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The crescent and Islam: healing, nursing and the spiritual dimension. Some considerations towards an understanding of the Islamic perspectives on caring.

Caring from Islamic perspectives is not well versed in Eurocentric nursing literature. There is widespread misunderstanding of the concept and practice of Islam within the context of health care and nursing practice. The areas of contention, in the context of health care systems, are whether the western paradigm to nursing care and management are applicable to Muslims and non-Muslims in both Islamic and non-Islamic countries. What is lacking in some of the conceptual frameworks and models of care is not only the fundamental spiritual dimension of care, but also the significance of spiritual development of the individual towards healing. The focus of this paper is to provide an awareness of Islamic health practices, health behaviours, code of ethics and the framework of Islamic perspectives of caring and spirituality. A brief overview of the Muslim world, the historical development in caring and health and the pillars of the Islamic faith provide the context of the paper. The development of a model of care based on the Islamic perspective is suggested.

Attitude to Health↗

Psychiatry and Islam.

OBJECTIVE: To explore psychiatry in Islam, with a view to informing Western psychiatrists working with Islamic patients, and Islamic medical students studying in Western countries. METHODS: The first necessary step was to acquire some understanding of Islam, Sharia and Sharia law, as the basis on which the available psychiatric literature was considered. Standard textbooks on Islam and English-language papers in the psychiatric literature were examined. Discussions with knowledgeable Muslim people were conducted. RESULTS: Islam shares roots with the other Abrahamic, monotheistic religions: Judaism and Christianity. A central issues is unity: the unity of God, unity with God and unity within the Islamic community. Islam is more than a religion, because it informs all aspects of behaviour and has been described as 'a comprehensive way of life'. Individualism is less important than the welfare of the community. The Sharia is a list of rules and regulations derived from authentic sources. Psychiatric services in Islam, according to Western standards, are somewhat limited. This issue is being addressed through epidemiological studies, provision of new services and policy development. Although mental health legislation is not universal, forensic psychiatry has a role, in many ways similar to that in the West. CONCLUSION: Islam is based on unity and core values of compassion, justice and benevolence. Islamic psychiatry has a proud early history, and advances are occurring. There is an opportunity for the profession of psychiatry to bridge religious, ethnic and cultural boundaries.

Australia↗

A re-analysis of Price's "Islam and human rights: a case of deceptive first appearances".

Daniel Price in his analysis of Islamic Political Culture and Human Rights concluded that "... government rooted in Islam does not facilitate the abuse of human rights." A re-analysis of his data for 23 Islamic governments demonstrates otherwise. There is a significant trend (p<.03), despite the low statistical power available in only 23 cases, for an inverted quadratic relationship between Islamic Political Culture and Human Rights. Among the nations scoring low on Islamic Political Culture, the correlation between the two variables is -.01 (ns); among those scoring high on Islamic Political Culture, the correlation shifts to -.78 (p<.02). At lower scores for Islamic Political Culture, there may indeed be little relationship between Political Culture and Human Rights; however, at higher scores there appears to be a significant relationship between increasing Islamic Political Culture and a decline in Human Rights. The data suggest that extreme applications of Sharia law (if not any secular or religious legal system) may have serious implications for human rights--or at least, Western Euro-American conceptualizations of human rights. At the same time, support for human rights may increase as Islamic governments shift from mostly secular to moderate applications of Islamic law.

Human Rights↗

Transplantation ethics from the Islamic point of view.

Organ transplantation has been transformed from an experimental procedure at Western academic centers to an increasingly common procedure in private and public hospitals throughout the world. Attendant with advancements in organ harvesting, preservation, and transplantation come moral issues. Islam is a holistic religion that takes into account social affairs of man as well as spiritual ones. Islam has a long history of ethics literature including the subgenre of medical ethics. Historical considerations are discussed as to why Muslim thinkers were late to consider contemporary medical issues such as organ donation. Islam respects life and values the needs of the living over the dead, thus allowing organ donation to be considered in certain circumstances. The sources of Islamic law are discussed in brief in order for non-Muslims to appreciate how the parameters of organ transplantation are derived. The Islamic viewpoint, both Shiite and Sunni, is examined in relation to organ donation and its various sources. The advantages and disadvantages of brain dead and cadaveric donation is reviewed with technical and ethical considerations. The Islamic concept of brain death, informed and proxy consent are also discussed. We discuss the concept of rewarded donation as a way to alleviate the current shortage of organs available for transplantation and consider secular and religious support for such a program. Suggestions are made for greater discussion and exchange of ideas between secular and religious thinkers in the Islamic world and between the Islamic world and secular Western countries.

