250905P - SPIRITUAL CARE FROM AN ISLAMIC PERSPECTIVE: THE ROLE OF MUSLIM HEALTHCARE PROVIDERS

Presented at an Islamic Champlaincy Training Program, Kuala Lumpur, Malaysia, on September 5. 2025 by Dr Omar Hasan Kasule Sr, MB ChB (MUK), MPH (Harvard), DrPH (Harvard), Chairman of the Medical Ethics Committee at King Abdullah bin Abdulaziz University Hospital, Riyadh.

 

INTRODUCTION:

• Link the religious and spiritual principles to medical practice
• Religious and cultural practices of spiritual healing.
• Clinical opportunities for applying spirituality.
• Application of the concept of spiritual support in clinical practice.

QADAR IN DISEASE:

• Human illness is part of qadar. Medical treatment is not a denial of or attempting to reverse qadar. Both the disease and its treatment are part of Allah’s all-embracing qadar.
• The human, in his limited knowledge, cannot distinguish between curable and incurable diseases. Human experience has shown that diseases considered incurable a few years ago are now curable.
• It is therefore logical that humans, in ignorance of the true situation, should play safe by treating all diseases to the best of their ability, being fully aware that this is an attempt, and leave the rest to Allah.
• Immunization and other preventive measures are treatment before disease and are not a denial of qadar.

QADAR IN DEATH, al qadar fi al mawt:

• Allah alone determines the life and death of cells, tissues, organs, and the whole human organism. No human can give life or take it away.
• The human can be involved as an agent but not as a cause.
• This is a matter that King Nimrod could not grasp in his arguments with Ibrahim (PBUH). Ibrahim told the King that Allah gave and took away life. The King countered by killing one person and sparing the life of another one[i]. The king either did not understand or chose to ignore the issue at stake, creating life de novo.

LIFE, hayaat:

• Life, from the tauhidi-based holistic integrative Islamic paradigm, shumuliyat al Islam, is a complex phenomenon with biological, chemical, social, psychological, and spiritual components.
• The relations among the components of life are governed by the physical laws, sunan al kawn, of balance, mizan, equilibrium, i’itidaal, and reciprocal action-reaction, tadafu’u.
• Humans share biological life with plants and animals and share spiritual life with angels.
• Humans are the only creation to have both biological and spiritual life at the same time.
• Human life devoid of spirituality is like animal or plant life.

HEALTH, sihhat, raahat, ‘aafihat:

• Health is a positive and holistic state of well-being and not mere absence of disease or illness.
• Health includes spiritual, physical, psychological, emotional, and psychological dimensions in holistic balance and equilibrium.
• The spiritual component is the most important and its impairment adversely affects all the other components.
• Holistic measures of quality of life and health must incorporate all the dimensions above.

SOUL, ruh:

• The ruh, the permanent and eternal essence of each human life, was created before Adam.
• Ensoulment, nafakh al ruh, occurs in intra-uterine life. It is a spiritual event that also sustains biological life; Desoulment, naza’u al ruh, is followed rapidly by biological death.
• The limited knowledge of humans about the ruh is only from revelation, wahy.
• The Qur’an used several terms that seem to be referring to various manifestations of the same essence of human life: ruh, nafs, aql, naasiyat, lubb, dhihn, fuad, etc.
• These terms can be mapped by experts in tafsir al Qur’an to spiritual, psychological, cognitive, emotional, and social modalities that professionals use in providing holistic spiritual support to patients.

SPIRITUAL SUPPORT, al da’am al ruhi:

• Patients should be supported to reach calmness devoid of fear or anxiety by accepting death as a transitional event
• The transition is from inferior and temporary life on earth, hayat al duniyat, through the interregnum, hayat al barzakh, to the superior and eternal life in the hereafter, hayat al akhirat.
• Death is not a terminal event, and neither does it break the reassuring direct communication between the human and the Creator.
• Of all links and relations that a human can have, it is only the link with Allah that persists after the disappearance of parents, siblings, children, spouses, friends, and enemies.

PSYCHOLOGICAL SUPPORT, al da’am al nafsaani:

• The patient should be supported to ascend from the lowest to the highest levels of the nafs
• From the evil-inclined soul, nafs al ammarat, to the self-conscious soul, nafs lawaamat
• From the self-conscious soul, nafs lawaamat, to the high levels of the calm soul, nafs mutmainnat.
• Nafs mutmainnat is described as raadhiyat, mardhiyat, qanuu’at
• At this level, the patient bravely faces the suffering and pain of illness.

COGNITIVE SUPPORT FOR THE PATIENT, al da’am al ma’arifi/al fikri:

• The patient should be supported to appreciate illness as just one minor phenomenon in the wide and expanding spatio-temporal dimension of the universe ‘aalamiin
• The patient should be guided to appreciate that illness can have beneficial aspects, such as forgiveness of sins and bringing out the best in the human who can overcome pain and suffering and stay calm and composed.

EMOTIONAL SUPPORT, al da’am al ‘aatifi:

• The patient’s self-worth, self-esteem, and self-confidence to face the challenges of illness should be enhanced
• The patient should be aware of the superiority of human creation that overcomes innate weakness, such as evil-doing fisk, and spilling blood, safk al dima, to become a vicegerent, khalifat, who, with limited control of the universe, taskhiir, is able to build a material civilization, imarat al ardh.  

