“Every soul will taste death. And we test you O Humanity with good and evil as a trial, then to Us you will all be returned.” (Quran 21:35)
How often do we think about death? What does a ‘good’ death look like for us and our loved ones? These may not be simple questions to answer and each individual will have their own perspective on the concept of death and dying.
Society, cultural heritage, religious beliefs, family values and our own unique experiences among other factors will influence what we think and what we would like to happen when our life reaches its end.
Modern technology and medical advancements have improved our longevity and standard of living.
The global average life-expectancy is currently just over 70 years old – 200 years ago it was about half of that.
Our increased life-expectancy, however, is not without its drawbacks.
Longer lives often means an accumulation of chronic diseases over time – diabetes, hypertension, arthritis, kidney disease, cardiovascular disease, chronic pain and various cancers affect millions worldwide.
The Prophetic advice on health espouses a preventative medicine approach and lifestyle and indeed to seek treatment if one is afflicted with an illness.
“…make use of medical treatment, for Allah has not made a disease without appointing a remedy for it, with the exception of one disease, namely old age.” (Sunan Abu Dawud Vol #4, Hadith #3855)
Doctors have a duty to treat disease and alleviate suffering.
But sometimes the goals of care for a patient’s treatment may need to be reconsidered, such as when it involves progression of a debilitating disease where further treatment is futile, with all medical options exhausted.
Some may see that being afflicted with an illness is a divine test and an opportunity to gain spiritual closeness to Allah and enlightenment by exhibiting patience and enduring hardship.
When a decision is made to transition someone to palliative care, this sees the goal change from one of curing to one of caring – prioritising comfort and dignity through the dying process.
So then, what Islamic principles underlie the care we provide in end-of-life situations?
Suicide and euthanasia (assisted dying) are prohibited in Islam as life is considered sacred and death is but a transition point to the hereafter.
Palliative care, however, is permissible and encouraged as a means to preserve the dignity of the dying person.
It focuses on alleviating symptoms of discomfort at the terminal stages of an illness and does not hasten or influence its course.
It is important that discussions around end-of-life care involve the treating medical professionals and family whenever possible to allow appropriate decision-making that aligns with the dying person’s Islamic beliefs and values.
To illustrate this concept, take for example a case scenario involving Ahmad, a 70-year-old man who was diagnosed with metastatic cancer and has exhausted all treatment options including multiple surgeries and courses of chemotherapy.
After a family meeting with his treating doctors and family members, Ahmad’s prognosis was estimated to be a few weeks before succumbing to his illness and he was still suffering from severe pain.
The decision was made to pursue palliative care and focus on treating Ahmad’s symptoms.
He opted to spend the time he had left at home with his family.
An imam was also organised for Ahmad while he was in hospital through the hospital chaplaincy to provide spiritual support.
Once he was discharged home, a community palliative care nurse and his GP coordinated follow-up at his home to monitor his symptoms and adjust treatment if needed.
His family were also able to organise a hospital bed and some equipment through the hospital to be delivered home to make Ahmad as comfortable as possible.
Taking care of our loved ones when they are palliated can be a difficult time for everyone involved and being mindful of their needs while having access to resources for carers and family will aid significantly in providing the best care.
For more information about palliative care in Australia, you can visit the Palliative Care Australia organisation website at https://palliativecare.org.au/
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