Mapping potential cultural and religious tensions in end-of-life care for Muslim patients: A scoping review

Introduction: Muslims constitute the largest religious minority in Euro-American countries. Interactions between Muslim patients and healthcare providers in end-of-life care may give rise to religio-cultural ethical dilemmas, resulting in tensions. Understanding these tensions may support care providers in navigating the critical transition from life to death within non-Muslim majority contexts. Aim: To thematically map ethical tensions arising from religio-cultural dilemmas in end-of-life care for Muslim patients, and to equip healthcare professionals in Euro-American contexts with the insights needed to address them. Design: A scoping review was conducted in accordance with the Johanna Briggs Institute (JBI) methodology. Data sources: A comprehensive literature search was performed in Scopus, Medline, CINAHL, and APA PsycInfo, from inception to 7 November 2024, in collaboration with a medical information specialist. Empirical studies addressing religio-cultural ethical dilemmas and tensions in end-of-life care for Muslims were included. Analysis: Ethical tensions were examined using a structured framework integrating theological perspectives with empirical findings. Results: Of 9237 records screened, 12 studies met the inclusion criteria. Three overarching themes emerged: (1) end-of-life communication, (2) spiritualizing pain, and (3) treatment withholding/withdrawal. Tensions were most pronounced when divergent moral frameworks prioritized conflicting principles. Conclusions: Ethical tensions in end-of-life care for Muslim patients in Euro-American healthcare settings reflect diverse, context-dependent interpretations of Islamic principles. Addressing these tensions requires early, culturally sensitive engagement and the development of a shared ethical framework in close collaboration with healthcare providers, Muslim chaplains, mosques, imams, and umbrella organizations.