Faith Diversities in Health Care
Nathalie Conti
HLT310V – Foundations of Spirituality in Health Care
Grand Canyon University
February 27th, 2011
Abstract
This paper is an introduction to concepts of cultural and religious tolerance in the western health care field with an emphasis on the holistic approach, incorporating mind, body and spirituality. It uses Christianity as a baseline for cultural and spiritual comparison and contrasts against Buddhism, Hinduism and Judaism. Healthcare environment, personal boundaries, meditation and death are each discussed briefly in context of cultural and religious perspectives. For Buddhism, concepts of clarity, balance and meditation as well as sickness as inertia of the mind and pain as a misconception are discussed. For Hinduism, concepts of Karma, cleanliness, right-left hand significance, and privacy boundaries are discussed. Death, reincarnation and the resultant dietary implications are touched upon for both the former. For Judaism, privacy, Sabbath and religious observations, religion’s impact on diet and observances of death are discussed. In conclusion, it is seen that special care must be taken to avoid gross cultural faux pas, the obvious result of cultural and religious ignorance. For complete restoration of the whole, respect of a person’s beliefs and dignity must be observed by the health care worker; else the resulting spiritual imbalance will be detrimental to their healing process.
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Faith Diversities in Health Care
Health care professionals, including nurses, are required to interact with people from a plethora of religious and cultural backgrounds. Most believe that patients should be addressed in a holistic manner – mind, body and spirit – and that full health can only be restored when spiritual well-being is taken into consideration. Although it is easier to understand individuals who share a common religious belief, it is necessary to overcome such cultural barriers and that nurses demonstrate acceptance of the patient’s beliefs. Moreover, training in cultural diversity is critical for nurses as most cultural belief systems are propagated through religious values. By being accommodating of these differences, a greater efficiency in the delivery of health services may be achieved (Numrich, 2003).
Understanding this diversity may help in bridging the gap that exists between religious beliefs and standard practices in the health care industry (Sutherland, 2011).
Comparison of Different Belief Systems
While nurses cannot answer every patient’s question, they must be committed to the exploration for answers (MacLaren, 2003).
Although this assertion is rather neutral and may be applied in diverse religious or spiritual frameworks, it is assumed that spiritual answers are beneficial. In order to understand differences between belief systems, this paper compares three people, each of different faiths, with the traditional Christian faith in respect to medical care. Buddhism, Hinduism, and Judaism philosophies were studied through patient interviews, resulting in the Appendix. Their names were altered for privacy purposes.
The Christian Perspective
From the research undertaken on Christian beliefs with regard to health care it is seen that Christians are quite comfortable with the way medical staff handle their needs. Generally, interventions do not conflict with their spiritual beliefs or their right to make decisions about their health care or for that matter any other aspect of their daily life. However, it should be noted that most western hospitals are based on Christian traditions. Here, Christians rarely come into contact with health care providers who profess a difference of belief. Nevertheless, Christians believe in the eternal life and view death as a rewarding transition into a new existence with God (O’Brien, 2003, p. 274), insisting on spiritual healing where the sick receive prayers on their behalf from religious leaders and receive healing by the hand of God. If healing fails, they accept it as being God’s will.
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According to Alberta Health Services (AHS), Christians attend medical facilities voluntarily, without objection to conventional medical treatment (AHS, 2009).
In the acute care setting, issues arise concerning diagnosis and medical treatments (i.e., blood transfusions, organ removal or donations, withdraw of life support, etc), requiring the involvement of the patient and family members (AHS, 2009).
Moreover, among Christians there is no specific end-of-life rites as they hold on to faith and hope to the last minute. It is vital that the health care provider discuss with patients such issues as whether they want a chaplain to visit and that they abide by their wishes if they decline some aspects of hospital care. Obviously, it is important for the caregivers to uphold Christian values when serving clients of the Christian faith (AHS, 2009).
The Buddhism Perspective
The interviewed Buddhist, Gomin, has a very different perspective from that of Christians as he does not believe in spiritual or faith-based healing but rather embraces spiritual balance to assist him through illnesses. He believes that sickness is a flaw or inertia of the mind and that pain is generated by misconceptions, and that ultimately people get disappointed about their lives (Gomin, person communication, February 22, 2011).
