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Multi-Faith
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[Back to Faith Index] [Back to Document Index] [Search] Document No 83 7/2006 Page last updated: 7 July, 2006 This Document is a copy of Section B of the Chaplaincy Staff Handbook of the Doncaster and South Humber Healthcare NHS TrustThe author is the Revd. John E. Palin, Head of Chaplaincy, the copyright belonging to the Doncaster and South Humber Healthcare Trust. For permission to use in part or as a whole, please speak to John Palin on 01302 796209. Some references may reflect a South Yorkshire context. INDEX
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INTRODUCTION TO SECTION B
PLEASE ensure that the specific notes that follow on religious traditions are read in the context of this introduction. COMMON SENSE AND RESPECTIn the following notes there will be many references to issues like personal hygiene, modesty as between the sexes, and family involvement when a patient is dying or has died. It will be noticed that peoples of similar ethnic origin but of more than one religious tradition share many of these concerns. This whole area of concern becomes less complex if we remember that every patient is entitled to respect and consideration concerning these intimate issues. People of all backgrounds will welcome the opportunity to discuss these matters when appropriate. The notes help you to ask relevant questions, once you know the faith community of the patient. TREAT PEOPLE AS INDIVIDUALSThe guidance notes that follow give very general advice. Always ask the people concerned. It may be that differences will emerge as families become westernised in culture. There may be generational differences and of course, degrees of strictness in adherence. Do not however assume that westernised fluent English speaking people are going to be less concerned than people who have been born in other countries. Treat people as people not as representatives of groups. Be aware also of people's readiness to make compromises out of consideration for you. Are they happy to have made such compromises? BE CAREFUL TO IDENTIFY THE RELIGIONPeople of similar ethnic origin have different religious traditions e.g. it would be unhelpful to confuse Muslims, Sikhs and Hindus. Remember for example that India has many religions including Christianity! FAITH REPRESENTATIVESAs a general rule the smaller the religious grouping to which the patient belongs, the more likely is the contact with faith leaders to be well established. Wherever possible seek the help of the family if a religious leader is needed. Switchboard or the Chaplaincy may be able to help you to find the right person. Be very careful that you have correctly identified the religious group. TAKING EXTRA CARE FOR MINORITY RELIGIOUS NEEDSOnce you are aware of any patient with minority group religious needs you should ensure support is available from their faith community. This applies to Christians and non-Christians alike. Families may themselves need your help to locate the right support. Chaplains will be pleased to help wherever possible and families may appreciate any help they may be able to give. Page B1
WHAT IF THE HANDBOOK DOES NOT HELPPlease make good use of this second section for general reference. It is helpful to the Chaplains if they know you have done this but there will be times when you need to discuss concerns and seek more information. Use the normal contact procedure. Page B2 MAIN RELIGIOUS GROUPSCHRISTIANS
Christians believe in one universal God who has revealed Himself to be Father, Son and Holy Spirit. God became incarnate in Jesus Christ who is understood to be God and Man. Through Christ we become adopted children of God who are to grow in the Spirit so that Christ is formed in us. The death of Jesus is victory over sin and death and his Resurrection celebrated at Easter is the foundation of Christian Faith. Christians are baptised ‘into Christ' as infants or adults. It is the main religion of Britain and of many people who have settled here from the West Indies and Eastern Europe. Christians belong to historic churches and denominations that can be divided thus: • The Anglican Communion represented by the Church of England, the established Church in England. • The Roman Catholic Church which is the ancient historic Church of the West under the authority of the Pope. • The ancient Eastern Churches, Orthodox, Oriental. These are national churches, e.g. Greek, Russian, Bulgarian, Serbian Orthodox or the Oriental Churches, e.g. Coptic Church in Egypt, Armenian, Nestorian, etc. • The Protestant Churches mainly represented in England by what are termed Free, i.e. non established Churches, e.g. Methodist, Baptist, United Reformed, Salvation Army, Society of Friends, Pentecostal churches etc. KEY ISSUES AND CONSIDERATIONS Patients may wish to see a Chaplain. They may appreciate support, prayers and often, Holy Communion. There may be a request for a Bible or prayer book and also the chance to attend a service in the hospital chapel. Roman Catholic patients will expect to see a Chaplain and have provision made for their sacramental needs. Efforts should be made for Orthodox and Oriental church members to see an appropriate priest. DIET Fasting may include Lenten observations and a meatless diet on Good Friday, Ash Wednesday etc. Some may wish to receive Holy Communion fasting. CARE OF THE DYING AND WHAT TO DO AFTER DEATH Christians should be offered the support of the Chaplain of their tradition. There are no formal objections to post-mortem. Cremation is more acceptable than was once the case but members of Eastern churches prefer burial. The dead body must be treated with respect and dignity. Page B3 • Church of England (Anglican) Prayers may be said at the bedside of the dying and sometimes the patient is anointed. Prayers of commendation and thanksgiving may be said after death. Always ask if the family would like to see a Chaplain or their own priest. • Roman Catholic The Sacrament of the Sick with anointing is of particular importance. The Roman Catholic Chaplain or another priest must be called to the dying person or to one who has just died. • Free Churches Free Church patients would welcome prayers but not always a sacramental ministry. Their own minister or a Free Church Chaplain would be acceptable. SUNDAY WORSHIP Sunday is the Day of the Resurrection. The chance to attend a service or to watch one on the television may well be important. HOLY COMMUNION To receive Holy Communion is to share the life and spirit of Christ in remembrance of his death and in thanksgiving for his saving love. It is most important that this ministry is maintained for communicant patients. Others who have lapsed often welcome the opportunity to return to the sacraments when in hospital. Patients should be given privacy and the Chaplain every help in making arrangements. Authorised lay people are allowed to administer Holy Communion from the Reserved Sacrament (Anglican and Roman Catholic) but someone coming back into sacramental fellowship must be seen by a priest. CHAPLAINS AND VISITING CLERGY Visiting clergy and ministers who have come to see members of their congregations should be welcomed. They are not allowed to lead worship or make sacramental provision without Chaplaincy authority. On some occasions visiting clergy may be deputising for Chaplains who are unavailable. Page B4