SOCIAL SUPPORT, al da’am al ijtima’e:

• The patient should be given support to live the remaining life with the highest quality of social relations with the family and the wider community.
• Members of the family should be welcome as partners in patient care and should be treated as honored guests of the hospital with all the rights of the visitor, huquuq al dhaif.
• The patient should be enabled to stay in contact with the outside community and not be confined to the 4 walls of the hospital room: news, visits, participation in radio talks, etc.

PHYSICAL SUPPORT, al da’am al maadi:

• The spiritual support professional cannot ignore the physical needs of the patient.
• The primary necessities, dharuraat, are those needed to preserve life, like basic staple food and water.
• The needs, haajiyaat, bring emotional satisfaction like favorite dishes served attractively.
• Embellishments, tahsiinaat, and complementaries, mukamillaat, are what are beyond the necessities and needs.

SPIRITUAL HEALING:

• Dua, ruqyah, tawakkul, and raja are spiritual treatments.
• It is permitted to slaughter on behalf of the sick, taqarruban ila al llaah, and to give to the poor.
• HCWs must make dua for the patients because qadar can only be changed by dua.
• HCWs can make ruqya for the patients by reciting the two mu’awadhatain or any other verses of the Qur’an.
• Payment for ruqya is allowed.

THE CONCEPT OF ISLAMIC CHAMPLAINCY:

• The issue of Islamic chaplaincy raises several conceptual issues that need discussion from the perspective of shari'ah-compliant hospitals. 
• Chaplaincy is a service that serves people in spiritually vulnerable situations with fear of death, illness, or stress, such as the army, prisons, hospitals, and those living in educational institutions. 
• The American and European practice was to assign chaplaincy to priests or other persons with a religious vocation. This practice would be repugnant to Islam, which does not accept a priesthood.
• Chaplaincy will play a significant role in a shari'ah-compliant hospital because it is part of comprehensive, holistic care for the patient that addresses spiritual and psychosocial needs. 

WHO IS A MUSLIM CHAPLAIN:

• Islam allows any Muslim with the requisite knowledge and skills to perform religious duties, including giving spiritual support to the sick. 
• From this perspective, all hospital staff can perform chaplaincy duties according to knowledge, ability, and availability. 
• However, some chaplaincy duties may require more time, deeper knowledge, and higher skills necessitating training and appointing staff as full or part-time chaplains in a shari'ah-compliant hospital.

ROLES OF A CHAPLAIN:

• The chaplain fulfills a necessary supportive role in the hospital by taking care of patients’ religious and spiritual needs primarily, but also social and psychological needs. 
• The chaplain is a religious guide/counselor (murshud diini), a psychological counselor, a problem solver of ethical and fiqhi dilemmas, and an advocate for patient rights and welfare in front of healthcare givers and hospital administrators. 
• Spiritual support involves encouraging and enabling patients to perform acts of ibadat, dua for the patient, talking to patients about Allah and the hereafter, giving patients hope in the mercy of Allah, and preparing terminal patients for eventual death, and being around and supportive at the last moments.  The chaplain is also needed to support patients spiritually when they receive bad news.
• Chaplaincy must be recognized as an essential service in the hospital. 

TRAINING FOR CHAMPLAINCY:

• Special training programs should be set up at the national level to select, train, and certify chaplains.  
• Entry into chaplaincy can be from any social or medical background. 
• Psychological, aptitude, and personality tests are essential to make sure the prospective candidate has the mental and emotional background to handle a stressful job with deep human interactions. 
• The training should be offered at two levels: a short overview for all health caregivers and a longer training for certified chaplains. 

CHAMPLAINCY CURRICULUM – ISLAMIC SCIENCES:

• The chaplaincy curriculum should include introductions to social sciences, Islamic sciences, medical sciences, and hospital administration. 
• The essential social sciences for chaplaincy are psychology, sociology, and anthropology from the medical perspective. 
• The necessary Islamic sciences are the basics of the ‘aqidah with emphasis on pre-determination (qadar), prophetic teachings on disease and its treatment, the role of supplication (dua and ruqya) in medical treatment, 
• Qur’anic verses and hadith dealing with disease and its treatment, 
• Basics of taharat and salat for the disabled patient, 
• Handling of the terminal patient, bereavement, and preparation for burial. 

CHAMPLAINCY CURRICULUM – MEDICAL SCIENCES:

• In medical sciences, the aspiring chaplain should be taught basic medical terminology, basic disease classification, major diagnostic and treatment modalities, and the procedures of emergency and intensive care units. 
• The aspiring chaplain must understand the structure of hospital administration, the ward routines, and the specific functions of different health caregivers. 

CONCLUSION:

• Islam has concepts of life and health that can guide spiritual support for the patient.
• The multi-dimensional manifestations of the ruh require that spiritual support consider spiritual, psychological, emotional, social, and physical modalities of patient welfare.
• Little research has been carried out on spiritual support from the Islamic perspective.
• Because of its multi-dimensional aspects, spiritual support should be recognized as a separate profession that goes beyond religious guidance, irshaad diini.