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Document No 05

2003          Page last updated: 30 July, 2005

WARD GUIDE
FOR THE RELIGIOUS
CARE OF DYING PATIENTS

Produced by the Hospital Chaplaincy Department

Compiled by Rev Bob Evans
Hospital Chaplaincy Department

2003
To accompany The MULTI FAITH WALL CHART

INDEX

Introduction

An Overview

Atheists & Agnostics

Baha'i

Buddhists

Christians

Christian Scientists

Greek Orthodox

Hindus

Jains

Jehovah's Witnesses

Jews

Mormons

Muslims

New Age

Rastafarians

Seventh Day Adventists

Sikhs

Spiritualists

Unitarians

Zoroastrians

Deathbed Weddings

Wills

Contacting the Coroner

References

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DEALING WITH DYING PATIENTS FROM MULTICULTURAL BACKGROUNDS

INTRODUCTION

How many patients are there from a religious background other than Christianity? How often are you likely to nurse a Sikh or Buddhist patient?

71% of people in the UK who responded to the Census 2001 question on religion said that they regarded themselves as Christian; 15% said they had no religion and just over 5% said they were from one of the other major world faiths, with half of those being Muslim.

Figures in the table are for the year 2002,
from UKCH Religious Trends 4 (2003/4); ed Peter Brierly

Let me outline some points that highlight some concerns in dealing with patients of different religious backgrounds.

•  No religion is monolithic ; all have their fundamentalist AND their liberal wings; all have their orthodox AND progressive expressions - so there is one over-riding rule in dealing with such patients:

ASK THE FAMILY

Some readers will be from the religious/cultural groups represented in this booklet, and may not recognise everything said about your faith and practices. I can only present a general belief about what is generally believed, because of the rainbow views held in any religious system.

•  Many patients from other cultural backgrounds die at home - that is where they want to be. I spoke to 2 experienced ward managers of long standing service who had seldom had to deal with such patients and their families at death. This is borne out by the return which comes into our office - which is the address label of every patient who dies in UHW stuck onto an A4 sheet, whenever the sheet is full on both sides, it is sent to the Chaplaincy. Of approx 50 deaths in the last 3 weeks only one had a name which might suggest that he was from a different ethnic/religious origin to the majority of those treated in UHW

•  There are rituals which have to take place before death , so it's no good saying to a family enquiring about a relative “she's fine”, then phoning later to say “we couldn't save her” - the family need notice so that rituals may be performed AT death.
For some, there are beliefs about the afterlife which will mean that their relative is not at peace unless rituals are complete, and the family will be distressed.
For others there will be social consequences which prevent the family from being involved in the social life of the community; and there will be the guilt that they were not able to be there in the last moments.
So, GIVE NOTICE.

•  50% complaints to the Trust relate to the circumstances surrounding the death of a patient. It's important to the family and the Trust that you get it right.

AN OVERVIEW

•  VIEWS ON THE AFTERLIFE

We are probably most familiar with the view held by most practicing Christians that there is an afterlife involving the resurrection of the body, God's judgment and the immortality of the human soul.

Hindus, Sikhs and Jains believe that the afterlife is bound up with reincarnation.

Their Karma is what controls the next stage in their existence. If they have lived a good life this time round, then they will be reincarnated to a life nearer Nirvana, perfection, if their life has not been so good, then they will be reincarnated in a lower order.

This means that if death is approaching, for say a Hindu, then they might want to put their affairs in order by having their family bring in money or gifts which the patient might touch in order for the to be given away to the poor and needy, so do not be surprised by large numbers of people around a very sick person.

Buddhists have a concept of the afterlife in terms of re-birth rather than reincarnation - their stream of conscious is not lost after death and may well influence future lives for good until it is subsumed into Nirvana - perfection. This is achieved through a life of discipline and meditation. THEREFORE the mind of a dying patient should be as clear as possible. The ideal is to die fully conscious with a clam state of mind, so they would not wish to be distracted by medication or noise, or religious symbols if they are very ill.

So staff should take great care in explaining the reason for sedation or pain relief if it is necessary.

