Factsheet 15: Culture and Religious Practices in Healthcare, Death and Bereavement Key considerations for reviewers • Were the persons cultural and religious practices considered according to their wishes? • It might be useful to ask the question “Do you or your relative/ friend have any religious practices or customs that you would like us to be aware of?” The sensitive use of questions will be more helpful than an assumption. Introduction It is important to consider different cultural aspects and faith practices during healthcare, death and bereavement. In particular, people who are members of a religion may wish to practise some elements of their religion in relation to their treatment, up to their death and after their death. However, it is important to never assume how a person’s cultural background will dictate their needs and practices. The person and their family should always be consulted about what is appropriate for them. Please find below a list of faiths (in alphabetical order) summarising some of their religious and ritual practices. Baha’i Most Baha’is have a positive attitude towards healthcare staff and are willing to seek medical help and advice when sick. As well as taking prescribed medication, Baha’is believe in the power of prayer in healing. The use of habit-forming drugs is strictly prohibited except when prescribed by a physician. In death Baha’is treat the body of a deceased person with great respect. Autopsies and post mortem examinations are acceptable if necessary. Wherever possible the remains should be returned to the parents or local Baha’i community for burial. Most Baha’is would have no objection to blood transfusions and may receive transplants or donate organs for transplant. Examinations are acceptable if necessary. Brahma Kumaris Most Brahma Kumaris have a positive attitude towards healthcare staff and would be willing to seek medical help and advice when sick. Brahma Kumaris teachers live a celibate life and may prefer medical examinations to be undertaken by someone of the same sex. They would have no objection to blood transfusion or organ transplants. Dedicated Brahma Kumaris would prefer the body to be in special white clothes and all favour cremation over burial. Buddhism Buddhists will normally wish to be as conscious as possible when death approaches, and it is important to negotiate issues of medication at this time. Some Buddhists may express a strong wish to die at home rather than in hospital. Healthcare staff should discuss in full the practical implications of this decision with the person and relatives if terminal illness is diagnosed. They may ask their spiritual teacher to be with This information was correct as of 29/7/2019 LeDeR Programme Fact Sheet 15. V 5-0 them, to chant passages of Buddhist scripture. Some believe that the spirit may remain associated with the body (and may continue to meditate) for some time after ‘physical’ death, so the body should not be disturbed during this time until the spiritual teacher advises when the body can be moved. Objections may be made to post mortems, due to the belief that the mind may stay in the body for some time after the heart has stopped, and interfering with internal organs may undermine the optimal dissolution of consciousness, therefore the body should not be moved for 72 hours. Chinese folk religion (Shendao, Shenism, Shenxianiam) Traditional Chinese religion is a diverse mixture of beliefs and practices. Different funeral rituals are carried out in different parts of China, and many contemporary Chinese people carry out funerals according to various religious faiths such as Buddhism or Christianity. Throughout known Chinese history ancestors have been worshipped by their descendants and satisfying the needs of departed relatives is a constant concern within Chinese folk religion. A set of traditions broadly associated with Chinese folk religion consists of different rites depending on the age of the deceased, the cause of death, and the marital and social status of the deceased. Respect is given to elders and there are often elaborate funeral preparations in these cases. For those not considered elders (children and unmarried/ childless adults) there may be no special ceremony and many Chinese do not like to mention a child who has died, so counselling may be difficult. Chinese families may not want to be given back any of the child’s belongings as it is considered bad luck. Most Chinese people believe that burial brings peace to the person who has died although there are other accepted ways of disposing of bodies. Post-mortems may be refused as they are seen as invasive and particularly so for Muslim Chinese. Organ transplant can cause difficulty as traditionally the body should be buried whole, so they may be reluctant to donate organs or tissue. Chinese people may want to use Traditional Chinese Medicine (TCM) in conjunction with or instead of western medicine. TCM and