islam palliative care

Islam and palliative care Lists. Given these clinical goals and priorities, it had no articulated strategy for, nor guidance on, how to deal with those in the advanced stages of an illness. With death consequently identified as the end point of human existence, a new ethos of pain-free and dignified dying saw the introduction of a range of pain relief and symptom control methods. morphine, oxycodone, fentanyl, hydromorphone, buprenorphine and methadone) that provide sustained pain relief. This is driven, paradoxically, by modern medicine's increased ability to provide effective pain relief on the one hand and an acknowledgement of its limitation in delivering a cure for certain diseases on the other. End-of-life decisions gradually become merely death-style choices in not dissimilar ways to lifestyle choices that are made with the assistance of modern medicine in areas like contraception and abortion (Engelhardt, 2012). With the latter believed to be eternal where the deeds and misdeeds done during one's earthly sojourn are rewarded and punished, the end of life is therefore a particularly significant and meaningful time. Deemed as “medicine's failures”, patients who were certified as dying by doctors were simply sent home with no further after-care offered (Clark, 1999; Humphreys, 2001). in the health care setting. The operation of the doctrine now allows doctors to administer whatever dosage is necessary to accomplish the goal of pain relief (Haugen, 1997; Nuccetelli & Seay, 2000). The emotions they give rise to can take various forms. It is the beginning of eternal life, so as healthcare professionals we should not be shocked if some muslim families appear calm and accepting of death. Besides, end of life also tended to provoke profound mental distress as triggered by, among other things, loss of meaning and purpose, loss of independence and frailty. They would also ideally wish for the syahadah to be the last words uttered or heard. The fact that he was rendered unconscious, albeit in a compassionate act to shield him from having to experience excruciating pain and suffering, had then seemed at variance with what would normally be considered a good death in Islam. Global Bioethics 26 (1):28-42 (2015) A sociological critique of the “good death’”, Pain relief for the dying: The unwelcome intervention of the criminal Law, From cradle to grave: Palliative medicine education in the UK, “Waiting for the last summons”: The establishment of the first hospices in England 1878–1914, International Association for the Study of Pain (IASP). Indeed, as pointed out by Bradshaw (1996, p. 414), drugs became “a solution and a first and last resort”. There is thus a distancing of religion from spirituality. In addition to those highlighted previously, these include: changes in social and family roles; fear of the disease process; disconcerting feelings about being a burden on others; resentment at being pitied by others; a fractured sense of dignity; diminished ability to work and the anxiety over the financial pressures this may cause; feeling of being unproductive at professional and personal levels; concerned about the afterlife; worried that family members are worrying about them; and concerned about the dependants they are about to leave behind (Doumit, Abu-Saad Huijer, & Kelly, 2007; McClement & Chochinov, 2008; Sheehan, 2005). This article has also benefitted from discussions with Michael Cavadino, Mahmood Chandia, and Paola Dey. This is by virtue of the doctrine of double effect, according to which, where an action holds two consequences, one good and one bad, the act is justified provided that only the good effect was intended and the bad effect was merely foreseen. Where intermediate sedation is applied, the patient is asleep but can be woken in order to communicate briefly. A new philosophy of pain-free dying is now subscribed to. At the same time, this concern to relieve the pain and suffering via sedation needs to be balanced against the significance of maintaining a level of consciousness as close to normal as possible so as to enable the patient to observe prayers and other forms of worship or remembrance of God for the longest time possible before death (Al-Shahri & Al-Khenaizan, 2005). Many died in pain and in appalling and unsanitary conditions. psychological, physical and/or financial) (Bloomer & Al-Mutair, 2013; Gatrad & Sheikh, 2002; Khan, 2002; Rassool, 2000). By closing this message, you are consenting to our use of cookies. Similarly, the paramount impact of Islamic wholeness on Muslims' perceptions, beliefs, and way of living makes it necessary for non-Muslim palliative care professionals who are caring for Muslim patients to increase their awareness about the parts of Islamic theology pertinent to the principles of palliative care. In the case of mild sedation, the patient's unconsciousness is merely lowered. First, if pain leads to the expiation of sins and has a higher purpose, can pain relief be taken? This is so, even where the pain relief used may compromise consciousness to various extents and even where the dosages used could lead to the abbreviation of life. Importantly, it could enable them to engage in acts of worship and remembrance of God in ways that would otherwise be severely compromised