Spiritual and Ethical Reflections on Passive Euthanasia: Lived Experiences of Muslim Physicians

Abstract

This study investigates how Muslim physicians personally and spiritually navigate ethical dilemmas surrounding passive euthanasia in end-of-life care. Moving beyond legalistic or normative frameworks, it adopts an interpretative phenomenological approach and involves ten Muslim physicians—seven males and three females—aged between 35 and 58 years, all with at least ten years of clinical experience in intensive care or palliative medicine. Participants were recruited through purposive sampling from hospitals in three major cities in Indonesia. Data were collected via in-depth semi-structured interviews lasting 60–90 minutes, conducted in a private setting, and audio-recorded with consent.  Thematic analysis reveals four central dimensions: the existential burden of moral choice, the negotiation between Islamic teachings and clinical protocols, the use of religious coping mechanisms, and a perceived lack of institutional support for faith-informed ethical reflection. Physicians report profound internal conflict—torn between their roles as medical professionals and spiritual beings—often resorting to prayer, fasting, and personal ijtihad in the absence of clear religious or organizational guidance. These findings highlight a gap in current medical ethics training and suggest that moral decision-making is deeply rooted in emotional and spiritual realities. The study calls for a culturally and religiously sensitive framework in clinical ethics education, one that acknowledges the inner moral struggles healthcare providers face in high-stakes environments. Ultimately, the research expands understanding of Islamic bioethics by showing how ethical decisions are not merely rules to be followed, but personal journeys shaped by faith, reflection, and human vulnerability.