Health Sciences
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American Muslims are a diverse and growing population, numbering nearly 200,000 in Southeast Michigan. Little empirical work exists on the influence of Islam upon the healthcare behaviors of American Muslims, and there is to date limited... more
American Muslims are a diverse and growing population, numbering nearly 200,000 in Southeast Michigan. Little empirical work exists on the influence of Islam upon the healthcare behaviors of American Muslims, and there is to date limited research on the roles that imams, Muslim religious leaders, play in the health of this community. Utilizing a community-based participatory research (CBPR) model through collaboration with four key community organizations, we conducted semi-structured interviews with 12 community leaders and explored their perceptions about the roles imams play in community health. Respondents identified four central roles for imams in healthcare: (1) encouraging healthy behaviors through scripture-based messages in sermons; (2) performing religious rituals around life events and illnesses; (3) advocating for Muslim patients and delivering cultural sensitivity training in hospitals; and (4) assisting in healthcare decisions for Muslims. Our analysis also suggests several challenges for imams stemming from medical uncertainty and ethical conflicts. Imams play key roles in framing concepts of health and disease and encouraging healthy lifestyles outside of the healthcare system, as well as advocating for Muslim patient needs and aiding in healthcare decisions within the hospital. Healthcare partnerships with these religious leaders and their institutions may be an important means to enhance the health of American Muslims.
Research Interests: Health Care, American Muslims, Community Health, Chaplaincy, Islam, and 15 moreMedicine, Community Based Participatory Research, Minority Health, Humans, Female, Male, Michigan, Data Collection, Clergy, Middle Aged, Adult, Community Organization, Healthcare system, LIFE EVENT, and Interviews as topic
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Research Interests: Health Behavior, Focus Groups, Health Care, Cultural Competency, General Internal Medicine, and 15 moreIslam, Adolescent, Medicine, Community Based Participatory Research, Humans, Female, Male, Michigan, Clinical Sciences, Aged, Middle Aged, Adult, Health Priorities, attitude to health, and Delivery of Health Care
Somali women are at increased risk of adverse pregnancy outcomes. Anxiety and perceived stigmatization toward female genital cutting (FGC) further fuels an atmosphere of miscommunication and distrust, contributing to poorer health... more
Somali women are at increased risk of adverse pregnancy outcomes. Anxiety and perceived stigmatization toward female genital cutting (FGC) further fuels an atmosphere of miscommunication and distrust, contributing to poorer health outcomes. While the attitudes and experiences of Somali refugee women toward healthcare are widely known, the views of Somali refugee men are largely unknown. This study examines the perspectives of Somali men toward FGC and women&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s childbirth experiences in one refugee community in the USA. Community-based participatory research partnerships with key stakeholders within the Somali refugee community incorporated qualitative methods comprising semi-structured focus groups and individual interviews to elicit male participants&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perspectives on FGC, experiences during childbirth, and the perception of increased cesarean deliveries among Somali women. Qualitative analyses involved a framework and team-based approach using grounded theory and conventional content analysis. Acculturation influenced changes in traditional gender roles fostering new dynamics in shared decision-making within the household and during childbirth. Participants were aware of FGC-related morbidity, ongoing matriarchal support for FGC, and were generally not supportive of FGC. They perceived health-care providers as being unfamiliar with caring for women with FGC fueling profound aversion to cesarean deliveries, miscommunication, and distrust of the health-care system. Our work yields new insights into Somali reproductive healthcare through Somali men, namely: strong matriarchal support of FGC, discomfort in men&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s presence during delivery, and a strong aversion to cesarean delivery. Our findings support the need for advocacy to engage Somali women, their partners/spouses, and health-care providers in facilitating greater continuity of care, building greater trust as men become engaged throughout the spectrum of care in the decision-making process while respecting traditional norms. Cultural health navigators should bridge communication and support between providers and patients. Our work provides foundational knowledge to inform culturally appropriate health interventions within a Somali refugee community.
Research Interests: Cognitive Science, Male Circumcision, Female Genital Mutilation, Grounded Theory, Ethnicity And Health, and 15 moreAcculturation, Medicine, Community Based Participatory Research, Pregnancy, Humans, Arizona, Cross Cultural Communication, Female, Male, Focus Group, Adult, Parturition, Language Barriers, attitude to health, and Interviews as topic
Research Interests: Applied Ethics, Bioethics, Decision Making, Economic Justice, Family, and 15 moreInformed Consent, Medical Ethics, Developing Countries, Autonomy, Islam, Cultural Diversity, Clinical Decision Making, Humans, Engineering Ethics, Beneficence, Developed Countries, Internationality, cultural characteristics, Ethical Analysis, and Interviews as topic
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Research Interests: Health Sciences, Emergency Medicine, Bioethics, Health Care, Cultural Competency, and 15 moreCultural Competence, Health Equity, Cultural Diversity, Medicine, Humans, Minority Groups, Female, Male, Disparities, Clinical Sciences, Ethnic Group, Cultural Sensitivity, Health Care Disparities, Ethnically diverse, and healthcare disparities
Economic globalization and advances in technology have made it more feasible and even necessary to develop international research collaborations in global public health. Historically, collaborations in global research described in the... more
Economic globalization and advances in technology have made it more feasible and even necessary to develop international research collaborations in global public health. Historically, collaborations in global research described in the literature have been mostly "North-South" collaborations in which the more developed "North" country works together with a developing "South" country to conduct research in the latter. This type of collaboration has for the most part, represented unequal partnership and rarely left behind a lasting impact. Recently, the opportunity for a new kind of international research partnership has emerged in which the host country has significant financial resources, but relatively limited expertise in research Methodology or techniques and research implementation. This type of collaboration features a relative equalization of power between the international partners. The purpose of this paper is to describe the process of building...