Jehovah's Witnesses Really DO believe in an afterlife of hellfire and torment for those who reject their way or are excommunicated, so their refusal to accept blood products is not something that can be easily got round with an earnest chat setting out the facts alone. To be excommunicated means social exclusion in this life and worse in the next.

The Jewish faith is regarded as among the most life affirming. Ideas of the afterlife are hazy and varied, so Jews are concerned about this life and all that it has to offer. Thus there is an inordinate amount of worry by families about diet and is the patient eating well - the ubiquitous chicken soup may well be produced as a means of speeding recovery.

The family will not want the patient to lose hope. There may be an element of denial when a poor prognosis is made.

They have a prayer which begins “Others have prayed and they have been helped...”

•  DIET

Muslims – Do not eat pork, and only eat Halal meat which has been ritually killed. They do not usually drink alcohol.

Jews – Do not eat pork, their ritually prepared food is called Kosher

Hindus – Do not eat beef

If you are not sure about which meat does not go with which religion, then a vegetarian dish is the safest thing to offer.

Buddhists are usually vegetarian. I came across one Buddhist who was given a meal with vegetables and meat, which he declined, telling the ward caterer, I'm vegetarian, so she simply pushed the meat off the plate and gave him the plate with only vegetables, which was still not acceptable.

Jains are strictly vegetarian as their religion is expressed by an absolute regard for life – some will only drink water as it is strained through a cloth in case there is an insect floating in it.

Rastafarians usually observe Jewish dietary laws

Mormons are forbidden all stimulants in their diet, which means that they will not drink tea, coffee, alcohol or certain soft drinks like Coke or Pepsi.

•  TAKING THEM SERIOUSLY

Clothes :

Many of us will come to patients of other faiths with our own perceptions of what is right and normal, and it may be that we're presented with things that catch us off guard.

Mormons & Sikhs are very concerned about modesty and wear sacred underwear.

The Sikh will always wear his, so that he will remove one leg from the old pair, and then put the new pair on that leg before taking the other leg out of the first pair.

Some Mormons go through a special Temple service which means that they will wear sacred undergarments (like Sikhs) These would be removed only for operations. They would not want these put on public display - treat them with respect - it is an all in one garment which has appropriate openings for hygiene and making love.

It might sound strange to us, but making fun of such things could deeply offend.

Rastafarians seek a life of purity which means that they will not wear second hand clothes – so hospital garments which have been used before are not acceptable.

Polytheism

There are no heretics in Hinduism – it is a religion which has many gods, or one God with many manifestations, some of which are fierce and frightening, some with a number of limbs, some like Ganesh, the Elephant God which seems totally at odds with normal church and chapel going peoples' ideas of monotheism. Again to laugh at or belittle another person's beliefs because they seem strange to us can lead to them feeling that their religion is not taken seriously by westerners.

Suffering

A Buddhist would not fear death itself but approach it in an accepting manner - although there may be many different traditions and rituals depending on country of origin, attitudes to death do not vary. This can be a problem for some staff - there is much anger to do with bereavement in our culture.

It can be a problem to Buddhists, hence the story of “Kisagotami and the mustard seed” is often read at funerals.

In the story a young woman has a child who dies. She approaches the Buddha and asks him to restore her son. He replies that he will do so if she can go to her village and obtain a mustard seed from the home of someone who has known no suffering.

She calls at the first home and explains her need of the seed so that her child may live and her neighbours are anxious to lend a hand, but when she explains that it must come from someone who has not suffered they are unable to help; and so she goes from house to house to discover the same.

The story is told to let us know that suffering is inevitable and that we must be resigned to it rather than fight against it.

SIKHS

Founded: 1500AD

Leader(s): Guru Nanak

Census 2001 (Cardiff & Vale): 1002

Holy Book: Guru Granth Sahib

Afterlife: Reincarnation

Organ Donation: No religious objection

Funerals: Cremation

Local Contacts :
212a Pearl Street Roath 204655514
97-103 Tudor Street, Riverside 2022 4806

In the 16th century Guru Nanak reacted against excessive ritual in Hinduism and the caste system.

A sick or dying Sikh might receive comfort from the family reciting hymns or scriptures (the Guru Granth Sahib) to him, preferable in private.

