Between quality of life and hope. Attitudes and beliefs of Muslim women toward withholding and withdrawing life-sustaining treatments

Abstract

The technological advances in medicine, including prolongation of life, have constituted several dilemmas at the end of life. In the context of the Belgian debates on end-of-life care, the views of Muslim women remain understudied. The aim of this article is fourfold. First, we seek to describe the beliefs and attitudes of middle-aged and elderly Moroccan Muslim women toward withholding and withdrawing life-sustaining treatments. Second, we aim to identify whether differences are observable among middle-aged and elderly women's attitudes toward withholding and withdrawing life-sustaining treatments. Third, we aim to explore the role of religion in their attitudes. Fourth, we seek to document how our results are related to normative Islamic literature. Qualitative empirical research was conducted with a sample of middle-aged and elderly Moroccan Muslim women (n = 30) living in Antwerp (Belgium) and with experts in the field (n = 15). We found an unconditional belief in God's sovereign power over the domain of life and death (cf. determined lifespan by God) and in God's almightiness (cf. belief in a miracle). However, we also found a tolerant attitude, mainly among our middle-aged participants, toward withholding and withdrawing (treatment) based on theological, eschatological, financial and quality of life arguments. Our study reveals that religious beliefs and worldviews have a great impact on the ethical attitudes toward end-of-life issues. We found divergent positions toward withholding and withdrawing life-sustaining treatments, reflecting the lines of reasoning found in normative Islamic literature. In our interviews, theological and eschatological notions emerged as well as financial and quality of life arguments.

Keywords: End of life; Grounded theory; Islam; Moroccan Muslim women; Non-treatment decision; Qualitative empirical research; Withholding and withdrawing life-sustaining treatments.