{"id":4712,"date":"2025-10-29T02:26:57","date_gmt":"2025-10-29T01:26:57","guid":{"rendered":"https:\/\/blogs.bmj.com\/medical-ethics\/?p=4712"},"modified":"2025-11-03T02:05:52","modified_gmt":"2025-11-03T01:05:52","slug":"when-death-becomes-a-checklist-confronting-secular-bias-in-healthcare","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/medical-ethics\/2025\/10\/29\/when-death-becomes-a-checklist-confronting-secular-bias-in-healthcare\/","title":{"rendered":"When death becomes a checklist: Confronting secular bias in healthcare"},"content":{"rendered":"

By Hana Abbasian<\/p>\n

In modern healthcare, death is often treated as a medical event to manage<\/a>, a problem to solve, or a process to streamline. We focus on measurable outcomes: pain scores, vital signs, sedation levels. While these metrics are important, they can obscure a deeper truth: dying is a human and often spiritual experience.<\/p>\n

Secular frameworks in medicine tend to emphasize what can be measured, standardized, or optimized. Yet these priorities may unintentionally marginalize aspects of dying that cannot be quantified: presence, meaning, ritual, and reflection<\/a>. Patients\u2019 final moments can become subordinated to institutional convenience, rather than recognized as ethically and emotionally significant.<\/p>\n

In my recent article<\/a> in the Journal of Medical Ethics, I explored Islamic perspectives on death, intention, and consciousness to show how cultural and spiritual frameworks can enrich our understanding of dying. Engaging with these perspectives made me acutely aware of the secular assumptions that dominate modern healthcare, where meaning, ritual, and presence are often overlooked. By examining death through both secular and spiritual lenses, we can better appreciate the dimensions of care that go beyond physiology, including dimensions that matter to patients, families, and caregivers alike.<\/p>\n

The secular bias<\/a> affects more than just patient care. Families may be excluded from meaningful rituals, grief may be medicalized, and clinicians themselves can be trained to prioritize physiological outcomes over moral presence. In striving to relieve suffering, we risk erasing the very experiences that make death meaningful for patients, families, and caregivers.<\/p>\n

Recognizing secular bias does not mean abandoning scientific rigor. It means expanding our understanding of care to include what is ethically and emotionally essential. Conversations about dying should not stop at symptom management, they should explore what matters to the person in front of us. What does a \u201cgood death\u201d mean to them? How can we preserve consciousness, connection, and dignity in ways that respect their values?<\/p>\n

Practical steps are possible: clinicians can reflect on their own assumptions, engage patients and families in discussions about priorities, and consider interventions that balance physical comfort with meaningful awareness. Training programs might integrate ethical reflection on dying, acknowledging that end-of-life care is about both minimizing pain and honoring the moral and existential dimensions of being human.<\/p>\n

By confronting secular bias in healthcare, we reclaim the human dimension of death. We recognize that while medicine can manage the body, it is our attention to consciousness, connection, and meaning that shapes a truly compassionate approach. Death is inevitable, but the way we witness and care for it can still reflect our deepest values.<\/p>\n

Article:<\/strong> An Islamic reflection on double-effect sedation, intention and consciousness<\/a><\/p>\n

Author: <\/strong>Hana Abbasian1,2<\/sup><\/p>\n

Affiliations:<\/strong><\/p>\n

1 Harvard Medical School, Boston, MA, USA<\/p>\n

2 Centre for Addiction and Mental Health, Toronto, ON, Canada<\/p>\n

Conflicts of Interest and Sources of Funding: <\/strong>No conflicts of interest or external funding sources for this manuscript are reported.<\/p>\n","protected":false},"excerpt":{"rendered":"

By Hana Abbasian In modern healthcare, death is often treated as a medical event to manage, a problem to solve, or a process to streamline. We focus on measurable outcomes: pain scores, vital signs, sedation levels. While these metrics are important, they can obscure a deeper truth: dying is a human and often spiritual experience. […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":503,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[8050,8088,8135],"tags":[],"class_list":["post-4712","post","type-post","status-publish","format-standard","hentry","category-death-and-or-dying","category-healthcare","category-religion-spirituality"],"yoast_head":"\nWhen death becomes a checklist: Confronting secular bias in healthcare - Journal of Medical Ethics blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2025\/10\/29\/when-death-becomes-a-checklist-confronting-secular-bias-in-healthcare\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"When death becomes a checklist: Confronting secular bias in healthcare - Journal of Medical Ethics blog\" \/>\n<meta property=\"og:description\" content=\"By Hana Abbasian In modern healthcare, death is often treated as a medical event to manage, a problem to solve, or a process to streamline. 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