Table 1.

Coding matrix showing the organization of theoretical codes and concepts.

THEORETICAL CODING		#	ILLUSTRATIVE PARTICIPANT QUOTES
Belief in medical professional attributes		1	You can think of medical professionalism as basic human behaviors like dignity, honesty, truthfulness, discipline … Compassion, being a good listener, being sincere, and being able to build rapport. – P7
Respect for evolving religious culture	Tradition	2	There are cultural values that we have to respect … but the religious point of view is [important] for Muslim … Such values are red lines that we shouldn’t cross – P14
		3	National professionalism depends on culture. Eye to eye contact, in the west, indicates respect between a man and a woman. In our civilization it may mean something we should avoid. – P5
	Evolution	4	People started to open up in the past years … Things that used to be restricted in the name of religion are now ok! Religious interpretation … evolves. – P8
		5	In the past there was the issue of women covering their faces and hijab and whether the doctor is allowed to see them or not. Now, the patient comes in and they know it is OK. – P10
		6	Patients now come asking for the female physicians! – P13
		7	“Currently … there are the people that will say: man, don’t bring religion into [a medical discussion] … Show me with studies and convince my brain. – P6
Value of RCCs in medicine	Added values	8	It will be much easier for physicians to understand and respect the medical concept when you connect it to Islamic teaching… they will be more likely to comply and respect it. – P1
		9	Do I sometimes use religious terms when I talk to patients? I think I do and I think it’s reasonable … Because … they find it helpful to hear:… God willing this medication would help you. – P12
	Concerns	10	I don’t think it’s helpful to label things [with religious terms] because people [get] polarized. – P9
		11	How are you going to measure taqwa (doing good for Allah’s sake)? You cannot! – P3
		12	The next generation will be even faster … communicating with the world … If we do not go to the right concepts, we will be outdated. – P15
		13	If I don’t follow [medical professionalism defined by RCCs] … am I going to be considered a kafir [disbeliever]? – P7
Conflicts and challenges		14	Someone would pray that [I’m cursed] because I told their dad about the [troubling] diagnosis … He would yell: “have taqwa! Be afraid of Allah! You are killing my father!” – P8
		15	A patient has a mass and you tell them they need a biopsy and they say I prayed istikhara [a prayer to seek God’s guidance] and I’m happy with not doing the biopsy. If you disagree with that, they would say but God will take care of me. – P12
		16	I say we don’t have enough evidence … to support hijama [religiously inspired cupping] … But [patients] look at me with wide eyes and say: doctor, Prophet Muhammad said to do this! – P13
		17	Even clinicians disagree with brain death … how can you ethically deal with that when you have someone brain dead and the family wouldn’t allow you to pull the plug? – P4
		18	For non-Muslims, I will [offer this treatment]. For Muslim patients I rely on an Islamic fatwa (ruling) that does not allow this treatment… – P14
Shaping practice	Adapting medical practice	19	A patient was telling me she wanted to try hijama instead of [medical treatment]. There was no harm to delay the treatment a bit in this case. – P14
	Preserving medical practice	20	The mother wanted to [delay treatment] … and a [religious healer] to treat her daughter. I respected their expectation … but it was my duty to correct them because it interfered with patient care. – P1
	Relinquishing medical practice	21	Islamic scholars define [suitability of a treatment]. Beyond that … I cannot do it because of my professional belief. You could find another physician or go to another country” – P15
		22	Life is in Allah’s hands and it’s mine to take [through euthanasia or abortion]. – P2
Finding the gold standard	Religious cultural gold standard	23	We are restricted by Islamic juristic laws … religious ruling is number one for me. – P14
	Medical gold standard	24	If all scientists or physicians agree [an intervention] will help humanity, I will keep digging in my religion to find a solution or explanation from the religion’s point of view. – P13
	Shifting & merging	25	If you found a conflict between the two [religion and medicine], what it’ll end up being is that one of the two got misinterpreted … So, you reconcile the two so that you don’t show conflict. – P6