March 2011 Article of the Month
Abu-Ras, W. and Laird, L. "How Muslim and non-Muslim chaplains serve Muslim patients? Does the interfaith chaplaincy model have room for Muslims' experiences?" Journal of Religion and Health 50, no. 1 (March 2011): 46-61.
SUMMARY and COMMENT: Wahiba Abu-Ras, PhD, is Assistant Professor of Social Work at Adelphi University and President of Muslim Mental Health; and Lance Laird, ThD, is Assistant Professor of Family Medicine at Boston University's School of Medicine, where he is Assistant Director of the Boston Healing Landscape Project, a "program for the study of cultural, therapeutic, and religious pluralism." Their research explores "the approaches of Muslim and non-Muslim chaplains to providing spiritual and religious care for Muslim patients and how they portray the needs of Muslim patients in [New York City] hospitals and health care settings in comparison with the needs of non-Muslim patients," as well as "...the types of culturally appropriate spiritual resources Muslims currently have, and what is needed" [p. 49].
From a sample of 40 hospitals in New York City's five boroughs, "in-depth, semi-structured face-to-face interviews" were arranged with 33 chaplains: 10 Muslim, 7 Jewish, and 16 Christian. Participants were asked "(a) what experience [they] have in caring for Muslim patients, (b) their assessments of Muslim patients’ needs, (c) their approaches to pastoral care with Muslim patients, (d) what spiritual resources Muslims currently have, and (e) what measures should be taken to address Muslim patients’ needs" [pp. 49-50].
Among the results:
In their discussion of the data, Abu-Ras and Laird consider "the 'one size fits all' approach to chaplaincy" -- namely, an interfaith/CPE model, especially as held by non-Muslim chaplains -- and how that "might present challenges for many Muslim patients" [p. 56]. They emphasize specific needs of Muslim patients that might thereby go unattended, including "theological perspectives and counseling about illnesses, ethical and legal advice regarding ritual obligations as well as medical decisions, ritual prayer and Qur’an recitation, and Friday sermons" [p. 57]. The authors report that non-Muslim chaplains in the study note a need to call upon local imams but have some difficulty accessing such resources, and they see in this fact a necessity for more Muslim chaplains. An argument for more Muslim chaplains is also supported by the data signifying "prejudice and discrimination against Muslim patients": "Several chaplains acknowledged their unawareness of Islam, doubts about their ability to discern Muslim needs, and their prejudices about 'seeing heavily veiled women'" [p. 57]. "We suggest that non-Muslim chaplains...need to take a measure of their gut reactions to Muslim patients in an Islamophobic social environment and how this environment influences their Muslim patients’ responses to them" [p. 58].
The authors address the limitations of their study [p. 58] and seem fairly careful to distinguish between their discussion of the potentially broad implications of the data and any attempt to make sweeping generalizations. For this reader, that distinction did become blurred in some rhetoric: "One wonders whether Protestant, Catholic, or Jewish patients must ask for Bibles, prayers, worship services, or kosher food before the hospital begins making them available." In many hospitals, that situation may be more the case than the authors seem to assume, though the general thrust of the statement is well taken and instructive.
One of the more interesting comments in the article, to this reader, is an assertion that the "dimensions of proclamation, ritual, and theologically informed counseling and legal advice [which could address the needs of Muslim patients] might resonate with more traditional Protestant, Catholic, and Jewish practices, but not necessarily with contemporary interfaith chaplaincy practice" [p. 57]. This raises the complex and general question of the place of religion-specific needs within the interfaith model. Abu-Ras and Laird state further on: "Investigating how Muslims currently in chaplaincy training programs negotiate the integration of the interfaith CPE model with Islamic religious traditions might provide greater insight into the barriers and challenges to increasing the availability of professional Muslim hospital chaplains" [p. 57]. Perhaps studying the CPE experiences of Muslims in particular could also bring fresh perspectives on the educational issues behind the professionalization process of modern chaplaincy.
Suggestions for the Use of the Article for Discussion in CPE:
Thanks to a good introduction (for a lay audience) and clear writing, this article may easily be read not only by CPE students but by local clergy, health care workers, and even patients; and so it presents an opportunity to expand CPE discussion to include Muslim clergy and/or patients as well as Muslim and non-Muslim health care providers. For students with clinical experience, the open-ended questions used in the study's interviews would serve as an appropriate structure to begin the conversation: "(a) what experience [the students] have in caring for Muslim patients, (b) their assessments of Muslim patients’ needs, (c) their approaches to pastoral care with Muslim patients, (d) what spiritual resources Muslims currently have, and (e) what measures should be taken to address Muslim patients’ needs" [pp. 49-50]. Students could be asked to respond to these items prior to reading the article (--essentially replicating the essence of the study informally) or afterward (in which case the question would be how the findings resonate with them). The sections on "Barriers for Non-Muslim Chaplains" and "What Should be Done to Meet the Needs of Muslim Patients?" may deserve special attention. Also, Abu-Ras and Laird hold that "it would be unfitting for Muslim patients to receive health care without incorporating spirituality" [p. 48]. Do students agree with this statement, and -- if so -- do they believe it should apply only to Muslim patients, to some non-Muslim patients as well, to all religious patients of any tradition, or to all patients generally? Finally, students should be encouraged to read, as a companion piece, Abu-Ras' "Chaplaincy services for Muslim patients in New York City hospitals..." [--see Related Items of Interest, §I, below].
Related Items of Interest:
I. The research presented in this month's featured article was part of a larger study of 56 hospitals in New York City. A November 1, 2010 report of that study, "Chaplaincy services for Muslim patients in New York City hospitals: assessing needs, barriers, and the role of Muslim chaplains," by Dr. Abu-Ras, is available freely from the Institute for Social Policy and Understanding. Dr. Abu-Ras also has an article forthcoming in Topics in Integrative Health Care: An International Journal: "Chaplaincy and spiritual care services: the case for Muslim patients" (scheduled for Summer 2011) --see the journal website at www.tihcij.com.
II. Abu-Ras and Laird provide a quite extensive bibliography, but there is unfortunately little other literature about chaplaincy to Muslim patients. One article that may be special interest:
III. In a forthcoming article in the Journal of Religion and Health (available online ahead of print), Aasim I. Padela, et al., report interviews with 12 community leaders about the role imams play in community health. The authors also address the lack of imams serving as chaplains:
IV. Our June 2003 Articles-of-the-Month page addresses issues with Muslim patients and offers a number of articles for additional reading. [Added 1/12/16:] See also our January 2016 Article-of-the-Month regarding Muslim patients' practice of salat after stroke.
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