A Sikh should die with the name of God whispered in their ear. (“Wonderful Lord”)

Sikhs when they die are generally cremated and mourners come to the Gurudwara and offer prayers The period of mourning normally lasts for 10 days.

Some mourners, particularly women will not eat until after the funeral (cremation) so do not allow delays except where necessary.

•  The 5 K's should not be removed from the patient.

•  Turban kept within sight of the patient in ITU

•  Sword, often a carried in Britain as an ornamental broach

•  Hair and beard should remain untrimmed.

•  The family may wish to wash the body themselves - there are no objections to non - Sikhs touching` the body.

THE 5 K'S

The dead person's face will be seen a number of times in the funeral ceremony. (reassure family that the post mortem cutting of the scalp will be done so that the face will not be affected)

Sikhs have no difficulty about post mortems and would have no religious objection to organ transplants.

Guru Gobind Singh prescribed the use of 2 names to symbolize membership in a casteless community, Most Sikh males are called Singh -Lion, females called Kaur – Prince(ess). Each will have a personal and a family name as well.

A Sikh will not eat beef, nor Kosher, or Halal food.

MOSLEMS / ISLAM

Founded: 622AD

Leader(s): Prophet Mohammed

Census 2001 (Cardiff & Vale): 11735

Holy Book: The Koran

Afterlife: Resurrection & Judgment

Organ Donation: No religious objection, though many will have a cultural objection

Funerals: Burial, within 24 hours

Local Contacts:
2 Glynrhondda St, Cathays 20226607
Maria Street, Butetown 20498435
61 Severn Road, Canton 20397640

Where possible, the patient should be nursed, facing South East toward Mecca.

For the Muslim, following death there will be a day of judgment at the end of the world, when the dead will be resurrected and judged. All will be rewarded according to the deeds done in their life. If the good deeds outweigh the bad deeds then they will go to heaven if not then they will go to Hell.

The family may want the Imam to be invited when readings from the Koran and prayers may be recited. - Chaplains have contact addresses, but the family will know.

A Muslim prays 5 times a day and washes under running water as part of getting ready for prayers – a washbasin is usually acceptable.

The Kalima "There is no god but "Allah" and Mohammed is his prophet” should be the last words a Moslem should hear.

Non-Moslem health workers should ask the permission of the family before touching the body (drains & tubes will need to be removed) - and if granted, should use disposable gloves. The family will organise washing of the body by people of the same sex as the patient. If there is no family, the local mosque should be contacted and they will make necessary arrangements.

Post mortems are distressing to the family - to open the body in order to discover the cause of death seems to deny that the death is God's will.

As a mark of respect immediate relatives may not eat until after the funeral - so don't delay.

To the Moslem, the human body is entrusted to the individual by God and does not therefore belong to them. Moslems would probably not wish to have organs transplanted - but this should not be assumed.

Problems may occur at Ramadan - some may have an objection to taking medicine during the fast, but the Holy Koran says that if one is ill, you may fast during another month of the year - possible in winter, so that the day is shorter!

When laying out the body, the head should be turned to the right before rigor mortis sets in so that the patient can be buried facing Mecca.

The arms should be straightened at the side; the big toes tied together.

Some families will wish to take body back to country of origin.

See note on contacting the Coroner to arrange funerals quickly p20

JEWS

Founded: 5000BC

Leader(s): Abraham

Census 2001 (Cardiff & Vale): 1052

Holy Book: The Old Testament

Afterlife: Resurrection & Judgment

Organ Donation: No religious objection

Funerals: Burial within 24 hours

Local Contacts:
Orthodox: Cyncoed Gardens, Cyncoed 20473278
Reformed: Moira Terrace, Adamsdown 20491689

Many Jews are Jews in descent only, and practice no religious observances at all.

Reformed Jews do not consider themselves to be a wing of Orthodox Judaism - rather they are another way of being Jewish; check with the family so that the right type of Rabbi is summoned.

The family should be asked if they want to have a rabbi present - bearing in mind that the rabbi is not a Jewish vicar, with no more status than anyone else in Judaism - they have no priest because there is no temple.

The patient would want to hear the Sh'ma - this can be recited by anyone - “Hear O Israel, the Lord your God is one God” as their last sounds.