Adult↗

An analysis of suicide and undetermined deaths in 17 predominantly Islamic countries contrasted with the UK.

BACKGROUND: Suicide is expressly condemned in the Qu'ran, and traditionally few Islamic countries have reported suicide. Undetermined deaths are classified by the World Health Organization (WHO) as Other Violent Deaths (OVD) in ICD-9, or Other External Causes (OEC) in ICD-10. It has been suggested that to avoid under-reporting of suicides, both formal suicide verdicts and OVD should be considered together because OVD may contain 'hidden' suicides. METHOD: The latest WHO mortality data, by age and gender, were analysed and tested by chi2 tests. Levels of suicide and OVD in 17 Islamic countries were examined and contextually compared with UK rates. The regional Islamic cultural differences in Middle Eastern, South Asian, European Islam countries and those of the former Union of Socialist Soviet Republics (FUSSR) were analysed separately to test the hypotheses that there would be no difference between regional suicide and OVD rates per million (pm) and 17 Islamic countries and UK rates. RESULTS: Suicide rates were higher for males than females, and 'older' (65+) higher than 'younger' (15-34) rates in every country reviewed. The rate for Middle Eastern males was 0-36 pm, South Asian 0-12 pm, European 53-177 pm and FUSSR 30-506 pm, with three countries exceeding the UK rate of 116 pm. The Western male average OVD rate was 22 pm; the UK 55 pm rate was highest. Middle Eastern OVD was 1-420 pm, South Asian 0-166 pm, European 1-66 pm and FUSSR 11-361 pm. OVD rates in 10 Islamic countries were considerably higher than the Western average and eight had OVD rates considerably higher than their suicide rates. CONCLUSIONS: Islamic suicide rates varied widely and the high OVD rates, especially the Middle Eastern, may be a repository for hiding culturally unacceptable suicides.

Adolescent↗

Theoretical model of psychotherapy: Eastern Asian-Islamic women with mental illness.

The Muslim immigrant population is increasing in the United States. To provide appropriate psychotherapy for this group, especially Islamic women, treatment professionals must have a deeper understanding of the culture of Eastern Islamic women. Islam is the lifestyle of this population and it influences their thinking, the relationships among themselves and with others, and all other activities of daily life. The holistic approach of the Eastern Islamic population is incompatible with the individualistic approach of Western psychotherapy in treating Islamic women. We explore a theoretical model of psychotherapy for Eastern Asian-Islamic women suffering from mental illness (MI) to develop an effective and appropriate therapy. Health care providers, specifically those dealing with MI patients, will gain insights from the suggested psychotherapeutic model and its relevance to Islamic concepts and practices.

Adult↗

Bioethics for clinicians: 21. Islamic bioethics.

Islamic bioethics derives from a combination of principles, duties and rights, and, to a certain extent, a call to virtue. In Islam, bioethical decision-making is carried out within a framework of values derived from revelation and tradition. It is intimately linked to the broad ethical teachings of the Qur'an and the tradition of the Prophet Muhammed, and thus to the interpretation of Islamic law. In this way, Islam has the flexibility to respond to new biomedical technologies. Islamic bioethics emphasizes prevention and teaches that the patient must be treated with respect and compassion and that the physical, mental and spiritual dimensions of the illness experience be taken into account. Because Islam shares many foundational values with Judaism and Christianity, the informed Canadian physician will find Islamic bioethics quite familiar. Canadian Muslims come from varied backgrounds and have varying degrees of religious observance. Physicians need to recognize this diversity and avoid a stereotypical approach to Muslim patients.

Abortion, Induced↗

Diagnosis through rosary and sand: Islamic elements in the healing custom of the Yoruba (Nigeria).