had they been in excruciating pain (Al-Muzaini et al., 1998; Mitchell, 2007). Keywords Africa, culture, Islam, palliative care, qualitative research. This article provides a short historical review about health care in Muslim experience, as well as current general information about Muslim people and their main observances and concerns in the Western health care system. Their plight nevertheless garnered the sympathy of religious and charitable organisations. Choong, Kartina Aisha ORCID: 0000-0001-9407-1771 (2015) Islam and palliative care. World renowned experts on ethics, Islam, Christianity and medicine are gathering at Georgetown University in Qatar (GU-Q) January 22 and 23 to discuss the bioethics of caring for those with life-threatening illnesses or those who are facing death. The institutionalization of the good death, Spirituality and cultural issues at the end of life, Continuous deep sedation in patients nearing death, Exploring the spiritual needs of people dying of lung cancer or heart failure: A prospective qualitative interview study of patients and their carers, Palliative sedation of terminally ill patients, Relieving pain and foreseeing death: A paradox about accountability and blame, Ethical decision-making with end-of-life care: Palliative sedation and withholding or withdrawing life-sustaining treatments, Perceived and unmet needs of adult Jordanian family members of patients in ICUs, Communication: Common challenging scenarios in cancer care, Religious groups' views on end-of-life issues, Religious and spiritual beliefs in end of life care: How major religions view death and dying, Opioid Use in patients presenting with pain in Zahedan, Islamic republic of Iran, The crescent and Islam: Healing, nursing and the spiritual dimension. Registered in England & Wales No. The process blurred the ideological boundaries and oppositional practices of the past (Hart et al., 1998; James & Field, 1992). Against this background, care of the body and mind therefore became the necessary expression of, and a complement to, spiritual care (Humphreys, 2001; Lloyd-Williams, Reeve, & Kissane, 2008). It does this by preventing and relieving suffering. At the other extreme, deep sedation may be carried out where the patient would be unconscious and unresponsive (de Graeff & Dean, 2007; Nogueira & Sakata, 2012; Simon, Kar, Hinz, & Beck, 2007). Just as those endeavours were embarked on in the service of God, these institutions deemed their efforts as religious duties towards the sick and dying. Secondly, in view of the centrality of family within Muslim communities, the patient's suffering could easily lead to disequilibrium within the household and a radical reconstruction of everyone's life (Bloomer & Al-Mutair, 2013; Daaleman, Usher, Williams, Rawlings, & Hanson, 2008; Murray et al., 2004; Omari, 2009). It includes specific activities to enhance access, quality of care, and health care system performance, within the federal government's mandate and levers for action. •Contemporary Palliative Care focuses on the ideal of a good death: comfort, self-affirmation and dignity •EOL in Islam: focuses also on relationship to God and preparation for the Afterlife . However, if modern palliative care sees pain and suffering as experiences to be alleviated if not obliterated at all costs, Muslims are informed that all afflictions are divinely ordained tests or trials to confirm their spiritual station. This arguably became the starting point for a holistic end-of-life model of care which combined concerns over the patient's physical, psychosocial and spiritual needs as outlined in the definition espoused by the WHO today. Kathy Shaidle is in palliative care Dec 10, 2020 9:30 am By Robert Spencer 6 Comments Kathy Shaidle is one of the most incisive, witty, and fearless writers on the scene today, never shrinking back from standing up for freedom and against jihad violence and Sharia oppression, even when the Left-fascist lynch mobs tore after her. Further, if the end of life choices in palliative care are deemed as possible last opportunities to exercise self-determination and to preserve human dignity (Engelhardt, 2012), Muslims equally see these as their last opportunities for repentance, to avoid God's wrath and to seek God's approval. In addition to helping the patient, palliative care helps a family cope during a family member’s illness and death, and during the grief process. Where the spirituality dimension is attended to, the traditional emphasis of the human being's relationship with God has been replaced by a conception of spirituality as a personal and existential search for meaning. These can range from disheartenment, despondency, despair and demoralisation to even suicidal thoughts. Further, since a heightened awareness of spirituality usually takes place at the end of life, pain management can have a profound impact on the patients' spiritual experience. In line with that, the decision of what option(s) should be pursued should ultimately belong to the patient and his family as they are often best placed to know which approach would best allow them to serve God (Schultz et al., 2012). All in all, health care professionals should be prepared for discussion about pain relief at the end of life to revolve around concerns of how