NOMINAL CHRISTIANS
In a culture with a long Christian history it is not surprising that many patients will describe themselves as belonging to a Christian tradition when in fact they are not active members of any church and may not even have a strong grasp of Christian beliefs. If there is a common factor it is perhaps a basic allegiance to Christian principles and openness to the ministry of Chaplains and other clergy. Because the needs of this large group are so diverse, negative classifications like NON-PRACTICING and NON-RELIGIOUS are best avoided. The reality is that people who have a measure of faith often insist that they are not ‘religious'. LAPSED CHURCH MEMBERS People lapse away from church involvement for a variety of reasons. Sometimes there are unresolved issues they would love to discuss. Sometimes ill health and infirmity have played a part or family conflicts. Lapsed Roman Catholics have usually had a church upbringing. The same may apply to lapsed Anglicans and Free Church people and they may welcome contact with Chaplains. Confirmed Anglicans who have not received Holy Communion for years may consider returning to the sacraments whilst in hospital care. LEVELS OF BELONGING People's sense of belonging to church is complex. Examples are family, social, locality, through occasional offices, i.e. baptisms, weddings and funerals, or a matter of personal faith. All of these factors can be significant in pastoral care. PERSONAL BELIEF Personal belief derived from past Christian teaching can be very strong and significant. Many people believe in God, in the centrality of Jesus Christ, in the importance of personal prayer, in Christian morality and in the after-life. Often there is a deep sense that the crises of life need recognition and ritual. Requests sometimes seem ill defined and even confused but they should never be ignored. THE OPPORTUNITY TO TALK AND PRAY In our secular society it is often difficult for people to raise their religious and spiritual concerns and quite serious matters are sometimes outlined with humour or diffidence. Barriers often have to be overcome so that seemingly chance encounters with Chaplains can become really rewarding. It is natural that at difficult times in our lives, that we turn to our core beliefs or past teaching but reach a point when there needs to be growth of understanding and insight. Very frequently the chance of prayer with a Chaplain is greatly appreciated and can place in words matters that are too difficult to talk about directly in conversation. There are also real spiritual issues like lack of forgiveness, bitterness, reactive depression and grief that are signs that spiritual ministry is needed and would be valued.
Page B5 IMPORTANCE OF STAFF AWARENESS It can be seen from the above that nominal Christians make less specific demands on Chaplaincy when considered from a religious view point and that there is a danger of neglect. The key is good and caring observation by care staff that are ready to make contact with Chaplains as appropriate.
Page B6 NON-BELIEVERS
There will be patients who when asked about their religion choose to describe themselves under the categories which suggest a rejection of religious faith. They are as entitled to respect for their position as people of religious faith. In particular the more general spiritual care of such people should never be neglected because of any confusion between the word ‘religious' and the word ‘spiritual'. The terms chosen may include the following: Humanist, Atheist, and Agnostic. HUMANIST Humanists believe strongly in the individual's right to freedom of choice in the main decisions of life and death and this may have a bearing on discussions about a patient's prognosis. All people are equal regardless of sex, culture, age, race or sexuality and must endeavour to find solutions to problems within themselves. In the event of death, it is possible for arrangements to be made for a secular funeral. These are sometimes organised by the Humanist Association. No religious symbolism is acceptable in such circumstances. It would be wrong to assume that a humanist patient would reject a visit by the Chaplain if there were assurances that his/her position will always be respected. ATHEIST The term is used to describe someone who does not believe in God in any form. Choice of this word may indicate a well worked out and considered philosophical position and does not imply in itself antipathy to religion. It does suggest a rejection of any form of religious belief rather than a mere absence of religious practice but great care is needed to assess what the patient wishes to convey. This is relevant when spiritual care issues are at stake. AGNOSTIC This term means that the person lacks religious faith but is open to the possibility that religious faith is well founded. The person may consider that the grounds of faith are unconvincing rather than proven to be false. It may go hand in hand with a spiritual philosophy and even an interest in religious questions. GENERAL ISSUES AND CONCERNS The general principles of spiritual care apply just as much to these patients as to any other. At the same time it is crucial to respect the position they uphold. Sometimes, but not always, there are unresolved issues concerning past bad experiences and hurts with the consequent rejection of organised religion. A respectful and kindly approach by visiting Chaplains may be acceptable on occasions. Also one must bear in mind that a patient's family may not share the same position and that this can cause difficulties at times of stress and worry.
