End-of-Life Medical Decision-Making in the Muslim-American Community: Engagement with Advance Directives
Asma Mobin-Uddin, MD, Director, Clinical Bioethics Consultation Service, The Ohio State University Wexner Medical Center and The Ohio State University Center for Bioethics
Uncertainty around end-of-life medical decision-making can cause significant moral distress and grief among families, patients and medical teams and can extend intensive care hospitalizations. Important tools that patients can use to decrease distress and communicate their wishes for end-of-life care include advance directives. Adoption of advance directives remains low overall throughout the United States. As of 2017, only 36.7% of Americans had completed this type of document. Engagement with advance directives is even lower amongst racial and ethnic minority populations, immigrants, people with lower socioeconomic status, young adults, rural residents, and non-English speakers. In the Muslim-American community, there has been limited research on barriers to advance care planning. However, clinical experience has shown that religious beliefs and cultural norms may contribute to decreased rates of completion of advance directives in these patients. For example, Muslim patients and families may be uncertain if withholding certain types of medical care is religiously permissible, so they may avoid completing advance directives due to this type of uncertainty. To support the goal of health equity, there is a need to identify barriers to having conversations about advance care planning in this religious community and then to develop culturally and religiously sensitive interventions that address these barriers.
This paper will present findings of a study currently underway that assesses beliefs about and barriers to advance care planning in the Muslim-American community. The study looks at demographic and socio-economic factors that correlate with Muslim patients who have an advance directive. It also explores knowledge and beliefs Muslim Americans have about end-of-life medical decision-making. The presenter will discuss how the study findings will be used to develop effective, religiously and culturally sensitive educational interventions and tools to increase rates of end-of-life planning in the Muslim-American community. The presenter is a Muslim physician and clinical bioethicist who has decades of experience in clinical practice and community engagement.
This paper will present findings of a study currently underway that assesses beliefs about and barriers to advance care planning in the Muslim-American community. The study looks at demographic and socio-economic factors that correlate with Muslim patients who have an advance directive. It also explores knowledge and beliefs Muslim Americans have about end-of-life medical decision-making. The presenter will discuss how the study findings will be used to develop effective, religiously and culturally sensitive educational interventions and tools to increase rates of end-of-life planning in the Muslim-American community. The presenter is a Muslim physician and clinical bioethicist who has decades of experience in clinical practice and community engagement.