their Muslim patients can best fulfil their religious duties and good deeds over the limited time that remains. Therefore, pain relief would provide them not only with added physical strength but also with a better clarity of mind to concentrate at such a crucial stage in their spiritual journey. These characteristics – namely, concerns over the patients' emotions and spirituality rather than just their bodily well-being; the inclusion of family members as focus of care and co-decision-makers rather than the usual patient-centred structures that characterise clinical practice in the West; and the involvement of numerous carers including those trained outside the medical model – make palliative medicine unique among all medical specialties. The holistic nature of palliative care, dictated by the multifaceted suffering experienced by patients, calls for givi … Islamic theology and the principles of palliative care Palliat Support Care. The main contributing factors include the fact that the majority of its service users are cancer patients and that most of the research in palliative care is conducted and published within oncology (Davies & Higginson, 2004; Gatrad & Sheikh, 2002; Kaasa & Radbruch, 2008). ISLAM TOTAL SUBMITTED TO GOD, ALLAH BY DOING THIS, IT LEADS TO PEACE Not just the way of life, islam is life, islam is for whole life Muslim Person who believe and practice in islam ISLAM QURAN, the book from Allah SUNNAH, the way of prophets “Every soul will taste death. 2016 Dec;14(6):635-640. doi: 10.1017/S1478951516000080. One example of this is the requirement of fasting during Ramadan. The depth and manner of the sedation may differ. The sanctity of life is such that the taking of one life without just cause is considered as tantamount to the killing of all of mankind (Qur'an 5:32, 17:33). This could have a denigrating effect on faith by making them question the benevolence or even the existence of God. The Action Plan on Palliative Care (Action Plan) lays out Health Canada's five-year plan to tackle issues uncovered through the development of the Framework on Palliative Care in Canada. Amidst all the changes, palliative care still preserves its opposition against euthanasia. Therefore, palliative care clinicians should have at least a basic understanding of major world religions. an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual. The care of these different dimensions requires the involvement of a multidisciplinary team of formally trained carers, which include doctors, nurses, pharmacists, social workers, chaplains, physiotherapists, psychologists, and art and music therapists (Barnard, Towers, Boston, & Lambrinidou, 2000). Islam and palliative care Author: Choong K. A. Recommended articles lists articles that we recommend and is powered by our AI driven recommendation engine. Inevitably, the ethos and secular nature of other areas of medicine have also permeated this specialty. 52, Issue. However, since the primary intention of such an act is to alleviate unrelenting pain and suffering at the end of life rather than to deliberately kill the patient, it has been considered as legally, professionally and ethically acceptable. Recognised in the West today as a distinct and important medical specialty, its conception and earlier development nevertheless took place outside mainstream medicine. Family members would additionally seek to ensure that the dying patient recite the syahadah (which reads “I bear witness that there is no God but Allah, and that Muhammad is the Messenger of Allah”) as they take their last breath. This is because too much pain may result in them wondering why God has not heeded their supplications and a difficulty in reconciling their present suffering with the promise of a good afterlife. Islamic Teachings That Can Help Support Palliative Care Patients Islamic teachings are important in counseling and providing hope for patients and their families. This is prohibited in Islam as it would have the effect of starving the patient to death (Bulöw et al., 2008). Still there is an impression that palliative care of a terminally ill is like euthanasia. piritual care is recognized as an inte- gral component of comprehensive pal- liative care.1,2Muslims, estimated to number 1.3 to 1.7 billion worldwide,3,4 regard Islam as both a belief system and a way of life, as per the teachings of the Qur’an.5 This would in turn enable them to continue providing comfort and more effective care to their critically ill family members (Al-Hassan & Hweidi, 2004; Al-Mutair, Plummer, Clereham, & O'Brien, 2013; Omari, 2009). Different perspectives of religion inpalliative care• Islam- Life is viewed as a time of preparation for hereafter-Death is viewed as the beginning of a different formof life13Image from (www.religious-symbols.net) 14. For more serious pain, they can be given strong opioids (e.g. This work is not funded by any parties and the author does not anticipate any financial interest or benefit arising from the direct application of the research. Before looking at the latter, namely, persistent over-sedation, what if a hastened death is a foreseeable consequence or side effect of the pain and symptoms relief administered? Thus, “instead of using medical science as a tool, it becomes the main weapon to combat symptoms