Page B7 PRIVACY The Trust's Spiritual Care Standards should ensure that secular patients are not troubled by unwelcome religious input, which is why generalised unauthorised visiting religious representatives and the distribution of literature are not allowed. Page B8 |
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JEWS
Judaism has been in existence for some five and half thousand years. It is based on the belief in one universal God. The love of God and the wish to carry out the Commandments given to Moses is embodied in the teaching of the Pentateuch, which is read every Sabbath in the synagogues throughout the country. The Jewish Sabbath begins at nightfall on Friday afternoon and ends with the first sighting of three stars on Saturday night. Orthodox Jews will not write, travel or work or cook on the Sabbath. It is a ‘day of rest' and there are synagogue services on Friday evenings and Saturday mornings. As well as the Orthodox, some Jewish people belong to Reformed and Liberal congregations whose rules of observance are somewhat less strict. Some Jews may be largely secularised but it will be necessary to ask questions about care based on these guidelines. DIET Many Jews will ask for kosher food. This means specially prepared meat but never pork or rabbit and only true fish with fins and scales. Meat and milk products should never be mixed. This level of dietary observance must be established. Jews who are observant will not take meat and milk at the same meal. A kosher household will keep meat and milk utensils rigidly separate. Sometimes a vegetarian diet would be preferred to the risk of non-kosher food but this can only be a compromise. FASTING There are several minor feasts in the calendar but the prominent feast is Yom Kippur, the Day of Atonement, and a 25-hour fast usually falling in late September/October. If health permits this will be observed. This is also a day for prayer and reflection. CARE OF THE DYING AND WHAT TO DO AFTER DEATH According to tradition a dying person should not be left alone and families may wish to sit with their relatives during the last hours or days. The patient may wish to hear or recite psalms and the Shema prayer. No mutation of the body after death is allowed unless there is a legal requirement for a post-mortem. The funeral should take place as soon as possible and will be a burial. Depending upon the sex of the deceased a male or female will prepare the body for burial with usually three members of the community present. The body is washed and shrouded before being placed into the coffin. Prayers are said. There is a family mourning period of seven days during which prayers are said and mourners visit the bereaved household. ABLUTIONS AND TOILET Jews are religiously enjoined to wash their hands and say a brief prayer before eating. Very Orthodox women prefer to keep their head covered. Page B9 ATTITUDES TOWARD MEDICAL STAFF AND ILLNESS The medical profession is treated with great respect. Close-knit family ties will encourage questioning by relatives. Ideas of modesty do not usually preclude medical examination by someone of the opposite sex. Page B10
MUSLIMS
The religion of the Muslims is known as ISLAM. Although the heartland of Islam is the Middle East many British Muslims come from families that have their origin in Pakistan, Bangladesh and India. There are some 200 million people who profess Islam with large numbers scattered from the Adriatic to Malaysia, Africa and South Africa. Muslims believe in One God and follow the revelation of His Prophet Muhammad who was born at Mecca in 570AD. The Holy Book is the Qur'an. The five pillars of Islam are: • Declaration of faith. • The mandatory five daily prayers facing Mecca. • The fast of Ramadan (ninth month of the Muslim calendar) during which Muslims do not eat or drink between dawn and dusk. • Almsgiving for the poor. • Pilgrimage to Mecca. DIET Halal is the food lawful to Muslims. Pork and Alcohol are forbidden. Dairy products are acceptable providing no non-halal animal product has been used. Ramadan fasting is necessary for all healthy Muslims whereas the ill might reduce the severity of their fast. For those fasting a meal is needed before dawn and another after sunset as well as a glass of water and a bowl to rinse their mouths before prayer. KEY ISSUES AND SPECIAL CONSIDERATIONS • Hands, feet and mouth are always washed before prayer. • Whole body is washed after menstruation. • Showers are preferred to baths. • Washing facilities after the use of a bedpan. • Observe strict personal modesty for both sexes. • Termination of pregnancy is not allowed. CARE FOR THE DYING AND AFTER DEATH Burial must proceed as soon as possible after death. Post-mortems are to be avoided unless law demands it. Organs should be buried with body. Next of kin will want to arrange for the washing of the body before burial. It is customary for people to express their emotions freely after a death. Wherever possible they should be given privacy to do this in ways compatible with not disturbing others. Patients may want to sit or lie facing Mecca. Friends and family may wish to sit with the patient reading the Qur'an and making supplication. Page B11 PROCEDURE AT DEATH DO NOT WASH THE BODY. Where no relatives are available staff should wear gloves to avoid direct contact. The body should face Mecca and the head turned towards the right shoulder before rigor mortis. The body can be made respectable in the usual way i.e. combing hair, straightening limbs but the family will wash the body before burial. BLOOD TRANSFUSIONS AND TRANSPLANTS In strictly orthodox terms they are only accepted with reluctance but the decision lies with the individual. ATTITUDES TO MEDICAL STAFF AND ILLNESS A Muslim believes that whatever happens can only happen with the consent of Allah and according to his judgement. In adversity and calamity a Muslim is forbidden to despair and is required to be patient seeking help through prayer and remembrance of Allah. IDEAS OF MODESTY In certain cases Muslim women may not wish to be examined by a male member of staff or not without a female present. Muslims should only be accommodated on mixed wards in emergency situations. An open minded and helpful attitude is needed and appreciated. Page B12 HINDUS
