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Cultural Approaches to Pediatric Palliative Care in Central Massachusetts: Islam (Muslim)

This subject guide is a collaborative project with the Children's Medical Center Pediatric Palliative Care Team, the Lamar Soutter Library, and Interpreter Services.

Islam (Muslim)

Islam (Muslim)

The Five Basic

Principles of Al-Islam/ Beliefs

  • Shahadatain (Declaration of Faith) - To declare there is only one God, Allah, and that Muhammad is his messenger.
  • Salat (Prayer/Worship) - Muslims must pray five times a day.  The Qur’an is the final revelation to Humanity.
  • Zakat (Charitable Contributions) - Requires that once a year a Muslim is to give at the rate of 2.5% to a charitable cause.
  • Sawm (Fasting) - Participate in the month long fast of Ramadan, in which they restrain from food, drink, and sex during daylight hours.
  • Hajj (Pilgrimage to Mecca) - if in good health and with enough money, one must make the pilgrimage to Mecca once in their lifetime.


  • One God, or Allah, is most important principle
  • Complete submission to God
  • Prophet Muhammad and Holy Qur’an
  • A judgment day and life after death
  • Commitment to fast during the holy month of Ramadan: abstaining from food, drink, sexual intercourse and evil intentions and actions
  • Commitment to attempt a pilgrimage to Mecca (in Saudi Arabia) at least once in life
  • Duty to give generously to poor people
  • Belief in Oneness of God
  • Belief in His Angels
  • Belief in His Books (All the revealed Scriptures)
  • Belief in His Messengers (All of them)
  • Belief in Hereafter (Life after Death)
  • Belief in the day of Judgment
  • Belief in Reward and Punishment


Daily practices

  • May engage in prayer 5 times a day facing Mecca (dawn, mid-day, mid-afternoon, sunset, night); face, hands and feet are washed before prayer. Do not interrupt or walk in front of patient when he/she is saying prayers unless it is an emergency
  • Days of observance occur throughout the Muslim lunar calendar


Dying and death

  • Death is controlled by God’s plan
  • Euthanasia or any attempt to shorten life prohibited
  • Organ or body donation acceptable
  • Autopsy permitted only for medical or legal reasons
  • Confession of sins and begging forgiveness often occurs in presence of family upon death
  • Important to follow five steps of burial procedures which specifies washing, dressing, and positioning of the body. First step is traditional washing of the body by Muslim of same gender
  • As moment of death approaches, Islamic Creed should be recited
  • Grief expressed by shedding tears, but forbidden to wail, beat breast, slap face, tear hair or garments, or complain or curse
  • The Janazah Prayer (Prayer for the deceased) must be said in Arabic and led by a male- an Imam is preferred.  This process should take place within 72 hours after death.  Therefore, a death certificate should be signed quickly to facilitate the process.

Facilitating practices

  • Explore what practices are most important to patient/family
  • Be aware that some customs prohibit  handshakes or any contact between genders
  • Female patients may want a female physician
  • Be aware of language barriers.



  • Tayyib= what is good, pure, clean, wholesome, nourishing, pleasant and tasteful.
  • Halal= what is lawful and allowed for Muslims to eat
  • Halal Diet – Pork, and some shellfish prohibited; alcohol is possibly prohibited
  • Only vegetable oil is to be used
  • Any food invoked by a name besides God’s may be prohibited
  • Children, pregnant women and those who are ill are exempt from fasting laws, however may resist and need support from faith group/leader
  • May only eat with right hand, which is considered to be the clean hand


  • No restrictions on blood or blood products, medications, amputations, organ transplants, or biopsies
  • Most surgical procedures permitted
  • Doctors are seen as helpers of God’s will
  • Abortion is prohibited except in cases of rape, incest and if the life of the mother is threatened. A fetus is considered a human being after 25-week gestation.

Holy days and festivals

  • Fasting during the month of Ramadan is included in the 5 pillars of Islam and is considered to be a spiritual obligation. Fasting happens from sunrise to sunset.  The ill and children are exempt from fasting, but they may join anyway if safe to do so.
  • Jum’ah Prayer (Congregational Prayer) held ever Friday, the Holiest Day for Muslims and takes place at noon prayer.  One may not work during this time.
  • Islamic days are based on the lunar calendar. Muslims do not work on two Holy Days during the year; 1) Eid-ul-Fitr (Celebration of the Fast Breaking)-this is held on the first day of the ninth month of the lunar calendar. 2) Eid-ul-Aha (Celebration of the Sacrifice of Abraham) - a three day celebration beginning of the 10th day of the twelfth month called Dhul Hijjah.
  • These Holy Days consist of prayer and a short sermon in congregation followed by food, entertainment, feeding, of the poor and visiting the sick and shut-in.




  • Sunni roughly means ‘words and actions’ or example of the Prophet Muhammad
  • Believe that when the prophet Muhammad died, it was his wish that the next leader would be elected.  Abu, Bakr, Muhammad’s closest friend, was elected.
  • Believe the caliphs (leaders) of Islam should continue to be elected (and they are).
  • 85% of Muslims are Sunni


  • Shia roughly means , Party of Ali’
  • Believe that when the prophet Muhammad died, it was his wish that Ali, his cousin and son-in-law would be the new caliph
  • Shia Muslims choose to ignore the elected Sunni leaders, and instead follow their own leaders, direct descendents of Muhammad called Imams
  • 15% of Muslims are Shia
  • Iran and Iraq are the only countries that have a majority of Shia Muslims. Shia Muslims are the minority in the rest of Islamic world.
  • Can also be found in Pakistan, Azerbaijan, Afghanistan, India and Syria
  • Some Shia Muslims pray only 3 times a day; all Sunni Muslims pray 5 times a day



Reproduced by permission from George Handzo, BCC at 

Dictionary of Patients' Spiritual & Cultural Values for Health Care Professionals was developed by the Pastoral Care Leadership and Practice Group of HealthCare Chaplaincy, New York, NY. (Revision and update of earlier work by the Rev. Susan Wintz, BCC and the Rev. Earl Cooper, BCC)