A dying patient would not want to be left alone. The family will usually be present. If stretched for personnel, ask the chaplain.

Health workers should handle the body as little as possible, and cover with a plain white sheet.

Traditionally, when a Jewish patient dies:

the body should be left for 8 minutes - feather over mouth and nostrils; eyes and mouth closed by the eldest son; body laid on the floor with feet towards the door; lighted candle placed near the head; body straightened, hands by side, fingers straight - done soon after death by family.

The body should not be left alone - the Jewish burial society will make arrangements for the funeral and for the body to be watched over by watchers who will not leave it alone until the funeral.

The Jewish faith is regarded as among the most life affirming. Ideas of the afterlife are hazy and varied, so Jews are concerned about this life and all that it has to offer. Thus there is an inordinate amount of worry by families about diet and is the patient eating well - the ubiquitous chicken soup may well be produced as a means of speeding recovery.

The family will not want the patient to lose hope.

They have a prayer which begins “Others have prayed and they have been helped...”

Post mortems would not be welcome - but enquire with the family - Reform, Liberal Jews may be more amenable to transplants that Orthodox.

See note on contacting the Coroner to arrange funerals quickly p20

HINDUS

Founded: 5000BC

Leader(s): The Aryans

Census 2001 (Cardiff & Vale): 2603

Holy Book: The Vedas

Afterlife: Reincarnation

Organ Donation: No religious objections

Funerals: Cremation

Local Contacts:

4 Merches Place, Grangetown 20371128
Mardy Street,Grangetown 20231408

The Hindu has no division between secular and sacred - so some would not say that there is a Hindu religion because their life is permeated by their culture which they would say involves the worship of ONE God, but with 1000's of manifestations - there are no heretics in Hinduism - they are eclectic, they can assimilate any type of worship. This can lead to them feeling that their religion is not taken seriously by westerners.

Modesty is important, if a doctor of the same sex cannot be provided, then a chaperone would certainly need to be provided; the same is true of Sikhs.

A dying patient's family may well bring in money and clothes for him to touch, so that they can be distributed in his name to the needy

The dying patient may appreciate hearing the words of the Gita (Bhagavad Gita) read.

A pundit - priest - may be called to offer prayers, and may tie a thread round the wrist or neck.

The patient should ideally die hearing the sacred name of God, and be sprinkled with Ganges water and possibly have basil leaves placed in the mouth. Replace these after a post-mortem.

Some may wish to lie upon the floor as they would wish to die near the ground.

The family will wish to wash the body themselves, and put on new clothes before taking it from the hospital, if no family, then health workers should handle with disposable gloves.

No jewellery or religious ornaments should be removed; mortuary staff will have to replace any displaced during their examination.

There are no objections to transplants and organ donations.

Hindus would not allow a post mortem unless legally essential; then they would insist that all organs should be returned to the body before cremation.

To open the body is seen as disrespectful to the dead, and the family.

The eldest son of a patient has important ritual duties to perform, no matter what his age. Traditionally this would involve him lighting his funeral pyre - but in Britain this might mean that a child as young as 4 would press the button at the crematorium which draws the curtains round the coffin. - Therefore do not be surprised to see young children with the family as a patient approaches death.

BUDDHISTS

Founded: 536 BC

Leader(s): Siddhartha Gautama

Census 2001 (Cardiff & Vale): 1233

Holy Book: Many

Afterlife: Reincarnation

Organ Donation: No religious objection

Funerals: Cremation

Local Contacts: 12 St Peter's Street, Roath 20 462492

Buddhists in UK will come from a number of different cultures and bring with them different practices - the traditions represented will come from Chinese/Vietnamese, Indian/Sri Lankan, European.

Many are vegetarian and will want food that both contains no meat AND has had no contact with meat.

Buddhists have a concept of the afterlife in terms of re-birth rather than reincarnation - their stream of conscious is not lost after death and may well influence future lives for good until it is subsumed into Nirvana - perfection. This is achieved through a life of discipline and meditation. THEREFORE the mind of a dying patient should be as clear as possible. The ideal is to die fully conscious with a clam state of mind.

