Death From COVID-19, Muslim Death Rituals and Disenfranchised Grief – A Patient-Centered Care Perspective

Abstract

In Islam, religious directives regarding death are derived from the Quran and Islamic tradition, but there is a variety of death rituals and practices, lived by Muslims across contexts and geographies. This narrative study explored the dynamics of death and bereavement resulting from COVID-19 death among religious Muslims in Israel. Narrative interviews were conducted with 32 religious Muslims ages 73–85. Findings suggest several absent death rituals in COVID-19 deaths (i.e., the physical and spiritual purification of the body, the shrouding of the body, the funeral, and the will). Theoretically, this study linked death from COVID-19 with patient-centered care, highlighting disenfranchised grief due to the clash of health authority guidelines with religious death practices. Methodologically, this narrative study voices the perspectives of elder religious Muslims in Israel. Practically, this study suggests ways to implement the cultural perspective in COVID-19 deaths and enable a healthy bereavement process.

Bereavement in the Time of COVID-19: Learning from Experiences of those Bereaved as a Result of Deaths in an Acute Hospital Setting in 2020

“…The inability to visit the dying and restricted funeral and after death rituals has been associated with feelings of anger, guilt and lack of acceptance of death ( Torrens-Burton et al, 2022 ). The importance of observing faith practices associated with death has been highlighted, with Muslim interviewees describing disenfranchised grief when death rituals and practices were disrupted by health protection measures ( Gabay & Tarabeih, 2022 ). The important role in communication that clinicians take on when visiting is restricted has been highlighted in a study which found that clinicians communicated more frequently with both patients and relatives the closer the patient was to death and often used video technology for these interactions ( Everitt et al, 2022 ).…”

Is it the “public” health system? The VOICE model for inclusiveness in universal (national) health systems - lessons from COVID-19

“…Members of religious minorities faced heightened discrimination by the majority group ( 23 ). The involvement of the police to enforce the health guidelines created fear and a sense of humiliation ( 41 ). Reports in the mass media depicted members of religious minorities as lacking respect for the physical distancing measures and jeopardizing public health ( 44 ).…”

“…Moreover, the disempowerment of the religious minority spiritual leaders responsible for the sustainability of their communities during the five waves of the pandemic caused a breach of trust between these communities and the health authorities and inhibited the support of religious leaders for public health measures ( 41 ). COVID-19 guidelines inhibited the practice of death rituals and created multi-level clashes between values and beliefs and guidelines, inhibiting effective processing of grief and effective functioning following loss.…”

“…COVID-19 guidelines inhibited the practice of death rituals and created multi-level clashes between values and beliefs and guidelines, inhibiting effective processing of grief and effective functioning following loss. Muslims, in particular, experienced disenfranchised grief at the individual and community levels, jeopardizing wellbeing and leading to distrust of authorities and policymakers, deeper polarization in the society, lower utilization of health services, poor mental health, and worsening of chronic illnesses ( 41 ).…”

“…Health authorities and policy makers were perceived by members and leaders of religious minorities as failing to recognize the loss of community; as devaluing the spiritual leaders of religious minorities who are responsible for the continuation of community and excluding them from decision making; as unaware of potential adaptations to religious values and beliefs that were possible in previous pandemics; failing to provide resources to help community members plan for practical needs after death; failing to improve wellbeing and resilience through grief counseling and self-care for elders during this challenging time; failing to create and make accessible communication platforms that alleviate anxiety and process collective loss in order to restore social identity ( 24 , 41 , 41 , 45 , 46 ). These experiences resulted in distrust, disappointment, and anger at health authorities, rejection of the vaccine, poor compliance with guidelines, ineffective grief, deeper polarization from the majority population, and poor utilization of health services.…”