Hinduism is the ancient religious tradition of India. It has evolved over 5000 years of cultural development and embraces many diverse beliefs, values and customs. British Hindus may have family origins in Gujarat or in the Punjab or East Africa. One God is understood to be manifest in many images and incarnations. Hindus believe in the rebirth of the soul and in the principle of karma, the law that determines rebirth and deliverance. Married women and children may wear red markings on their foreheads. Married women may also wear nuptial threads/necklaces and male adults a ‘sacred thread'. Bangles may not be removed except on a husband's death. It is a bad omen to remove or break at other times. Hindu literature includes the Vedas, the Upanishads and the great epics. Particularly important is the Bhagavad Gita. Although discouraged in India the Caste system remains a powerful influence on social inter relationships particularly concerning marriage. DIET Hindus do not eat beef. Some will eat eggs. Dairy produce is acceptable so long as it is free from animal fat. Many are strict vegetarian. Meals must not be served from plates or utensils that have been in contact with meat. Tradition may explain a reluctance to eat certain foods at certain times e.g. it is considered unwise to take milk or citrus fruits when suffering from a cough. KEY ISSUES AND SPECIAL CONSIDERATIONS Female patients may prefer a female doctor and consideration should be given to modesty. There are no religious objections to blood transfusion or organ transplantation. Hindus are accustomed to having running water or a jug in the same room as the toilet and if a bedpan is used a bowl of water must be offered afterwards. CARE OF THE DYING AND WHAT TO DO AFTER DEATH Before death a Hindu desires to offer food and other articles of use to the needy, religious persons or to the Temple. Hindu patients may wish to die at home. Consult the family asking if they wish to perform the last rites as distress may be caused if non-Hindus touch the body. If no family is available the following procedure should be followed: • Wear disposable gloves, close the eyes, straighten the limbs • Jewellery, sacred threads and other religious objects must not be moved • Wrap the body in a plain sheet without a religious emblem. In most cases it should not be washed, as this is part of the funeral rites and will usually be carried out by relatives later with water from the temple. • Post-mortems are disliked but accepted if required by law. • A Hindu is cremated. • Coping with the unfamiliar organisation side of death in Britain can be extremely distressing to bereaved relatives and practical help may be needed to contact undertakers and deal with the paperwork. Page B13 FASTING Very few Hindus would insist on fasting when in hospital; they would even take hot milk, fruit, tea and salad without salt. At the end of each period of fasting visitors may bring in ‘Prasad' so that the patient can join in the celebration. This will be in the form of a small quantity of food, perhaps sweets which have been offered to God in thanksgiving and are now shared amongst those present. ATTUTUDES TO MEDICAL STAFF AND ILLNESS Generally speaking Hindu patients will accept the authority of the professional. They may favour home remedies for routine ailments and be slow to seek professional attention. IDEAS OF MODESTY As with all Asian patients Hindu women may prefer to be cared for and examined by females. An open minded and helpful approach can save patient embarrassment. Page B14
SIKHS
The Sikhs have their origin in the Punjab region of India though many came to Britain via East Africa. Sikhs believe in one God and in the cycle of the soul's rebirth. They respect the equality of all people regardless of caste, colour, creed or sex. Spiritual salvation is obtained by taming the ego through devotion and service. Prayers are offered five times daily. To indicate equality all men are given the name Singh (Lion) and all women the name Kaur (Princess). There are ten revered Gurus. The sacred book is known as the Granth. The place of congregational worship is called the Gurdwara. TURBANS AND THE FIVE K'S These are the five marks of the male Sikh: • KESH - long hair kept under a turban. • KANGHA - small comb worn in the hair. • KARA - steel bracelet worn on the right wrist. • KACHHA - special type of underwear. • KIRPAN - sword worn symbolically. KEY ISSUES AND SPECIAL CONSIDERATIONS • Female patients prefer female doctors. • The 5 K's should not be disturbed unless really necessary and then careful explanation must be given. • Most Sikhs are accustomed to having water in the same room as the toilet, therefore a bowl of water should always be provided when a bedpan has been used. DIET Sikhs are lacto vegetarians. Beef and pork are not normally eaten. Some will accept fish, meat or eggs. FASTING Some Sikhs may wish to fast when there is a full moon but this is not universal. CARE OF THE DYING AND WHAT TO DO AFTER DEATH The family will normally be present and say prayers. At death normal procedures may be followed but do not remove the 5 K's. Sikhs do not like post-mortems but will accept legal necessity. The body should be released as soon as possible. Sikhs are cremated. The body is washed and white clothes put on before cremation.