So staff should take great care in explaining the reason for sedation or pain relief if it is necessary.

As death approaches a monk may be invited to say prayers with the patient.

A Buddhist would not fear death itself but approach it in an accepting manner - although there may be many different traditions and rituals depending on country of origin, attitudes to death do not vary. This can be a problem for some staff - there is much anger to do with bereavement in our culture.

See Introduction

After death make sure that the patient is wrapped in a plain sheet with no religious ornament, so that consciousness may still be departing from the body.

There should be no objection to post mortem or transplants.

JAINS

Founded: c526 BC

Leader(s): Mahavira & others

Census 2001: (approx 15,000 in UK)

Holy Book: Angas; Purvas

Afterlife: Reincarnation

Organ Donation: No religious objection

Funerals: Cremation

Local Contacts: No local meetings

Jainism has never condoned war, the caste system, or the killing of animals for any reason. Jain teachings recognise that humans are imperfect, but that through strict control of the senses and thoughts we can obtain perfection, freedom and happiness.

Like Hindus and Buddhists, Jains believe that our actions influence the course our current life and of our lives to come. They believe that they are reborn again and again until the soul attains perfection. The people who have reached the highest state of being is a “Jina” (“Winner” over passions) from which the term Jain is derived.

There is a reluctance to kill any living thing, including insects. Jains are therefore strict vegetarians.

FOOD: They also abstain from alcohol, root vegetables, meat, fish, eggs, or any foods prepared using them. Food prepared for Jains should be prepared separately from that prepared for other patients– there may a revulsion and sense of spiritual pollution if their diet is compromised. Some Jains eat only during daylight hours. Most families are willing to provide their own food if facilities are available for storage and preparation.

FASTING: Some Jains will fast on the 5th and/or 14th day of each lunar month. During fast they will take only boiled water. A week long fast takes place during August or September. However, it is unlikely that Jains will fast if they are very ill.

DRUGS: Some Jains may refuse antibiotics, because they do not wish to harm any form of life, but may accept them with regret if absolutely necessary. Some Jains may refuse opiates due to their emphasis on endurance, self-discipline and suffering.

There is no supreme creator god, the universe has always existed, but many deities are worshipped. Most Jains worship 3 times a day, morning, noon and before sunset, though the most important time is in the morning. They may chant, silently or aloud, using a string of prayer beads

DEATH: It is important for a dying Jain that the family should be present, so that forgiveness may be asked or charitable gifts made. There may therefore be many people present. In rare cases, when a patient is elderly or incurably ill, they may decide, after a great deal of consideration, to withdraw from the world, by reducing their food and fluid intake, and refusing medication.

There are no religious objections to blood transfusions or organ donation.

BAHA'I

Founded: 1844

Leader(s): Ali Muhammed titled “The Bab”

Census 2001 (Cardiff & Vale):

Holy Book: The writings of The Bab and Baha'u'llah, The Bible and the Koran

Afterlife: Resurrection & Judgment

Organ Donation: No religious objection

Funerals: Burial within 1 hour's journey and as soon as possible after death.

Local Contacts:
Spiritual Assembly Of The Baha'is Of Cardiff
31 Pembroke Road, Canton
20221065

Baha'i teaching is focused on the following points:

Racial unity; Emancipation of women; Economic justice; Citizenship within a global perspective; A universal auxiliary language; The environment and development; A world federal system; Religious dialogue with other faiths.

Bahá'is are required to pray and meditate on a daily basis. Prayers are preceded by ritual washing. Only those who are ill, or old (over 70) are exempt and they may instead recite a specific verse from their scriptures. Travellers and women during their periods are partially exempt.

Bahá'is do not take tobacco and alcohol. Habit-forming drugs are prohibited unless prescribed by a doctor. There are no dietary restrictions in the Bahá'í Faith.

Bahá'is believe that the soul is eternal and that even after death the physical body should be treated with respect. Embalming and cremation are prohibited for Bahá'ís unless required by law. The body is to be buried within one hour's journey from the place of death, and as soon as possible after death.

See note on contacting the Coroner to arrange funerals quickly p20

ZOROASTRIANS / PARSEES

There are no special last offices.

The family may wish to be present during, or help in, the preparation of the body.