The inhabitants of south western Nigeria are known as the Yoruba. Their earliest contact with Islam goes back to the 14th century, but it was only in the 19th century that the faith got firmly established, as Islamic mores and intellectual culture which included medical tradition - became well entrenched. Before the advent of Islam, diagnosis of ailments, witchcraft attacks etc., was carried out through a traditional procedure which involved the use of palm kernels, cowries, the latter similar to "bone throwing" among the Zulu of South Africa. This traditional system has since lost position to divination with rosary (subha) and sand (khatt al-raml), particularly among Muslims. This development notwithstanding, elements of the indigenous medical tradition medical tradition have been incorporated into the Islamic tradition. Inam Ahmad al-Buni (d.622.H) remains a point of reference among Yorouba Muslim healers and standard works on divination with sand, for example, Ahmad al-Afandi's (fl.1290 A.H.) ilm al-raml and al-Adhami's Mizan al-adl fi masqasis ahkam al-raml (1322.A.H.) continue to be popular. Nevertheless, the native Muslim diviners have developed their own literature for this and for divination with rosary, which betrays the level of their linguistic competence as well as the degree of acculturation and hybridization of indigenous and Islamic elements in a healing custom. This paper will examine how traditional elements had been grafted on Islamic divination, and how the practitioners continue to resolve the inherent contradictions between the two phenomena in their dual role as votaries of the Islamic faith and social workers in a medical tradition with a strong religious underpinning.

Acculturation↗

Abortion in Islamic countries--legal and religious aspects.

The debate over abortion is still controversial as ever. As one of every four people in the world is of the Muslim religion, it is important to learn more about the Islamic point of view toward this dilemma in medical ethics. The first part of this paper gives a general view of the sources of Islamic law and discusses modern developments in Islamic medical ethics regarding abortion. The second part focuses on the legal aspects of abortion in different Islamic states, dealing with the need to supply solutions to women who for different reasons wish to abort and at the same time enact laws that would not contradict Islamic principles. A study of three Muslim states (Egypt, Kuwait and Tunisia) demonstrates three different approaches toward legalizing abortion--a conservative approach, a more lenient approach, and a liberal one--all within Islamic oriented states. This leads to a conclusion that a more liberal attitude regarding abortion is possible in Islamic states, as long as traditional principles are taken into account.

Abortion, Induced↗

The politics of engagement between Islam and the secular state: ambivalences of 'civil society'.

The paper reveals contemporary transformations of the interaction between Islam and secular states from opposition to engagement. In-depth ethnographic evidence challenges the predominant juxtaposition of Islam against the secular state. Following micro-sites of interaction between the Gülen movement and the state from Turkey to Kazakhstan, my fieldwork revealed a continuum of engagements between them. The paper analyses the engagements ranging from contestation and negotiation to co-operation. The case illustrates the extent to which scholarly interest in opposition and clash has left a wide-ranging variety of state-Islam interaction understudied with regard to civil society. It also reveals the conditions under which effective Islamic horizontal organizations have provided the platforms of vertical engagements with the secular states. The major argument of the paper is that both civil and uncivil outcomes in the Muslim world are primarily shaped by the nature of state-Islam interaction. The evidence suggests that the key to understanding the relationship between Islam and civil society is the state.

Anthropology, Cultural↗

Islamic medical ethics in the 20th century.

While the practice of Western medicine is known today to doctors of all ethnic and religious groups, its standards are subject to the availability of resources. The medical ethics guiding each doctor is influenced by his/her religious or cultural background or affiliation, and that is where diversity exists. Much has been written about Jewish and Christian medical ethics. Islamic medical ethics has never been discussed as an independent field of ethics, although several selected topics, especially those concerning sexuality, birth control and abortions, have been more discussed than others. Islamic medical ethics in the 20th century will be characterised on the basis of Egyptian fatawa (legal opinions) issued by famous Muslim scholars and several doctors. Some of the issues discussed by Islamic medical ethics are universal: abortions, organ transplants, artificial insemination, cosmetic surgery, doctor-patient relations, etc. Other issues are typically Islamic, such as impediments to fasting in Ramadan, diseases and physical conditions that cause infringement of the state of purity, medicines containing alcohol, etc. Muslims' attitudes to both types of ethical issues often prove that pragmatism prevails and the aim is to seek a compromise between Islamic heritage and the achievements of modern medicine, as long as basic Islamic dogma is not violated.