Page B15 ABLUTIONS AND TOILET Showers are preferred to baths. Washing hands and mouths is customary before meals. IDEAS OF MODESTY Women prefer to be examined by a female doctor. Mixed wards should be avoided wherever possible. Care should be taken to avoid embarrassment. Page B16 |
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ZOROASTRIANS/PARSEES
Zoroastrianism is the religion of Zoroaster the Prophet of ancient Iran. There is a conscious effort on the part of man to use free will to choose good against evil within a happy joyful life and so to obtain salvation in heaven. Many Zoroastrians are Parsis whose homeland is around Bombay and Gujarat. Children are initiated into the faith between the ages of 7 and 15 years. On the initiation day they are given sacred sudreh (shirt) and kushti (girdle). These garments are treated with great respect. Parsis unwind and redo the kushti twice a day when prayers are said. SPECIAL CONSIDERATIONS • Hygiene is of great importance. Running water or freshly drawn water would be appreciated. • Daily prayers are essential. The sacred girdle is tied and untied during the prayers and sick patients may need help with this. • Zoroastrians are unlikely to accept blood transfusions. DIET No general restrictions but some will prefer a vegetarian diet. CARE OF THE DYING AND WHAT TO DO AFTER DEATH The body must be bathed before being dressed in white clothing. Most families provide a special sudreh to be worn under the shroud with the kushti. The family may wish the head to be covered with a cap or scarf. If there is no available family another Zoroastrian should be asked to attend. Prayers should start after death. Cremation or burial is acceptable. The full three names of the deceased must be used in the prayers. Zoroastrians would by tradition reject transplants and would dislike post-mortems unless unavoidable. PRONESS TO SPECIFIC ILLNESSES Because of the smallness of the community and marriage choice restrictions there is some proness to hereditary illness e.g. Rhesus negative blood group, G6 PD a blood condition for which Aspirin is contraindicated, diabetes, cancer and coronary problems. ATTITUDES TO MEDICAL STAFF AND ILLNESS Parsis have had to be westernised in their outlook since their small numbers could not sustain a totally separate way of life in the countries in which they have settled. However questions of medical procedure should be discussed. Page B17
BAHA' I
The Baha'i Faith began in Persia in the middle of the last century and has spread throughout the world. The teachings of the founder, Baha'u'llah centre on the unity of mankind and of religions, and include the harmony of religion and science, the equality of men and women and the abolition of prejudice. There are some 200 Spiritual assemblies in this country. Although some Baha'i people are of Persian origin the majority will be of British origin. There is a respect for modern medicine. They recite a prayer each day and read from their scriptures twice a day. KEY ISSUES AND SPECIAL CONSIDERATIONS There is a dawn to dusk fast each year from 2 to 21 March but invalids are not expected to observe this. There is opposition to alcohol and drugs but drugs will be taken if medically necessary. Apart from the prohibition on the use of alcohol there are no dietary rules. CARE OF THE DYING AND WHAT TO DO AFTER DEATH There are no objections to transfusions or organ transplants. The body must be treated with respect after death. Burial should take place as close as possible to the place of death. No objection to post-mortems if legally necessary. Relatives will wish to say prayers for the dead. ATTITUDES TOWARDS MEDICAL STAFF There is a great respect for medicine and also for power of prayer in healing. Page B18
JAINS
Non UK Jains originate in the Gujarat area of India but some have lived in East Africa. They follow the teachings of Mahavira. SPECIAL CONSIDERATIONS Occasionally Jains voluntarily undertake to take only one meal a day or fasting from sunrise to sunset either for a day or a week. They will avoid destroying any form of animal life including insects. Their diet must be very strictly vegetarian. Milk, curds and ghee (clarified butter) are allowed. Useful address: Vanik Sanak of the UK 92 Osbourne Road Page B19
BUDDHIST
Buddhism is the way of life and thought based upon the teachings of the Buddha who lived in India in the 5/6 th century BC. He is revered not as a God but as a founder of a way of life. There are some 311 million Buddhists throughout the world. They seek to emulate the example of perfect morality, wisdom and compassion of Buddha culminating in the transformation of consciousness known as enlightenment or nirvana. The Buddhist way of life involves moral rules, the keeping of festivals, pilgrimage and social responsibility. There are a number of traditions within Buddhism and many cultural variations. Many people born into Buddhist communities are from Asian countries e.g. Sri Lanka, Thailand, Korea, Japan and Tibet etc. There are also many Western Buddhists who have adopted Buddhism as a way of life but who do not necessarily share Asian cultural traditions. KEY ISSUES AND SPECIAL CONSIDERATIONS Peace and quiet for meditation and chanting would be appreciated and visits from other Buddhists. There is no essential conflict with modern medicine but the understood relationship between body and mind leads to an affinity for psychosomatic medicine. There may be a need for water for cleansing before meditation. Images of the Buddha or religious literature should be treated with great respect. DIET Most Buddhists will be strict vegetarian and some western Buddhists may be vegan. CARE OF THE DYING AND WHAT TO DO AFTER DEATH A side room would be appreciated wherever possible. Buddhists appreciate full information about the prognosis to