Orthodox Parsees require a priest to be present, if possible.

After washing, the two sacred garments are required these will be supplied by the family. Relatives may cover the patient's head with a white cap or scarf.

It is important that the funeral takes place as soon as possible after death.

Post-mortems are forbidden unless required by law.

Organ donation is forbidden by religious law.

Zoroastrian funerals are a series of prayers for the departed.  The traditional method of disposal of the dead is by exposing the body to vultures in elaborately built Towers of Silence (Dokme).  The basis behind this method is that the body is disposed of quickly, naturally, and does not pollute the air, water, or ground

For further information contact:

The Zoroastrian Information Centre
88 Compayne Gardens London NW6 3RV Tel 020 7328 6018

See note on contacting the Coroner to arrange funerals quickly p20

RASTAFARIANS

Founded: 1930

Leader(s): Marcus Garvey

Census 2001 (Cardiff & Vale):

Holy Book: The Bible

Afterlife: None

Organ Donation: Unlikely, but ask the family.

Funerals: Burial

Local Contacts:

Ras (Prince) Tafari Makonnen – better known as King Haile Salassie (1892-1975) is held in high esteem and regarded as the Messiah.

The Old and New Testaments are still regarded as scriptures, but Rastafarians do not consider themselves to be Christian.

Rastafarianism is a personal religion.  It places emphasis on personal dignity and a deep love of God.  There are no churches, services or official clergy.

The average Rastafarian eats a diet of I-tal food . I-tal food is natural food that has not been preserved or chemically altered in any way, similar to organic foods in the west. Most Rastafarians are vegetarians, though they do eat fish. Even those who do eat meat never touch pork. Alcohol is forbidden, and coffee and salt are strongly discouraged. A diet of vegetables, fruit and seeds is considered one that will keep impurities out of the body and ward off sickness.

Amongst Rastafarians, visiting the sick is important.  Visits are often made in groups.  Family members may wish to pray at the bedside. There are no rites or rituals, before or after death. The father buries children.

Rastafarians will be unwilling to receive any treatment that will contaminate the body.  They w ill not wear second hand clothes – there may be difficulties about hospital garments previously worn by others.

They will prefer alternative therapies such as herbalism or acupuncture.  However, those who seek the advice of doctors are likely to accept some conventional treatment.

The distinctive hairstyles (dreadlocks or locks), are a symbol of the Rastafarian faith.  Orthodox members may not permit their hair to be cut.

The role of women is a subordinate one.

In Rastafarianism, there is no afterlife, and so the Kingdom on earth becomes very important.

CHRISTIANITY

Founded: 29 AD

Leader(s): Jesus Christ

Census 2001 (Cardiff & Vale):

Holy Book: The Bible

Afterlife: Resurrection & Judgment

Organ Donation: No religious objection (Not the case for Greek & Russian Orthodox)

Funerals: Burial or Cremation

Local Contacts: Contact the Hospital Chaplaincy 74 3230

Despite being more familiar with this majority group of patients, please bear in mind that the Chaplains are on site or always on call in the Trust. We take this seriously because for Roman Catholic and Anglican patients, prayers, confession, anointing with oil are important for the patient to be at peace with themselves as death approaches.

Parents of dying children in neo-natal and paediatric wards may well consider it vital that their child is baptized before death.

Again ASK THE FAMILY - be proactive - if in your judgment death is impending, instead of asking “would you like to have a chaplain present?” ask “may I send for the chaplain?” we aim to answer any such call within 20 minutes.

Chaplains are available to meet the spiritual needs of patients - sometimes this means formal religious activities, on other occasions it may mean discussing life (and death) with the patient and their family. A patient may appreciate a visit from the Chaplain for prayers prior to an operation.

It is better for the patient if we can be involved as early as possible, so that we don't just turn up at the last moment and just say the words - instead, we value the opportunity to develop a relationship with patient and family.

The baptism of infants in emergencies is important. A Hospital Chaplain is available 24 hours a day, but in the absence of a Minister of Religion, anyone may perform a baptism.  This is done by making the sign of the cross on a person's forehead.  A little water is poured on the forehead (or another accessible part of the body), with the words, “…(Name)…”, I baptise you in the name of the Father, and of the Son, and of the Holy Spirit.  Amen”.