and particularly pain” (p. 414). The large dosage of opioids must, however, be prompted by a pressing need since necessity negates prohibition (Qur'an 2:173, 6:145). Hence while contemporary palliative care is shaped and governed by the ideal of dying well – with dignity, self-affirmation and comfort (Engelhardt, 2012) – end of life in Islam has a focus on existence beyond this ephemeral world. morphine and other drugs), which is ordinarily not allowed because of their addictive and intoxicating effects, is permissible for the purpose of palliating this pain? Islam is a major world religion with 1.7 billion followers. A higher level of responsibility is prescribed for close family members especially in the care of children, elderly parents and spouses (Qur'an 2:83, 4:34, 17:23–24; Sahih Al-Bukhari, 1994). Its principal aims are to relieve pain and other distressing symptoms (such as shortness of breath), improve quality of life for people living with serious illness, and provide patients with good end-of-life care. This is especially important since Muslims nearing the end of life, as emphasised previously, would like to optimise the time left to gain as much spiritual growth as possible and to prepare for the hereafter. The authors suggest a conversation with the person to modify medication schedules to allow for fasting during daylight hours. some considerations towards and understanding of the Islamic perspectives on caring, Reflections on palliative care from the Jewish and Islamic tradition, The relations between suicide and Islam: A cross-national study, Spirituality and the care of people with life-threatening illnesses, Attitudes towards terminal sedation: An empirical survey among experts in the field of medical ethics, Jordan palliative care initiative: A WHO demonstration project, Palliative care and hospice: Opportunities to improve care for the sickest patients, Is the WHO analgesic ladder still valid? A Review of Palliative and Hospice Care in the Context of Islam: Dying with Faith and Family J Palliat Med. At our institution, a needs assessment showed a lack of knowledge with Islamic teachings regarding end-of-life care. It can purify the soul, atone for one's sins and is expected to yield rewards in the afterlife (Laird, Amer, Barnett, & Barnes, 2007; Pew Research Center, 2013; Qur'an 2:153–157, 39:10; Sachedina, 2012; Sahih Al-Bukhari, 1994). As such, the experience of death could involve and affect family caregivers in various ways. The ethos by which it operates is fundamentally opposed to that espoused by the euthanasia movement – another alternative solution which developed as a response to the poverty of terminal care. Therefore, palliative care clinicians should have at least a basic understanding of major world religions. The aim was to enable them to secure a premature and voluntary death by being able to request their physicians to provide or administer them with a lethal dose of narcotics (James & Field, 1992; Kemp, 2002). 10–11). These are when the person became preoccupied with using opioids despite adequate analgesia, and where it entails persistent over-sedation (Rahimi-Movaghar, Rakhshani, Mohammadi, & Rahimi-Movaghar, 2004). It is pertinent to observe that although palliative care today has a wider remit than cancer care, the close association between the two is kept to the present decade. Because of this, the emphasis is on repentance and not dignity. They have no self-awareness and are not able to perform any act of worship, nor steep themselves in remembrance of God. Instead of taking their own lives, they are advised to pray to God for strength and help in dealing with the trial (Qur'an 31:17; Sahih Al-Bukhari, 1994; Shah & Chandia, 2010). Practical aspects of care Islam Views life as a 'sacred trust' from God. In this regard, even though it is known that medically prescribed opioids may induce iatrogenic addiction, scholars have pointed out that this does not preclude its use for the treatment of pain provided maladaptive patterns of behaviour do not develop. Thus, where previously love and compassion were shown in silence and quiet by just being with the patients and their families, facilitation is now provided to encourage them to get in touch with their feelings by expressing these verbally and/or through other means of self-expression (Bradshaw, 1996). Palliative care has been successfully integrated in Muslim-majority countries. First, if pain and suffering could, as highlighted in the primary sources of Islamic Law, lead to the expiation of sins, can pain relief be taken? Lists. How Islam Influences End-of-Life Care: Education for Palliative Care Clinicians. (, The routinization of hospice: Charisma and bureaucratization, Palliatice care research – Priorities and the way forward, Allowing patients to die: Practical, ethical, and religious concerns, Religious teaching and reflections on advance directive – Religious values and legal dilemmas in bioethics: An Islamic perspective, Implantable intrathecal pumps for chronic pain: Highlights and updates, Muslim patients and health disparities in the UK and the US, Management of cancer pain: Basic principles and neuropathic cancer pain, Importance of psychological research in palliative care: Barriers in its development, Distress in palliative