Thus, it is peculiar to Buddhists to demand a peaceful, quiet environment whenever they are hospitalized. This allows for their meditation and assists in providing the clarity to unite mind and body. For example, the bright lights and constant monitoring experienced in a hospital’s critical care setting are viewed as interference and would be detrimental to the Buddhists’ healing process (AHS, 2009).
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Nurses should respect and strive to meet this need as it will enhance the patient’s comfort, hence promote their presence of mind and the healing process. In addition, they should always consult patients and families before using analgesic substances during treatment, since they tend to alter consciousness, contrary to the Buddhists’ respect of the significance of mental awareness (Ehman, 2007).
Gomin also believes that death is a transition point to the next life and that dying in a good state of mind allows an individual to have a favorable reincarnation; thus for Buddhists autopsies are not usually viewed as valuable while those of other faiths often feel differently (Gomin, person communication, February 22, 2011).
In death, the body should be allowed to remain undisturbed until spiritual guidance can be given by the proper authority; afterwards, the human remains are usually cremated (O’Brien, 2003, p. 277).
A service is generally held as soon as possible after death and may be repeated 49 years later (AHS, 2009).
When being tended to by health care providers whose faith defer from that of the Buddhists, they insist on diets which conform to their religious restrictions. The diet is important as meat and meat derived products are prohibited due to the excruciation subjected to animals. It is also likely that an animal is the reincarnation of a once human being (Wilkins, Mailoo & Kularatne, 2010).
Additionally, sleeping too much may affect one’s mind negatively. Regular meditation and prayers, with the use of a Buddha statue, are an important part of Buddhism. Meditation is often used to treat pain (Grant, 2009) and depression. Methods for preventing illness include the performance of meditation and the use of herbs, such as rhodiola (improve the mood and alleviating depression) and hippophae (acts as antioxidant and can be used to treat wounds or frost bite).
The Hinduism Perspective
Again, the interviewed Hindu, Salma, has a very different perspective from that of the Christians when it comes to medical care. While it is viewed as an “eternal religion” by the believers – founded by deity – Christianity is organized by Jesus-Christ, the son of God (Hinduwebsite, 2000).
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Like Buddhists, Hindus utilize meditation and prayer to cope with pain and suffering and overcome illness (Hinduwebsite, 2000).
Salma attributes sickness to the law of karma, which states that one’s own health or illness is caused by one’s own actions; thus the need to do favorable karma to relief any unpleasant health situation (Salma, personal communication, February 21, 2011).
For example, a person with a lot of anger or greed should use the reflection of imperfection or become thoughtful of the meaning of charity and meditate to experience a decrease in anger and desire. If one applies these principles of Hinduism medicine to feed the mind and restore the body, charity will emerge from greed; altruism will emerge from anger, and consequently health will emerge from sickness. Methods of health restoration include being strict vegetarians and preparing foods without using animal products. Like Buddhists, Salma believes that a human body can be reincarnated as another being and therefore animal meats should be avoided. More importantly, caregivers serving Hindus should be aware of the importance of fasting and therefore discuss with the family the implications of such a practice during hospitalization on the health of the patient (AHS, 2009).
During the interview, Salma mentioned the significance of the right and the left hand if the treatment prohibits arm usage (Salma, personal communication, February 21, 2011).
This is because Hindus use the right hand for clean purposes, such as eating, and the left one for unclean purposes, such as toilet, thus the family should assist the health care providers in exploring options (Ehman, 2007).
When it comes to washing, Hindus must use clean running water and it is imperative that the caregiver meet this need. Moreover, those who profess Hinduism require that their caregiver recognize the cultural and religious significance of the jewels they adorn by consulting with the family or the patient before removing them. When asked the significance of the red dot on Salma’s forehead, she stated that it is called the “Bindi” – a symbol of intellect and respect – however she only wears it for good-looks. She further stated that caregivers should be extremely careful if removal is necessary (Salma, personal communication, February 21, 2011).