western medicine are practised side by side in Chinese hospitals. According to many Chinese, acute illnesses and those requiring surgery are best treated by western medicine while conditions with prolonged symptoms are better treated with TCM. Chinese patients may have been taught to respect medical professionals highly and not to ask questions or challenge opinions. Where language barriers exist, it is advised that professional interpreters are used instead of relatives. Diet and lifestyle is very important in TCM. Many ethnic Chinese are lactose intolerant. Christianity Most Christians have a positive attitude towards healthcare and are willing to seek medical help and advice when needed. They usually do not object to blood transfusions, transplants or donating organs. Church of England, Church in Wales, Scottish Episcopalian Church & Anglican Some Anglicans will want the Chaplain or other minister to be with them as they approach death. If this is requested, the priest will treat it as an emergency and should be called regardless of the time of day. The relatives may want to see a priest after the person has died. Catholic, Roman Catholic and Ukrainian Catholic Some Catholics (especially older people) may abstain from meat on Fridays, and observe dietary discipline during Lent. Some Catholics may wish to receive Holy Communion, make their confessions to a priest and receive the Sacrament of the Sick or ‘Last Rites’ prior to their death. If this is requested, the priest will treat it as an emergency and should be called regardless of the time of day. Many Catholic families will want to see a priest after a death. After death, routine last offices are appropriate. This information was correct as of 29/7/2019 LeDeR Programme Fact Sheet 15. V 5-0 Orthodox (Eastern, Greek, Russian, Serbian & Coptic) Many Orthodox Christians will observe a discipline of fasting during Lent, and some during Advent. It should be noted that the Orthodox Church observes a different calendar from that used by Western Christians - Christmas and Easter are about 12-13 days after the ‘Western’ date. The person may request the presence of the clergy as death approaches. If this is requested, the priest will treat it as an emergency and should be called regardless of the time of day. The family may wish to see a member of the clergy after death. After death, routine last offices are appropriate. Methodist, Baptist, Quaker, Presbyterian (Church of Scotland), United Reformed Church, Salvationist (Salvation Army), Free/ Independent Church & Other Christian Some people from some denominations may wish to receive Holy Communion and may ask the Chaplain or members of their own church to pray with them from time to time. A person may sometimes wish a minister or other Christian friends to be with them as they approach death. After death, routine last offices are appropriate. Hinduism In Hinduism, it is forbidden to eat beef and many Hindus also avoid pig meat. They may wish to have statues or pictures of the gods with them. These should be treated with utmost care and respect. Ritual cleanliness can be very important, and a Hindu person may wish to wash in running water (i.e. a shower) before meditating. Modesty is also important; they may wish to be examined only by a doctor of the same gender. Most Hindu people will wish to die at home, if at all possible. A dying person will be visited by their family, and may ask to see a Hindu priest. After death, the family should be consulted before anyone touches the body. The family will usually want to wash the body at home. If staff have to attend to this, disposable gloves should be worn; the dead person’s limbs should be straightened and their eyes closed; jewellery, sacred threads, and other religious items should not be removed; and the body should be wrapped in a plain white sheet. Cremation should follow as quickly as possible after death. Humanist, Agnostic and Atheist No special arrangements. After death, routine last offices are appropriate. The option of a non-religious funeral should be given, which may have to be asserted with funeral directors. Jehovah’s Witnesses Witnesses adhere strongly to the New Testament prohibition on ingesting blood or blood products, and meat from animals which have been strangled. Blood and blood products are usually not acceptable in medical treatment, and the person will often have a very clear idea of their own moral boundaries in this matter. This should be clearly documented in the case notes and on any consent form which the person is asked to sign. After death, routine last offices are appropriate. Jewish Jewish people may follow a kosher diet to a greater or lesser extent. The most commonly followed prohibitions are pig meat (and any other animal that hasn’t cloven hooves and chews the cud – so beef could be kosher but rabbit not), shellfish (only seafood with a fin and a tail should be eaten) and meat and dairy should not be mixed.