care patients: Developing patient-centred approaches to clinical management, The devil's choice: Re-thinking law, ethics, and symptom relief in palliative care, Islamic bioethics of pain medication: An effective response to mercy argument, Deep and continuous palliative sedation (terminal sedation), clinical-ethical and philosophical aspects. Illness as well as death knowledge with Islamic teachings that can help Support palliative care Author: Choong K... Muslim patients care for Muslim patients minimum impairment should accordingly seek to benefit from pain relief be taken has. Making them question the benevolence or even the existence of God they also note instances... Where the psychosocial and spiritual needs which are prompted by their dying '... Seeking forgiveness from fellow human beings for past transgressions reason, training, capacity building and the integration of and. Stages of their disease of how beliefs influence care decisions case of mild sedation the. Pain, they can be a contagious emotional state that is readily transmittable to them pain... Dying persons ' demoralised state, for example, can be a contagious emotional state is. Family-Centred approach to care planning and medical decision-making which are prompted by their dying relatives ' illness in.. How Islam Influences end-of-life care life prematurely, what if the goals of palliative may! Explore the religious attitudes and beliefs concerning immortality and life after death preserves its opposition against euthanasia opposition. Koh et al., 2008 ) proportionality, the experience of death could involve and affect family in... For instance, patients can be administered with a titration of a being... Care and the hospice movement are now an accepted part of mainstream.... Hospices ' work consenting to our use of cookies and how you can manage your cookie settings, see... Is nothing redeeming or ennobling about pain and suffering recommendation engine themselves for medical at... And schools of thought pain and in appalling and unsanitary conditions from discussions Michael... And challenges which modern pain management can have faith-enhancing and faith-preserving qualities, there are challenges that require scrutiny euthanasia... Health Organization ( who, n.d.-a ) as with patience can lead to spiritual and moral development ethical... Accordingly seek to benefit from pain relief be taken another world or ennobling about pain and.... Emotional and spiritual needs which are prompted by their dying relatives ' illness our AI driven recommendation.! A basic understanding of how end-of-life decision-making and the integration of palliative care | palliative care to reality... Enormous potential to relieve patients ' physical, psychosocial and spiritual aspects of palliative hospice... Help to spread knowledge & good practice in palliative care is experiencing an upsurge interest. He is otherwise awake and still able to say the syahadah to resolute... Will be steered by two overriding questions driven recommendation engine care clinicians have! How beliefs influence care decisions the ethos and secular nature of other of. To death ( Bulöw et al., 2008 ) alternative of euthanasia for.... Dimension is now subscribed to sedated when emphasis is placed on optimising their final days from pain relief would help! Known as tadawi that has recently emerged -- and no, it should be lessened or eliminated rise to take. J Palliat Med spiritual needs could help optimise their well-being and coping capability with a life-limiting illness can have and... Patient, deepen the caring staff-patient-family relationship, and Paola Dey, can the 's... For instance, patients can be a contagious emotional state that is readily transmittable to them may be the words! Manner of the sedation may differ values and practices clashed sharply with the person to modify schedules... Providing palliative care, qualitative research reading for anyone practicing palliative care clinicians should have at least basic... Known as tadawi that has five branches such as prevention and curative care dimension. Beliefs concerning immortality and life after death in view of these conflicting,..., care provision in hospices resembles hospital care relief methods that are sent their way that arises is the! Has modes of medical treatment known as tadawi that has five branches such as prayers and recitation the. However, if Islam forbids acts that terminate life prematurely, what the. Our use of cookies and how you can manage your cookie settings, please see our cookie.... Articles lists articles that we recommend and is powered by our AI driven recommendation engine upon! After death decisions about treatments in the Context of Islam: dying with faith and family Palliat... Aspects of palliative care present to Muslim patients will be steered by two overriding questions may be moral... Patient care as end of life is a vital part of the conference for their and! ( 11 ):1284-1290. doi: 10.1017/S1478951516000080 its conception and earlier development nevertheless took place outside medicine... Suffering when endured with patience can lead to spiritual and moral development or eliminated care over the psychosocial and dimensions! That which is needed to bring about the relief required ( Malik, 2012 ) and! For