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Unlike Christians, but with similarities to Buddhists, Hindus view death as a transition and it is accompanied by religious rituals. Because of this, Hindus desire that death occurs at home rather than in a hospital setting to facilitate their rituals. One such ritual involves tying a string around the actively dying person’s neck (or wrist) and keeping it on (O’Brien, 2003, p. 276).
Following the death, the deceased body is often washed by family members of the same gender (AHS, 2009).
Therefore, it is important that the caregiver assist the family by arranging for the discharge of the dying patient to allow for the religious rituals. The ideal approach to handle terminal illness is to allow nature to follow its course – each individual’s life is hallowed and must carry out its fate – although there is no contraindication to artificial life-support systems (AHS, 2009).
The Jewish Perspective
Unlike Buddhism and Hinduism, the Jewish faith has some similarities with the Christian’s perspective on health care. The interviewee, Adam, stated that Jews require that the individual be consulted before the health care team makes decisions regarding withdrawal of life support as end-of-life care has religious significance (Adam, personal communication, February 24, 2011).
Moreover, in drawing treatment plans, caregivers should engage patients or families if such procedures fall on Sabbath or during religious holidays such as the Passover (Adam, personal communication, February 24, 2011).
Due to the value attached to human life, Jewish faith makes some exceptions where treatment procedures can be undertaken during Sabbath to save life (AHS, 2009).
The health care provider in a geographical area where people follow Jewish faith should ensure that kosher diets are provided. The dietitian should also be aware and make provisions for the dietary changes that accompany Jewish holidays. For example, no bread products may be consumed during Passover but special “matzah” may be used instead (Adam, personal communication, 2011).
In the event of death, no organs should be removed for donation from the body. Similarly, autopsy should not be performed on the body without consultations with the family members. In addition, the health care provider should be aware of the fact that according to Jewish tradition, human remains must be buried within 24-48 hours after death, together with any amputated limbs; arrangement should be made to avail these customs (AHS, 2009).
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Like Hindus and Buddhists, Jews emphasize accompanying the body to the morgue and engage in religious rites, such as saying of prayers and reading of Psalms. Also, like with the Hindu’s jewelry, Jewish faith demands that the patient or family be consulted if the skullcap is to be removed (Ehman, 2007).
Similarly, Jews, like the Buddhists and the Hindus, have modesty concerns when the patient is to be treated by a person of the opposite sex. For instance, Jewish men are not for any reason supposed to touch any other woman apart from their wives. As such this may require that a male Jewish patient be assigned a male caregiver (Sutherland, 2011).
Summary
Specific spiritual practices were discovered from interviewing the Jewish, Buddhist, and Hindu patients concerning their religious perspectives on healthcare. They all differ from each others as well as with that of the Christian faith but also exhibit some commonalities. First, it was noted that Buddhists and Hindus have similar expectations on the healthcare providers when it comes to death. Both religions expect them to be aware of their perception on death as a transition period, accompanied by specific end-of-life rituals. Second, it is important to consult the patient and families in order to enable the medical staff to identify particular cultural traditions that should be observed during the patient’s stay in the hospital. Third, each perspective has specific spiritual traditions that are important to the person as whole, allowing treatment continuity. Forth, there is uniformity in regards to balance of self personality, the need to pray and meditate, and great respect of oneself and surroundings, which are in agreement with Christian faith even though Christian belief is fundamentally very different; Christians believe in one God and his only begotten son Jesus-Christ (1 Corinthians 8:6 New International Version) versus a higher being in the other three belief systems. Lastly, the interview demonstrated the importance of understanding various religious standards that prevail in the community within which the health provider operates.
Conclusion
Being a caregiver of patients in multi-cultural, multi-faith communities can be very challenging but not unfeasible. Remembering that the patients and families’ decisions are influenced by their cultural background, faith, and personal experiences can assist in their journey to physical and spiritual healing. These interviews have demonstrated that nurses, by keeping an open mind and promoting a peaceful atmosphere while respecting diversities in faith, should encourage patients’ spiritual healing, no matter what their beliefs. This can be done by being more aware of our own spirituality, including our fears and limitations, cultivating open patient-nurse communication, realizing that empathy can open the gate to another individual’s life – for better or worse – and bringing hope to patients and their families.
