The family is frequently the patient’s advocate and voice, and as the patient is dying, the family also requires care. 1,8 This allows patients to self-determine by recognising their own idiosyncratic priorities through reconnecting to their source of empowerment – their own religious and cultural platform. Such an understanding may enhance the patient’s end-of-life experience and avoid conflict. 7 This requires healthcare professionals to develop an understanding of the sociocultural and religious traditions observed by the community served. For example, conflict may arise in relation to the religious sanctity of life versus the medical opinion of ‘futility’. Sociocultural beliefs at odds with current and conventional westernised medical practice can easily lead to conflict between healthcare professionals, patients and their loved ones. 4 Furthermore, physicians and their teams should utilise a framework of assessing palliative care needs, as established in the 2015 National Institute for Health and Care Excellence (NICE) guidelines, which incorporates religious and spiritual needs alongside physical, psychological and social considerations. 5 The UK government has made a firm commitment to patients approaching end of life, stating that all should have access to personalised care which focuses on the preferences, beliefs and spiritual needs of the individual. A significant number (47%) of the 500,000 deaths in the UK occur in hospitals. 4 Historically, people died at home within the comfort of the surroundings of their community, where their own religious beliefs and traditions were conducted with ease. Palliation and end-of-life care has become increasingly medicalised and continues to receive attention among the media, healthcare professionals, ethicists and politicians.
2 According to the 2011 census for England and Wales, the five largest religions are Christianity (33.2 million followers, 59.3%), Islam (2.7 million followers, 4.4%), Hinduism (817,000 followers, 1.5%), Sikhism (420,000 followers, 0.8%) and Judaism (263,000 followers, 0.5%). Providing culturally competent end-of-life care presents a challenge for medical practitioners, particularly in areas with high concentrations of ethnic or religious minority groups. An increasingly diverse population has emerged in areas such as London, Birmingham, Manchester, Leeds and Glasgow. The UK is no longer a homogenous religious and cultural entity. This paper seeks to examine some of the issues that healthcare professionals may encounter when caring for patients from the five major faith groups of the UK: Christianity, Islam, Hinduism, Sikhism and Judaism. 1 Exploring the main faiths of the UK allows healthcare professionals to pause and reflect on delivering effective and culturally competent care. 1,2 Discussions about spirituality may induce anxiety in healthcare professionals as they may not be accustomed to leading such conversations due to a lack of knowledge or cultural understanding.
#CATHOLIC TEACHING ON WITHHOLDING FOOD TO HASTEN DEATH HOW TO#
Most religions involve submission to a divine entity, and provide guidance on how to live purposefully, as well as rituals which comfort and influence patients and their families at the end of life. 1 The end of life is often where spiritual matters come to the fore and patients may wish to re-examine and reiterate their beliefs in order to die peacefully. Healthcare has traditionally focused on the physical aspects of care, while often overlooking the spiritual and psycho-social needs of patients particularly at the end of life.
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Exploring and understanding the specific nuances of the five major religions of the UK provides healthcare professionals the opportunity to comfort the religiously observant patient at the end of life.
Addressing the spiritual and physical needs of patients allows healthcare professionals to deliver truly holistic care. The last few decades have resulted in a multicultural and multi-ethnic patient population. Good palliative care seeks to promote the wellbeing and priorities of those with faltering health in a way that continues to support individualised notions of self-determination. Spiritual care forms a fundamental consideration in the endeavor to address the holistic experience of those patients receiving palliative care. As clinicians, the concept that there are good and bad deaths is already known understanding the origin and depth of non-physical suffering, and aiming to alleviate it is not possible without learning the individual experiences and beliefs that go with it. For many who pertain to particular theological paradigms, their faith cannot be compartmentalised, but is mobilised to inform all aspects of their being, most notably their ethical and moral persuasions.
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