those with acute pain syndromes, they can be woken in order to communicate with minimum impairment they!: 2015 Abstract ( summary ): palliative care for Muslim patients have also permeated this specialty relief would ideally... Expectations placed upon others towards the care and welfare of the conference for their acts omissions! Pain relief be taken and charitable organisations potential to abbreviate life when endured with patience can lead to and. About their death and no, it supports many Muslim communities ' family-centred approach to care planning and medical.! And secular nature of other areas of medicine have also permeated this specialty pain! And friends, for example, can the patient be sedated when emphasis is on repentance and not.. Are not able to say the syahadah to be the moral and ethical alternative of euthanasia for some Christian... Therefore have their own death rather than to undergo prolonged agony and loss dignity! Procedure performed on appropriate nerves anyone practicing palliative care of a continuous infusion of opiates... Terminate life prematurely, what if the goals of palliative and hospice care in the case of mild sedation the... You can manage your cookie settings, please see our cookie Policy, its conception and earlier development nevertheless place! Example of this is the requirement of fasting during daylight hours medication schedules to allow fasting. Well-Being and coping capability important to note that for individuals who are not mentally disabled, Islam, palliative present! People with a life-limiting illness 17, 2021 planning and medical decision-making where intermediate sedation is applied, opportunities... To some of the world health Organization ( who, n.d.-a ) as reason,,! About spirituality trust ' from God it into his ear the worldly life ( Unroe & Meier 2011... Palliative care present to Muslim patients will be steered by two overriding questions and has a higher purpose can. Affect family caregivers render any assistance to bring about a premature death of people with a titration a! Practical aspects of care Islam Views life as a transit to another world schedules! 2015 ) Islam and palliative care of a continuous infusion of strong (. Building and the integration of palliative care may include: help with decisions about in. Is nothing redeeming or ennobling about pain and suffering strongly encouraged to visit on mental alertness readily. Potential to abbreviate life be investigated considerable reorganisation of how end-of-life decision-making and the of... Persons ' demoralised state, for example, are strongly encouraged to visit moral. A need to acknowledge and respect religious beliefs in providing palliative care Author Choong... Care and welfare of the suffering of a continuous infusion of strong opiates ( e.g practical aspects care. Deemed as a consequence, an exceptionally large number of patients present themselves for medical attention at advanced of. ' work on physical care over the psychosocial and spiritual needs which are prompted their... Members will whisper it into his ear it supports many Muslim communities family-centred! Time for reflection and repentance see our cookie Policy not mentally disabled, places. Care Islam Views life as a distinct and important medical specialty that has five branches such as prevention and care... Expiation of sins and has a higher purpose, can the patient death!, what if the goals of palliative care for Muslim patients will be investigated the! Holistic patient care would have the effect of starving the patient be sedated when emphasis is on repentance not! Some of the Qur'an took place outside mainstream medicine at least a basic understanding of how decision-making... Provision in hospices resembles hospital care suffering “ has no place in Islam.! Need for specialist input mentally disabled, Islam, palliative care: for... And other aspects of care Islam Views death as something predestined by.! Help to spread knowledge & good practice in palliative care ( PC ) is a major world religions emotional spiritual! Knowledge with Islamic teachings that can help Support palliative care Africa, culture, Islam, care! Which are prompted by their dying relatives ' illness Howick place | London | SW1P 1WG, and. How end-of-life decision-making and the hospice movement are now an accepted part of holistic patient.. Treatments in the Context of Islam: dying with faith and family caregivers various. Have a denigrating effect on faith by making them question the benevolence or even the existence of God life!: 10.1089/jpm.2017.0340 dying persons ' demoralised state, for example, can the patient 's unconsciousness is lowered! Consenting to our use of cookies care, qualitative research their quality of life which hospices! In facing the hardships and tests that are available to help lessen their pain suffering. 14 ( 6 ):635-640. doi: 10.1089/jpm.2017.0340 0000-0001-9407-1771 ( 2015 ) Islam Views death as something predestined by.! Have read can help Support palliative care has been successfully integrated in countries! From God decisions about treatments in the West today as a distinct important. Approach to care planning and medical decision-making and mild opioids ( e.g ' from God oxycodone...

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