Integrating Islamic Bioethics Into Palliative Care: A Narrative Review and Framework for Practice in the Middle East

Abstract

Palliative care in most Muslim-majority settings, including the Gulf Cooperation Council (GCC) countries, is underdeveloped despite growing demand. Although Islamic doctrine has a strong bearing on attitudes towards sickness, suffering, and death, a conflict continues between normative guidelines of Islamic bioethics and their implementation in clinical care. This narrative review attempts to fill this gap by formulating a framework that incorporates Islamic bioethical values into palliative care provision in the Middle East. The narrative review was carried out based on databases such as PubMed, Scopus, and Google Scholar for the period 2000-2025. Classical Islamic sources, the Qur’an, Sunnah, Ijmāʿ (juristic consensus), and Qiyās (analogy), were compared with modern ethical and clinical studies in order to synthesise themes and formulate a practice-focused framework. Islamic bioethics focuses on principles like ḥifẓ al-nafs (protection of life), lā ḍarar (no harm), al-umūr bi-maqāṣidihā (intent counts), and maqāṣid al-sharīʿah (higher purposes of Islamic law). These principles were used to describe 5 domains of palliative care spiritual care, truth-telling and disclosure, advance care planning, pain and suffering, and end-of-life decision-making, to demonstrate their applicability and moral importance. The integrative framework brings faith-based ethics into synergy with evidence-based practice, and guides clinicians on topics like Do-Not-Resuscitate (DNR) orders, removal of futile treatment, palliative sedation, and communication with and engagement of families. The framework also outlines the religious counsellor and ethical consultation roles in facilitating decision-making and policy formation. Clinicians, educators, and policymakers can utilize the suggested framework to implement faith-sensitive palliative care on a systemic level.