Research Interests: Communication, Research Design, Political Science, Global Health, Culture, and 12 moreInternational Cooperation, Health Services Research, Medicine, Qatar, Cultural adaptation, Humans, United States, Health Care Quality, Data Collection, International Research Collaborations, Time Factors, and Socioeconomic Factors
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The maqāṣid al-shari'ah are championed as tools to address contemporary societal issues. Indeed, it is argued that maqāṣidbased solutions to present-day economic, political, and cultural challenges authentically bridge the moral vision of... more
The maqāṣid al-shari'ah are championed as tools to address contemporary societal issues. Indeed, it is argued that maqāṣidbased solutions to present-day economic, political, and cultural challenges authentically bridge the moral vision of Islam with modernity. Advocates also stress that maqāṣidī models overcome shortcomings within fiqh-based strategies by bypassing their over-reliance on scriptural and legal hermeneutics, their dated views on social life, and their analytic focus on individual Aasim I. Padela is the Chairperson and Director of the Initiative on Islam and Medicine. He is also Professor and Vice Chair of Research and Scholarship at the Department of Emergency Medicine; and Professor of Bioethics and Medical Humanities at the Institute of Health and Equity, both at the Medical College of Wisconsin. His scholarship broadly aims at improving health and healthcare through better accommodating religious values in healthcare delivery.
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This volume brings together diverse disciplinary perspectives to provide a multidisciplinary and multidimensional account of Muslim ethics operating in the COVID-19 era, where scriptural values, lived experiences, societal structures, and... more
This volume brings together diverse disciplinary perspectives to provide a multidisciplinary and multidimensional account of Muslim ethics operating in the COVID-19 era, where scriptural values, lived experiences, societal structures, and cultural contexts combine in fresh and diverse ways. Indeed, Islamic ethical evaluation often ignores contributions from the social sciences, and contextual factors are not fully understood when issuing Islamic edicts. This volume thus aims at a more connected account of how religious concerns generated challenges and how Muslims lived out their religious values during the pandemic. Alongside descriptive accounts are normative evaluations, and insights from interviews are connected with survey analyses; in this way, the chapters render a more complete account of the intersectional engagement of Muslim healthcare professionals and community members living in minority contexts with the early stages of the COVID-19 pandemic.
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The human being was created like this: They took the wings of an angel, and tied them to the tail of a donkey, in hopes that the donkey-from the radiance and companionship of the angel-might become an angel, too. So what is so wonderful... more
The human being was created like this: They took the wings of an angel, and tied them to the tail of a donkey, in hopes that the donkey-from the radiance and companionship of the angel-might become an angel, too. So what is so wonderful if this donkey became a human? God is able to do all things [1].
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The COVID-19 pandemic has spurred policymakers and religious leaders to revisit age-old questions about the ethics of pandemic control, the just allocation of scarce resources, and preparing for death. We add to these conversations by... more
The COVID-19 pandemic has spurred policymakers and religious leaders to revisit age-old questions about the ethics of pandemic control, the just allocation of scarce resources, and preparing for death. We add to these conversations by discussing the use of mechanical ventilation for COVID-19 patients. Specifically, we address the following: For Muslim patients/families when is it permissible to forgo mechanical ventilation? For Muslim clinicians, what circumstances justify the withholding or withdrawing of mechanical ventilation from patients? And for policymakers, is there an Islamically-justifiable rubric for allocating mechanical ventilation to patients in times of scarcity? Our Islamic bioethical analyses connect biostatistical data and social contexts with ethico-legal constructs to bridge the epistemic theories of biomedicine and the Islamic legal tradition. They reveal that forgoing mechanical ventilation is permissible for Muslims, that there are several conditions that allow for Muslim clinicians to justify withholding and withdrawing mechanical ventilation, and also several policy rubrics for ventilator allocation that would be justifiable.