enable them to make their own preparation. Dying is considered to be a very important part of life and should be approached positively and in a clear and conscious state of mind as possible. This might influence the use of drugs. There are no particular rituals after death. There may be a request for other Buddhists to be present. Concerning the care of the body after death, it is best to consult the family if the patient is an Asian Buddhist. Post-mortems may be acceptable but checks need to be made with people of far Eastern origin. Page B20 CULTURAL CONSIDERATIONSThe Patients Charter and our Trust's own Spiritual Care Standards bid us to be as caring and sensitive in our respect for culture as for religion. Culture is complex. A country has its culture but within that culture there are variations within age groups, social classes and geographical regions and between people of different ethnic origins. Religion and culture are often intermingled. For example, a middle-aged couple born in say Pakistan will be Muslim in religion and perhaps Punjabi in culture. Yet their British born children will be less influenced by their parent's culture yet remain believing Muslims. In this section we will give some guidelines on certain cultures which are not always to be associated with the practice of any one religion. CARIBBEAN COMMUNITYThere are many island countries in the Caribbean. The people who have settled here are mainly from English speaking islands with a minority from French speaking islands. Nearly all are from islands that used to be British. Many people are able to speak a local patois of English or French as well as the more standard form of those languages. The culture is a Christian one so there are people who are Anglican, Roman Catholic, Methodist, Baptist and Pentecostal. Today we frequently hear the term Afro-Caribbean. The majority of people from the West Indies and their descendents are themselves descended from African slaves but many have European blood and possibly also Indian or Chinese blood. In many traditional families their grandparents raised children but such families have been weakened by immigration or more typically British family patterns have emerged. Hospital diets may seem bland to older people. Visitors to the sick are most important and religious ministrations. When there has been a death people might want to be ‘more' involved in preparations for burial than is typical today amongst English people. Funerals are usually burials and are very well attended. There is no objection to blood transfusions unless the people are Jehovah's Witnesses or Rastafarian. THE CHINESEChinese people in Britain if not born here are likely to be from Hong Kong and to be of Cantonese origin. Some may have come from communities in Malaysia, Singapore or mainland China. The Chinese have a very rich, ancient and complex religious tradition influenced by Confucianist, Taoist and Buddhist teachings. Among older people these traditions are very strong. Westernisation and secularisation may have weakened these traditions among the young depending upon the family origins. Some young Chinese are Christian, bound together by Fellowships that worship in Chinese. DIET There are very definite rules about the preparation and eating of food. The older generation regard rice as the only staple food and soup is usual for sick people. Page B21
CARE FOR THE DYING AND WHAT TO DO AFTER DEATH Funeral and mourning customs vary very widely making it difficult to generalise. Position and wealth are factors in the custom of rites. On the death of a child or infant, burial takes place with little ceremony. As for adults the body is bathed. The custom was and sometimes still is for the body to be clothed in white or traditional Chinese clothing. Relatives may wish to see the body before the coffin lid is closed. VIETNAMESEAbout half of our Vietnamese population are ethnic Chinese. The country has Buddhist, Taoist and Confucianist religious influences often intermingled. A minority are Christian. DIET For ethnic Chinese see the notes on the Chinese. Ethnic Vietnamese are not subject to religious taboo but lamb is almost unknown. There is not much use of milk or dairy products. CARE OF THE DYING AND WHAT TO DO AFTER DEATH By tradition the body is laid out for viewing for 1-3 days after death before the funeral. Ritual food is offered to the soul of the deceased and relatives pay respects. TREATMENT There may be a dislike of giving blood samples. There is a respect for Western medicine dating from French colonisation but ethnic Chinese may honour traditional Chinese remedies. Modesty is important to Chinese and Vietnamese women who may prefer a woman doctor. ROMANY ORIGINSWhilst not all Travellers are of Romany origin many are and may still speak Romanes. They often have no regular contact with GPs and may need help with reading. There are no particular dietary considerations and most are Christians. KEY ISSUES Utensils for washing clothes, food and one's self must be separate. It is mochardi (unclean) to do otherwise. Romany people do not like undressing in front of others and prefer to keep legs and feet covered. Older Romany people do not wash their hair but use oils and bacon fat was once used as a moisturiser. Page B22