The chaplain should be informed as soon as possible.

ROMAN CATHOLIC PATIENTS

There is no official “Last Rites,” to be carried out on the deathbed. However, many patients and their relatives may take comfort from prayers, confession and anointing from a priest as death approaches. Instead the “Sacrament of the Sick” is offered to all early on in their time in hospital, to be of benefit whether they die or recover.

Roman Catholic patients usually appreciate Holy Communion at least weekly.

Some would regard Friday as a day not to eat meat.

ANGLICAN / CHURCH IN WALES

Many will appreciate their priest or a Hospital Chaplain to anoint or say prayers with them as death approaches. Anglican patients usually appreciate Holy Communion at least weekly.

FREE CHURCH

The Free Churches are largely those who are not Roman Catholic or Anglican. (but not Lutheran or Orthodox) Among the Free Churches are Methodists, Baptists, Presbyterians, Church of Scotland, Salvation Army, Independents, United Reformed, Free Evangelical Churches, Pentecostals, Plymouth Brethren, and others.

AGNOSTIC, ATHEIST
AND PEOPLE OF NO RELIGION

We do not assume that they have no beliefs. They may be glad of human support and friendship but should be approached with sensitivity.

NEW AGE

Eastern Mysticism mixed with perhaps Paganism and a worship of the world around.

Some patients will have or be given crystals which they will believe have healing properties and which they would not want to be removed.

JEHOVAHS WITNESSES

Founded: 1850 AD

Leader(s): Charles Russell

Census 2001 (approx 250,000 in UK)

Holy Book: The Bible (New World Edition)

Afterlife: Resurrection & Judgment

Organ Donation: As there is an objection to the use of blood products, they

are unlikely to agree to sharing tissue – however, ASK THE FAMILY

Funerals: Burial or Cremation

Local Contacts: 102 North Road, Gabalfa 20520956

Would not want blood products used against their wishes.

•  Genesis 9:4 "But flesh (meat) with...blood...ye shall not eat"

•  Leviticus 17:12-14 "...No soul of you shall eat blood...whosoever eateth it shall be cut off"

•  Acts 15:29 "That ye abstain...from blood..."

•  Acts 21:25 "...Gentiles...keep themselves from things offered to idols and from blood..."

See Royal College of Surgeon's Code of Practice for the Surgical Management of Jehovah's Witnesses (2002) at : http://www.rcseng.ac.uk/services/publications/publications/pdf/witness.pdf

Jehovah's Witnesses do not usually celebrate birthdays or Christmas.  The only festival is the annual memorial of the death of Christ, (Maundy Thursday).

Jehovah's Witnesses Really DO believe in an afterlife of hellfire and torment for those who reject their way or are excommunicated, so their refusal to accept blood products is not something that can be easily got round with an earnest chat setting out the facts alone. To be excommunicated means social exclusion in this life and worse in the next

Post Mortem - at the family's discretion.

The Hospital Information Desk at their headquarters in London (0181 906 2211) will put you in contact with the local Hospital Liaison Committee Chairman.

MORMONS

Founded: 1840 AD

Leader(s): Joseph Smith

Census 2001 (approx 170,000 in UK)

Holy Book: The Bible & The Book of Mormon

Afterlife: Resurrection & Judgment

Organ Donation:

Funerals: Usually Burial

Local Contacts: Heol Y Deri, Rhiwbina 20625342

Stimulants are forbidden as part of the diet, so coffee, tea and alcohol would be declined.

Mormon leaders may administer anointing with oil, laying on of hands and prayers at the request of the patient.

Some go through a special Temple Service which means that they will wear sacred undergarments (like Sikhs). These would be removed only for operations. They would not want these put on public display - treat them with respect.

Generally cremation is not encouraged

CHRISTIAN SCIENCE

Founded: 1879

Leader(s): Mary Baker Eddy

Census 2001: (approx 6150 in UK)

Holy Book: Science & Health; The Bible

Afterlife: Resurrection & Judgment

Organ Donation:

Funerals: No special arrangements – all at the choice of the family

Local Contacts: 28 North Road 20664238

Sickness is normally dealt with through prayers alone. But they will accept medical treatment when the law requires it.