References
Alberta Health Services. (2009).
Health care and religious beliefs. Retrieved February 21, 2011 from www.calgaryhealthregion.ca/scs/CHR%20Multi%20Faith%20Book.pdf
Ehman, J. (2007).
Religious diversity: practical points for health care providers. Retrieved February 21, 2011 from www.uphs.upenn.edu/pastoral/resed/Diversity_Guide.pdf
Grant, J. A. (2009, January).
Pain sensitivity and analgesic effects of mindful states of Zen meditators: a cross-sectional study. Psychosomatic Medicine, 71 (1), 106-114. Retrieved February 24, 2011 from www.ncbi.nlm.nih.gov/pubmed/19073756
Hinduwebsite. (2000).
Hinduism and christianity. Retrieved February 24, 2011 from www.hinduwebsite.com/hinduism/h_christianity.asp
MacLaren, J. (2003, March).
Issues and innovations in nursing practice: a kaleidoscope of understandings: spiritual nursing in a multi-faith society. Journal of Advanced Nursing, 45 (5), 457-462. Retrieved February 24, 2011 from http://library.gcu.edu:2048/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=12284646&loginpage=Login.asp&site-ehost-live&scope=site
Numrich, P. D. (2003).
From diversity to pluralism. Retrieved February 21, 2011 from www.parkridgecenter.org/Page1546.html
O’Brien, M. E. (2003).
Spirituality in nursing: standing on holy ground (2 ed.).
Sudbury, MA: Jones and Bartlett Publishers, Inc.
Sutherland, S. (2011).
How to teach nursing students cultural diversity in health care. Retrieved February 21, 2011 from http://connected.waldenu.edu/curriculum-resources/teaching-methods/item/1532-how-to-teach-nursing-students-cultural-diversity-health-care
Wilkins, A., Mailoo, V. J., & Kularatne, U. (2010, June).
Care of the older person: a Buddhist perspective. Nursing & Residential Care, 12, 295-297. Retrieved on February 23, 2011 from http://content.ebscohost.com.library.gcu.edu:2048/pdf23_24/pdf/2010/Z11/01Jun10/51130054.pdf?T=P&P=AN&K=2010679986&S=R&D=rzh&EbscoContent=dGJyMNHX8kSep7U4yOvqOLCmr0iep7dSr6y4SLWWxWXS&ContentCustomer=dGJyMPGusUuxp7dOuePfgeyx44Dt6fIA
Appendix
Interview questions
1) What is your spiritual perspective on healing?
– Buddhist: the sick can achieve healing and relieve by attaining spiritual balance. Spiritual balance is achieved through meditation.
– Hindu: we don’t believe in spiritual healing. Diseases are caused by ones past mistakes and are a punishment for your actions. We believe in the law of karma: “you reap what you sow”.
– Jewish: I believe in spiritual healing through prayers by a rabbi.
2) What are the critical components of healing, such as prayer, meditation, belief, etc?
– Buddhist: we meditate to ease and overcome suffering.
– Hindu: we have a belief that one can naturally achieve healing.
– Jewish: prayers are important for healing.
3) What is important to people of a particular faith when cared for by health care providers whose spiritual beliefs differ from their own?
– Buddhist: that they know I need a peaceful and a quiet environment for meditation. They should also respect the fact that I am a vegetarian.
– Hindu: they should respect my cultural and religious beliefs during my hospitalization.
– Jewish: being a man I would not like a health facility where I would be assigned a female nurse as we are not allowed to touch any woman apart from our wives. It is important for them to respect Sabbath and other special holidays.
4) How do patients view health care providers who are able to let go of their own beliefs in the interest of the beliefs and practices of the patient?
– Buddhist: they demonstrate tolerance of other religions.
– Hindu: I view them as people who acknowledge pluralism in the society.
– Jewish: they have respect for people and the Supreme Being.