CARE OF THE DYING When someone is dying there will be a great many visitors. After death the body will be clothed according to the family's wishes. Family and friends may place the body in the coffin with treasured possessions. The body may be taken home to allow a vigil. There are no particular objections to blood transfusions or organ donation. SOUTH ASIANSINDIA, PAKISTAN AND BANGLADESH • Asians will need water for washing in the same room as the toilet so after the use of a bedpan water should be on hand. There is a preference for running water for ablutions • Asian women should only be accommodated in mixed sex wards if unavoidable. Modesty is very important and a female doctor might sometimes be appreciated to save embarrassment. • The almost universal practice of addressing people by their first names can be confusing for Asian people. It is best to ask people for their family name and the most used personal name. LANGUAGESThese are some of the most relevant spoken languages. Chinese - Cantonese or Hakka Bangladeshis - Bengali, Hindi or Urdu Pakistanis - Urdu or Punjabi Sikhs and Punjabi Hindus - Punjabi or Hindi Gujarati Indians - Gujarati or Hindi Other North Indians - Most speak some Hindi Other South Indians - Most speak some English NATIONALITY AND MOST LIKELY RELIGIONPolish - Roman Catholic Ukranian - Orthodox or Uniate Catholic Hungarian - Roman Catholic or Protestant Romanian - Orthodox or Protestant Greek - Orthodox Turkish - Muslim Egyptian - Muslim or Coptic Christian Russian - Orthodox Indian - Hindi, Sikh, Muslim Page B23 Pakistani - Muslim Bangladeshi - Muslim Caribbean - Protestant or Catholic Sub Saharian Africa - Christian or Muslim North Africa - Mainly Muslim Malaysia - Muslim or Christian Indonesia - Muslim or Christian Ethiopia - Orthodox Middle East - Muslim or Christian NB All countries have their minorities. ASIAN NAME EXAMPLES
MUSLIM (Male) RELIGIOUS PERSONAL FAMILY/CLAN Mohammed Soleiman Khan MUSLIM (Female) PERSONAL COMPLIMENTARY Amina Begum Razia Bibi HINDU (Male) PERSONAL COMPLIMENTARY FAMILY Arima Pani Chupra Raj Kumar Sharma HINDU (Female) PERSONAL COMPLIMENTARY Bimla Behn Kamla Kumari SIKH (Male) PERSONAL MIDDLE FAMILY Ajit Singh Dhaliwal SIKH (Female) PERSONAL MIDDLE FAMILY Amarjit Kaur Sandhu Page B24
MINORITY FAITH GROUPSThis section does not imply that the faith groups described merit less respect than those listed under Major Faiths. They are included to indicate care issues relating to the religious beliefs of our patients. CHRISTIAN SCIENTISTSThe Church of Christian Scientist was founded on the teachings of Mary Baker Eddy in 1879. Its aims are to restore the healing ministry of Christ and the early Church. It is best known for its reliance on prayer alone for the healing of sickness and disease. Its members act freely and are not controlled by the church. They may avoid hospital treatment accepting nursing home care run by their fellow members but they may accept the wishes of families that they undergo conventional hospital treatment. KEY CONSIDERATIONS If the person is in hospital voluntarily he/she is likely to accept minimal medical treatment. They may ask for drug therapy to be kept to a minimum. They may ask for a Christian Science practitioner. They would appreciate privacy for prayer and bible reading. DIET The only prohibitions are on alcohol and tobacco. CARE OF THE DYING Worship is ritual free with no last rites. Post mortems are not usually acceptable. Routine last offices are acceptable. A female member of staff should care for a female body. Cremation is usually preferred. Transfusions may be acceptable but organ donation is not.
JEHOVAH'S WITNESSJehovah's Witnesses believe in one God and in Jesus as God's son though not in the Incarnation as mainstream Christians believe. They await the end of the present world system, which will begin with the Battle of Armageddon after which only Jehovah's Witnesses will survive. No festivals are celebrated except the annual memorial of the death of Christ according to their own date. KEY ISSUES They have a sincere belief that taking another's blood into the body is wrong though medical treatment is a matter of informed consent for the individual. They will be pleased to discuss alternatives to blood transfusions. There is no other objection to modern medical practice. DIET All food containing blood is rejected as is alcohol and tobacco. Page B25
CARE OF THE DYING There are no particular rites but a visit by an elder is appreciated. Against euthanasia, life should not be prolonged artificially. The dead body has no particular significance after the breath has gone. Burial or cremation is acceptable. MORMONSThe Church of Later Day Saints arose in America in the 19 th Century and has adherents all over the world. They believe that God, Jesus Christ and the Holy Spirit are separate personages though united in purpose. Revelation is continuous. The Second Coming is awaited. There is a strong tradition of self-sufficiency upholding law and serving the community. DIET Mormons believe in taking care of the body. Meat is eaten sparingly. Mormons drink neither tea nor coffee. Milk and fruit juice are acceptable. Alcohol and tobacco are forbidden. Some Mormons who have undergone a special Temple ceremony wear a sacred undergarment to be worn at all times, in life and death. CARE OF THE DYING Death is inevitable and is a blessing. There are no rituals but spiritual contact is important and archive church members will know how to contact their Bishop. The church has home teachers who assist caring by offering home support and by visiting at home or in hospital. Routine last offices are appropriate, the sacred garment being replaced. There is no objection to post-mortems as such. Burial is preferred. The church encourages blood donation. QUAKERSMembers of the Society of Friends believe that all life is sacred and the experience of God is available to everyone. Their emphasis is on way of life rather than a set of doctrines. Worship involves silence and waiting on the Spirit's inspiration for speech, prayer or reading. Other Friends may visit Quaker patients. DIET No special requirements. Some may be vegetarian or vegan. CARE OF THE DYING There are no special rituals. A visit from an Elder may be appreciated and there will be support from the community. There are no objections to transplants or transfusions.
