• George Muishout, Nuray Topcu, Anne de la Croix, Gerard Wiegers, and Hanneke Wm van Laarhoven.
• Department of History, European Studies and Religious Studies, Amsterdam School for Historical Studies, University of Amsterdam, Amsterdam, The Netherlands.
• Palliat Med. 2022 Jun 1; 36 (6): 1006-1017.

BackgroundMuslims are the largest religious minority in Europe. When confronted with life-threatening illness, they turn to their local imams for religious guidance.AimTo gain knowledge about how imams shape their roles in decision-making in palliative care.DesignDirect Content Analysis through a typology of imam roles. To explore motives, this was complemented by Narrative Analysis.Setting/ParticipantsTen Turkish imams working in the Netherlands, with experience in guiding congregants in palliative care.ResultsThe roles of Jurist, Exegete, Missionary, Advisor and Ritual Guide were identified. Three narratives emerged: Hope can work miracles, Responsibility needs to be shared, and Mask your grief. Participants urged patients not to consent to withholding or terminating treatment but to search for a cure, since this might be rewarded with miraculous healing. When giving consent seemed unavoidable, the fear of being held responsible by God for wrongful death was often managed by requesting fatwa from committees of religious experts. Relatives were urged to hide their grief from dying patients so they would not lose hope in God.ConclusionImams urge patients' relatives to show faith in God by seeking maximum treatment. This attitude is motivated by the fear that all Muslims involved will be held accountable by God for questioning His omnipotence to heal. Therefore, doctors may be urged to offer treatment that contradicts medical standards for good palliative care. To bridge this gap, tailor-made palliative care should be developed in collaboration with imams. Future research might include imams of other Muslim organizations.

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