There is no particular ritual at death.

Post Mortem at the family's discretion; Organ donation unlikely - because it is a material form of treatment

OTHER LOCAL CONTACTS

Unitarian Church
West Grove, Roath
20772744

Greek Orthodox Church
St Nicholas' Church
Greek Church Street, Butetown
20487889

Seventh Day Adventist Church
Cowbridge Road,
Canton
20881560

Spiritualist
1st National Spiritualist Church
Park Grove,
Cathays Park
20377630

Gateway Spiritualist Church
Northcote Street, Roath
20470461

DEATHBED WEDDINGS

Both persons must be free to marry – single or divorced. Patients must be conscious and able to understand what is happening.

During office hours phone Cardiff Register Office: 20871690

In the event of a registrar being required outside office hours telephone Cardiff County Hall 20872000 .

Speak to whoever is on reception and ask to speak to the on-call registrar (who is responsible for registering the deaths of Muslims & Jews).

You have to give your name and phone number to the person on reception, who will call the registrar, who will then telephone you. Explain the circumstances and make the arrangements.

Hospital Chaplains (20743230) are able to give advice and conduct a service of vows and prayers, but the legal ceremony MUST be conducted by the Registrar.

The letter below must be prepared for the Registrar:

To whom it may concern,

I confirm that I am the physician/consultant in medical attendance upon presently a patient at the University Hospital of Wales in Cardiff.

I confirm that he/she is not expected to recover from his/her present illness and cannot be moved to a place registered for the purpose of marriages.

I further confirm that the patient understands the nature and purport of the marriage ceremony.

Yours faithfully

To be signed by the Consultant/Senior Registrar and qualifications given. This letter should be addressed to the Superintendent Registrar, Park Place, Cardiff, and given to the registrars prior to the ceremony

WILLS

The RCN position states there is nothing in law to prevent a nurse from witnessing a patient's will. However there is a local policy within the Trust which advocates differently.

The nurse can sign the will providing he/she is not a beneficiary of the will. Perhaps at a later date they may be drawn into litigation if ever that will is challenged in a court of law.

It is for this reason that the RCN will not advocate our members signing the will in the clinical area for patients.

If a will is required to be signed at a clinical area the Trust should refer the matter to their legal department for attention.

CONTACTING THE CORONER TO ARRANGE FUNERALS QUICKLY

During office hours call the Coroners Office: 20527431

Outside office hours:

1. Call the police station 20222111- The Duty Inspector will have list of Coroners Officers on call
2. The Coroner's Officer will communicate with the doctor who will explain the religion of the patient and ask for any post mortem to be carried out later that day or within 24 hours for religious reasons.
3. If the Coroner agrees to receive the pathologist's findings over the phone or fax, he will then proceed to furnish the death certificate in a straightforward case.

   ---

CONCLUSION

The Hebrew Scriptures tell us that there is a time for every purpose under heaven.

“A time to be born, a time to die ....”

If we handle the illness or death of a patient sensitively, then it might be seen that the death is not untimely and thus we are able to help those who have to come to terms with loss of health or even loss of life.

REFERENCES

Multi Faith Wall Chart
To accompany this booklet: Cardiff & Vale NHS Trust Chaplaincy Department, 2003

Dealing with Death, Practices and Procedures
J Green and M Green, Published by Chapman & Hall (1992)

Death with Dignity – Meeting the Spiritual Needs of Patients in a Multicultural Society
Nursing Times articles on each religion 1989-1992

Caring for Dying People of Different Faiths
Julia Neuberger, Published by Lisa Sainsbury Foundation (1987)

Health Care Needs of a Multi-Racial Society
Perminder and Gurdev Bal, Hawker Publications, London 1995

The Ethnic Health Handbook – a factfile for Health Care Professionals
Ghada Karmi – Blackwell Science Ltd

Royal Marsden Manual (Chapter 22 – Last Offices)
http://ctserv.qmuc.ac.uk/marsden/MARSDEN/rm_22.htm#s4

BBC Website
http://www.bbc.co.uk/religion/religions/

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