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SEVENTH DAY ADVENTISTSIn this tradition the Jewish Sabbath is observed as distinct from the Lord's Day of Sunday. This means that the Sabbath rest begins with sunset on Friday evenings. DIET Some Adventists are vegetarian. The Church accepts the Levitical Food Code so that pork and shellfish are unacceptable as in the Jewish faith. CARE OF THE DYING Whilst there are no special rituals, a visit from the Pastor would be welcome. Burial is usually preferred. Many Adventists but by no means all are of West Indian origin in the UK. SPIRITUALISTSThe Spiritualist Church has a developed philosophy concerning the after life believing strongly that communication is possible between this world and the next. Its approach to these matters is not acceptable to most mainstream Christians. KEY CONSIDERATIONS There may be a request for a Healer to visit for treatment whilst accepting conventional treatment. DIET No special requirements. CARE OF THE DYING The state of mind and readiness to ‘go' is crucial. They believe that those present in the spirit world will come to welcome them. Routine last offices are appropriate. There are no objections to transfusions or organ donation. PLYMOUTH BRETHRENJ. N. Darby at Plymouth founded the first centre of the Brethren in England in 1830. They belong to a strictly biblical Protestant tradition and there are differences between Open and Exclusive traditions. KEY CONSIDERATIONS Some Brethren eat and drink only with fellow believers. Women do not cut their hair or appear bare headed in a public place, which could include a hospital ward. Men keep their hair short and are clean-shaven. Brethren have little contact with the media such as television and radio. Page B27
DIET No special considerations. CARE OF THE DYING Next of kin must be informed to facilitate visiting. A 24-hour vigil may be kept before death. After death the family would like complete control over what happens to the body and would like to attend the washing and last offices themselves. Families should be consulted before anything is done. There should be no unnecessary interference with the body unless demanded by the Coroner. Brethren are unlikely to give permission for transplants or organ donation. RASTAFARIANISMThis movement arose in the 1930s in Jamaica and Dominica among descendents of African slaves. Identification with Africa and resistance to slavery characterise this tradition of black self-respect and faith. Ras Tafari was the Emperor Haile Selassie 1, considered as a divine deliverer. The Old and New Testaments are revered as Scriptures and there is a love of God and there is a departure from Christianity. There are no services, clergy or churches. KEY CONSIDERATIONS Dreadlocks are a symbol of faith and pride. Hair should not be cut. Women have high standards of modesty. Second hand clothing must not be worn including hospital garments. Some may prefer traditional remedies to conventional treatment. Group visits are important. The body must not be contaminated. There could be difficulties concerning transplants and organ donations. No specific objection to blood transfusions. CARE OF THE DYING Group prayer at the bedside could well be important. There are no rites but a leader may be asked to come to help the sick person. Burial is often preferred to cremation. NEW AGE AND PAGAN MOVEMENTSThe term ‘New Age' is impossible to define but the movement reflects search for Spirituality amongst people who belong to no clear religious tradition. This may be associated with a rejection of what is understood by religious tradition but not inevitably so. ‘New Age' spiritualities may be characterised thus: • An appreciation of the interplay of body, mind and spirit with healing seen as holistic. • An interest in many forms of alternative or complementary therapies. • A readiness to study religious and spiritual traditions for e.g. Asian and Oriental teachings, Pagan traditions. • A reverence for the creation and a care for balance and conservation. Page B28
Those who describe themselves as Pagan belong to a movement, which attempts to revive what are held to be native pre-Christian beliefs and practices. There is sometimes antipathy toward Christianity and some Christians feel that Paganism is harmful. However, Christians and Pagans are often ignorant of each other's beliefs and misunderstandings arise. The main spiritual branches of revived Western Paganism are: • The Northern tradition and Odinism (Asartu) • The Wiccan religion • Druidic (Celtic) • Goddess orientated (Isian or Women's tradition) There is a belief in the immanence of God. The divine is often conceived in terms of a male and a female deity. Often there is belief in reincarnation. KEY CONSIDERATIONS Many are vegetarian. Some will however eat fish. Peace and quiet for meditation would be appreciated. Holistic and complementary therapies are appreciated alongside conventional medicine. CARE OF THE DYING Terminally ill people may prefer to die at home supported by their own support networks and Chaplaincy. After death symbolic jewellery should be left on the body and if present ornate staffs should be kept near the body. The Pagan Federation, BM Box 7097, London WC1N 3XX The Pagan Funeral and Hospice Trust, BM Box 3337, London WC1N 3XX It must not be assumed that all those whose personal spiritual beliefs reflect New Age and/or Pagan traditions, are a part of any movement or organisation; Christians are also exploring Creationist and Celtic traditions. Many of no particular faith are searching and reflecting and this should be respected.
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TRANSLATION
The following pages give details of translation services for foreign languages and British Sign Language. The National Interpreting Service is concerned with document translation. For face to face translation use a local service like the Sheffield Community Access & Interpreting Service (SCAIS), your own local list of professional authorised interpreters as used in the past or contact the county Police service or consult with your local general hospital Trust. CHAPLAIN'S NOTE ON LANGUAGES AND LANGUAGE
Older people of Indian, Pakistani or Chinese origin may have little or no English. People of Indian origin may understand Hindi but their first language is likely to be Punjabi or Gujarati. People of Pakistani origin may understand Urdu (closely related to Hindu) but their first language may well be Punjabi. Older Chinese people are unlikely to be familiar with Mandarin Chinese and more often speak Cantonese. Take care not to confuse West Indian dialect with a foreign language. People from certain West Indian Islands also speak French. Remember that people may revert to their first language at times of stress, physical weakness or following strokes. This does not necessarily mean that they cannot comprehend English. It is also worth remembering that people from other parts of Britain or people whose second language is English may sometimes have difficulty in understanding rapid local speech or dialect forms in your own speech of which you are unaware. NATIONAL INTERPRETING SERVICE
When the operator ask you “What organisation are you calling from?” – give the name of the Trust followed by the area, eg Doncaster, North Lincs, North East Lincs. Your ID Numbers are as follows:- Doncaster 269038 North Lincs 269039 North East Lincs 269040 Page B30 |
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Page last updated:
7 July, 2006
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