Bioethical Issues↗

AIDS in contemporary Islamic ethical literature.

AIDS has been mentioned in Islamic ethical literature since about 1985 as an illness pertaining to European and American homosexuals. Only since about 1990 has the presence of HIV/AIDS in Islamic countries cast light on the fact that the actual sexual behaviour of the population does not always conform to religious norms. The increase in the numbers of people with HIV has compelled religious leaders to take a stand on sexual practices they consider "deviant", from prostitution to homosexuality and extramarital sex. The aim of this paper is to analyse the attitude of Muslim religious authorities towards individual sexual behaviour and AIDS. It is based mainly on contemporary legal responses that largely provide the necessary information on most of Islamic medical ethics. According to Muslim scholars, AIDS is a warning from God not to indulge in illicit conduct. As a remedy against the spread of AIDS, they encourage compliance with traditional family values and the enhancement of faith and devotion and strongly oppose sex education. They oppose promotion of condoms or any form of safe sex outside of marriage, which they perceive as promoting promiscuity and defiance of divine law. All the above-mentioned arguments are not exhaustive of the Islamic attitude towards AIDS. Some religious groups disagree with such a conservative way of conceiving the fight against AIDS as being antithetical to both men's and women's well-being. They support an alternative view of reproductive health and human rights within the Islamic framework and stress the great tolerance of Islam and why it must include people with HIV and AIDS.

Acquired Immunodeficiency Syndrome↗

The position of Islamic tradition on contraception.

The first source of Islamic law, the Koran, does not mention contraception. On the contrary, most of the 'sayings' (hadith) of the Prophet Mohammed (the second source of Islamic law) on the subject, tolerate coitus interruptus (azl). The position commonly and historically shared by Islamic jurists coincides with Al-Ghazali's interpretation according to which, under many circumstances, coitus interruptus is a blameworthy but tolerated (makruh) act. However, there has always been a minority of jurists opposed to contraception. Analogical reasoning (qiyas, the fourth source of Islamic law) makes it possible to legitimize most modern contraceptive techniques. Nowadays, because of the risks of overpopulation, the majority of Islamic governments have passed family planning laws; however among the masses the wrong belief that Islamic law prohibits contraception is spreading.

Contraception↗

Reproductive issues from the Islamic perspective.

The Islamic faith is regarded by its followers, Muslims, as a complete way of life. A multitude of nationalities practise Islam and also various sects, and as a result there are various interpretations of Qur'anic guidance relating to almost every matter. Only a fully qualified jurist of the highest rank can issue edicts on problems that are not already clearly addressed in the Qur'an. This applies to contemporary issues and any Muslim is at liberty to debate and dialogue with the religious leader to obtain a ruling on a specific question. Marriage is described as half the faith in Islam and to have children is seen as a great blessing. There is no religious objection to an infertile married couple pursuing any form of infertility treatment including in vitro fertilization, surgical sperm retrieval and micro-assisted conception methods. However, there must be strict control to ensure that the gametes belong to the husband and wife. This relationship is described as 'halal' (permitted), whereas any union of gametes outside a marital bond, whether by adultery or in the laboratory, is 'haraam' (forbidden). Therefore, donor sperm pregnancies are strictly forbidden in all schools of Islamic law. The advent of ovum donation and surrogacy has led some Islamic scholars to allow this procedure between co-wives thereby avoiding the 'haraam' relationship between sperm and egg, but there is still debate on the definition of the mother. Similarly, treating any other situation outside a marriage relationship, for example fertilization of an ovum from cryopreserved sperm after divorce of the couple or death of the husband would be 'haraam' and strictly forbidden. The Qur'anic guidance is quite clear that the couple can pursue all permitted treatments but may need to accept that they may not achieve a pregnancy. Adoption is encouraged in Islam with the specific rule that the child must be able to identify its biological father by keeping his name. It must be emphasized that Muslims will vary on their degree of adherence to the faith and the practitioner should present all the options to the couple without assuming which treatments they will or will not accept.

Journal Article↗