American Muslims who interpret negative events in life as punishment from God are less likely to believe that donating organs after death is ethical than those with a more positive outlook, according to a survey conducted by researchers from the University of Chicago's Program on Medicine and Religion.

The study points to a complex relationship between attitudes toward organ donation and the Islamic faith. Previous research has shown that Muslims are less likely than other religious groups to believe organ donation is ethically justified, and suggests that religious values may be an obstacle to donation. This study, however, published online by the journal Transplantation, found that overall levels of religiosity among American Muslims did not influence attitudes toward organ donation.

"We need to unpack the theology and understand why certain people believe that God is punishing them and how that impacts their health behaviors," said study author Aasim Padela, MD, director of the Initiative on Islam and Medicine at the University of Chicago. "The medical community can't do that alone. The Muslim religious community has to be involved and work with researchers and clinicians to explore and intervene upon these ideas," he said. "As we see in this study, it affects organ donation attitudes and may impact other health behaviors."

Padela and his colleagues surveyed a group of 97 adults recruited from mosques about aspects of their religious beliefs and opinions about organ donation after death. Of this group, only race and ethnicity were associated with organ-donation attitudes; sex, country of origin, duration of residency in the United States, educational level and health insurance status did not matter. Arab Americans were more likely to believe that organ donation is justified than South Asian or African American Muslims.

Survey respondents who had higher levels of negative religious coping- the belief that negative events like sickness are punishment from God - were much less likely to agree with organ donation after death.

Padela said that given the ever-increasing number of people waiting for organ transplants in the United States, balancing the urgent medical need for more organ donation with deeply held religious beliefs requires more open and honest discussion of the issues within the Muslim community, as well as dialogue between the medical community and Muslim religious authorities.

"Some Islamic scholars hold that organ donation after death is not permissible, and ethically, we have to be honest about this with patients and their relatives," Padela said. "We have to create a culture of informed choice and have respectful conversations in the open, within mosques, community venues and the hospital. An open and nonjudgemental atmosphere will allow us to navigate the complex issues around religious beliefs, interpretations and organ donation."