Introduction to Cases and Reflections
The material in this section is part of a larger project by the Markkula Center for Applied Ethics on culturally competent care; that is, health care that is sensitive to the differing values and needs of cultural subgroups within our pluralistic society. These materials focus on the challenges that can confront Muslims in American health care settings. Underwriting for these materials was provided by a generous anonymous donor.
This set of cases will target some of the most common cultural and religious issues that arise in clinical health care settings for a particular population: Muslim immigrants. Admittedly, this population itself is anything but homogeneous; although categories are hard to define and firm numbers difficult to obtain, there are anywhere between 2 and 6 million Muslim immigrants in the United States today, hailing from many different regions around the world. Yet certain issues do commonly arise that may indeed speak to more than one Muslim subgroup, and certain religious requirements-such as that of regular prayer times throughout the day-are relatively common among Muslim immigrants from a variety of backgrounds.
The cases here are fictional composites made up from the details of many different real situations. We did not perform any systematic analysis of these populations or the issues that commonly arise within them. Rather, we conducted personal interviews with doctors, nurses, social workers and chaplains who work specifically with patients from non-majority cultures in U.S. clinical health care settings. From these interviews we constructed fictional cases, drawing on some of the more common, and difficult, issues that tend to arise within these patient populations.
The commentaries that follow the case address some of the cross-cultural and ethical issues that arise. Commentaries are offered by several scholars or practitioners who are, themselves, from Muslim religious and/or cultural backgrounds. Each one stresses the ways in which the provision of health care in these relatively typical U.S. clinical settings is, or is not, adequately culturally competent. The commentaries highlight what might have been done differently in each case to improve the quality of patient care. The final commentary for each case responds to the others from a non-Muslim and more explicitly Western bioethical perspective.
Case 1: Confronting a Fetal Abnormality
- Reflection by Doha Raik Hamza
- Reflection by Sheik Hassan and Hossam E. Fadel
- Reflection by Abdelmalek Yamani
- Reflection by Karen Peterson-Iyer
Case 2: Cancer: A Failure to Communicate
- Reflection by Doha Raik Hamza
- Reflection by Sheik Hassan and Hossam E. Fadel
- Reflection by Abdelmalek Yamani
- Reflection by Karen Peterson-Iyer
Further Resources
An Introduction to Culturally Competent Care
The Islamic Medical Association of North America (IMANA)
The Islamic Society of North America (ISNA)
Council on American-Islamic Relations (CAIR)
Imamia Medics International (IMI)
Karen Peterson-Iyer is a program specialist in health care ethics at the Markkula Center for Applied Ethics.
