Being a Muslim in a secularised Western world means … what, exactly? Professor of Islamic Ethics Chaïma Ahaddour focuses on Islamic perspectives on ethical issues at the beginning and end of life. In her work, she explores an unexplored field of research: “There is virtually no data on the attitudes of Western European Muslims towards contemporary social issues.”
How do middle-aged and elderly Moroccan Muslim women view dying and death? The views of the first generation of Muslims as well as that of the second are determined by their religious beliefs, says Professor Ahaddour. This also applies to those in their forties and fifties who grow up in an individualistic, Western context. “Many secularisation theories predict that Muslims will become more secular over the generations in a migration context. That prognosis is correct in a number of areas, but when it comes to life and death, faith continues to play a prominent role,” said Professor Ahaddour.
Eternal rest in peace
Putting religion first in a secularised environment is not always self-evident. “For example, the migration context has an impact on the performance of Islamic funeral rituals. When a Muslim dies, then according to Islamic precepts the body must be washed, wrapped in a shroud and buried within twenty-four hours, after which the dead will be given eternal rest in the grave. In Belgium, the performance of all of these regulations cannot be guaranteed: temporal concessions limit grafrust – the period during which a body may not be exhumed – and during repatriation a body is often laid out in a mortuary for a few days.
Although Islamic tradition dictates that a deceased person should be buried as soon as possible, the vast majority of Muslims wish to be repatriated to their country of origin after death, says Professor Ahaddour. “For the first generation, this is obvious: they were born and raised in Morocco and would like to be buried next to their families. The second generation is less linked to the country of origin. Most want to be buried in Belgium, close to their children. But because not all Islamic regulations are observed in Belgium, they feel compelled to choose repatriation. Just like the first generation, they want a guarantee that their body can rest in peace for all time.”
Second-generation Muslims fully assume the role of caregiver, but do not have that expectation of their own children.
Pluralistic nursing homes
In the field of elderly care, the reference point is also the Quran, says Professor Ahaddour. It states that Muslims should treat their parents with respect. First-generation parents therefore expect their children to take care of them if they become dependent. “But the second generation finds it difficult to meet that traditional care expectation: unlike their mothers, middle-aged Muslim women are not full-time housewives. The second generation – the so-called sandwich generation – combine raising their children and care of their parents with work.”
That is why they interpret the relevant Koran verse differently, says Professor Ahaddour. “They fully assume the role of caregiver themselves, but they don’t have that expectation with regard to their own children. For the second generation, the care obligation can partly be handed over to professional care because they believe that it can also be high-quality care.”
However, this openness to professional and residential care facilities is lacking in the first generation. Muslim elderly indicate that they would rather die than end up in a nursing home. “They fear that they will feel lonely and trapped there,” said Professor Ahaddour. “That negative view stems from experiences with nursing homes in the country of origin, where the elderly are often neglected.”
“That distrust is less prevalent among the second generation. Middle-aged Muslim women are open to pluralistic nursing homes, which take into account religious and cultural needs, and offer the opportunity to pray five times a day, fast, eat halal meat, follow an imam’s Friday sermon and be washed by a same-sex healthcare provider.”
Today, however, too little account is taken of these religious wishes, says Professor Ahaddour. “Nursing homes are mainly aimed at the average white Fleming. There is an urgent need for healthcare facilities that are attuned to the religious and cultural sensitivities of the Muslim community as the first generation of Muslims ages and requires care.”
Muslim elderly people have a negative view of nursing homes. That distrust is less prevalent among the second generation
Suffering is not meaningless
In addition to funeral rituals and care for the elderly, Professor Ahaddour’s research explores Muslims' views on bioethical issues at the end of life. For example, how do Muslims view euthanasia? “Terminating a life is an absolute no-go for Muslims. That view again stems from their image of God: God is considered the author of life and death. God gives life and therefore has the exclusive right to take someone’s life. Euthanasia is therefore seen by Muslims as blasphemy, and something that denies you access to paradise.”
But how do Muslims deal with unbearable suffering? “Sickness and suffering are seen as tribulations in worldly life. Patiently enduring those trials and trusting in God will pave the way to paradise. Suffering is therefore not meaningless for Muslims. But that doesn't mean they passively endure pain. When ill, Muslims also see a doctor and seek out medical treatment.”
Palliative sedation is often presented as an alternative to euthanasia in unbearable suffering. Drugs are administered that lower consciousness and thus relieve pain. In the Islamic world, however, palliative sedation is a topic for discussion: is it a form of slow euthanasia, or does God still determine the moment of death? “There’s a lot of reluctance towards palliative sedation, especially among the elderly. Yet both first- and second-generation Muslims who have ever been confronted with unbearable suffering in their immediate environment often view pain relief as a way to attain a quality end of life.”
Stricter than tradition
Ethical dilemmas are also associated with the beginning of life. Against the advice of medical experts, most Muslim couples do not opt for a prenatal test, which detects genetic abnormalities in an unborn child. "They don't trust such a test because they compare the limited knowledge of the doctor with the unlimited knowledge of God," said Professor Ahaddour. “If they do have a test, it is mainly to be prepared, and not so much to proceed with further testing or a termination of pregnancy in the event of an abnormality.” According to most Muslims, the latter is only possible if the mother’s life is in danger.
However, this makes them stricter than what the Islamic tradition indicates, says Professor Ahaddour. “According to religious scholars and Islamic sources, if three doctors separately determine that an unborn child has a serious birth defect or is not viable, a termination of pregnancy may be initiated, which must take place within a certain period of time. ”
Muslims grappling with ethical questions often turn to an imam. But even imams in Western Europe are often not sufficiently aware of Islamic perspectives on sensitive medical issues, says Professor Ahaddour. “As a result, many Muslim couples are unable to make an informed decision about prenatal diagnosis and termination of pregnancy.”
Professor Ahaddour therefore wants to develop a nuanced ethical framework himself, based on religious sources, such as the Koran, as well as empirical research. “By parsing Islamic sources and mapping different perspectives within the Muslim community, I want to raise awareness amongst both imams and medical professionals and help Muslim couples in their decision-making process.”