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Increased biomedical capacities have contributed to the medicalization of the dying process globally. For example, in the Middle East, societies which had little to no access to modern healthcare facilities a generation or two ago now... more
Increased biomedical capacities have contributed to the medicalization of the dying process globally. For example, in the Middle East, societies which had little to no access to modern healthcare facilities a generation or two ago now have some of the most technologically advanced hospitals in their midst. This newfound access to the powers of modern medicine has certainly improved lives but also has fueled misgiven hopes in the restorative and/or curative powers of biotechnology when individuals near death. For example, experience suggests that the ability to maintain physiological functions via ventilators, vasopressors, and the like motivates family members to pursue aggressive treatment regimens for their loved ones despite diminished odds of success [1]. In this way, the newfound capacities of modern medicine impose upon the Islamic ethico-legal imperative of preserving life to generate greater numbers of Muslims meeting their death in the confines of sterile hospital wards rather than in the warmth of their own homes. Adding to this dynamic is the state of "brain death," which further confounds individuals because their loved ones appear to maintain the traditional markers of life, namely breathing and heartbeat, despite clinicians suggesting that human death has occurred. In response,
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There are some vigorous debates over the extent to which religion plays a role in modern healthcare. These debates includes concerns over clinicians providing religious and spiritual support (Sloan and Bagiella 2000), religious frameworks... more
There are some vigorous debates over the extent to which religion plays a role in modern healthcare. These debates includes concerns over clinicians providing religious and spiritual support (Sloan and Bagiella 2000), religious frameworks being used to inform bioethical rules and regulations (Murphy 2012; Schuklenk 2018; Duivenbode and Padela 2019; McCarthy, Homan and Rozier 2020), and religious values being used to support modifying or limiting conventional healthcare (Campbell 2018). Regardless of these important debates, religion and medicine both respond to the human condition. They address the existential questions of what we are, what will become of us, and what will be our end. While medicine and religion converge in responding to these queries, their epistemic frameworks differ and can lead to conflicts between patients, providers, and policy makers.
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Discourses about the relationship between religion and science, whether viewed as one of conflict or compatibility, abound. Scientists, religious scholars and researchers, in peer-reviewed publications, through lectures, and even via... more
Discourses about the relationship between religion and science, whether viewed as one of conflict or compatibility, abound. Scientists, religious scholars and researchers, in peer-reviewed publications, through lectures, and even via social media, debate the truth claims of each “field” and propose ways to integrate, or alternatively, marginalize the deliverables of one type of knowing with respect to the other. In recent years these debates have made their way into Muslim circles as scientists and religious scholars assess how Western philosophical and Christian perspectives compare with Islamic understandings of science and religion. These scholars further grapple with developing frameworks for integration and resolution of potential conflicts between faith and modern science. At present much of these discussions appear broad and superficial; invoking thin conceptions of Islam and science. This has resulted in piecemeal solutions for boundary negotiation between the claims of tradition and claims of modern science. As scholarly work at the intersection of Islam and the biomedical sciences increases this paper anticipates a deeper engagement. We advocate that conceptions of Islam and of science be defined at the outset in a substantive way so that fruitful dialogue can occur, and we propose that the Islamic portion of the dialogue should be set at the level of particular theological and legal schools. Engaging modern science from within a particular Islamic school allows for fundamental Islamic metaphysical and doctrinal commitments to be foregrounded, and in so doing facilitates negotiation about how empirical findings and posited knowledge about nature can be accommodated by established theological frameworks and legal authority structures within the Islamic intellectual tradition.
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Advances in the sciences, particularly in the biomedical and life sciences, have created a knowledge gap that leaves various Muslim lay persons feeling bewildered even as Muslim scientists and religious scholars (ʿulamāʾ) labour to... more
Advances in the sciences, particularly in the biomedical and life sciences, have created a knowledge gap that leaves various Muslim lay persons feeling bewildered even as Muslim scientists and religious scholars (ʿulamāʾ) labour to integrate religious teachings with new scientific knowledge. For example, breakthroughs in artificial intelligence technology force Muslim theologians to consider anew traditional ideas of sentience and the nature of the soul. Advanced predictive epidemiologic modelling techniques, such as those used to forecast COVID-19 disease spread and mortality, spur Muslim legists to reconsider classical views on the obligation of establishing congregational Friday prayer. And the use of human-animal chimeras to grow organs in the lab pose multiple questions to Muslim scholars about the nature of a ‘human’ organ, as well as the ethical limits of biomedical research and healthcare enterprises. These topics are but the tip of the iceberg as biomedical development pushes new frontiers on a daily basis, and accordingly pushes religious scholars to bridge scientific discoveries and religious understandings.
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The growing complexity of science and society bewilders the religious public as well as their scholars. Both seek to find their moral compass in tradition and struggle to see how scriptural values speak to the issues of the day. This... more
The growing complexity of science and society bewilders the religious public as well as their scholars. Both seek to find their moral compass in tradition and struggle to see how scriptural values speak to the issues of the day. This chapter is aimed at building a bridge between ‘the religious’ and ‘the scientific’ by describing the ways in which these categories overlap in the production of moral knowledge. Specifically, the paper draws upon concepts related to the social dimension of knowledge, correspondence theory, and moral ends, to reconsider the application of the concepts of maṣlaḥa (human interest/societal benefit) and ḍarūra (dire necessity) in moral evaluation. The chapter argues that these latter constructs necessarily engage with social and natural scientific understandings and offer an entry-point through which scientific knowledge and ways of knowing can inform Islamic moral discourse. Building from there the chapter presents a conceptual framework and process model for enhanced Islamic bioethical deliberation and applies it to the case of organ donation.