Hindu End of Life: Death, Dying, Suffering, and Karma
Journal of Hospice and Palliative Nursing. 2010;12(6):337-342.
Professional Care Issues
Healthcare decisions in Hindu families will likely be made by the most senior member of the patient's family or the eldest son.[25]
Hindu culture believes in "human interdependence and
interconnectedness, which is understood to be the foundation of
well-being."[10]
(p28) In other words, Hindus do
not have the same concept of individuality and autonomy that Westerners
prize so highly; family and community are more important. Other cultural
differences may or may not be relevant, depending on the acculturation
of the family, and are directly contradictory to Western views. For
example, addressing the head of the family first shows respect in Indian
culture, while maintaining eye contact with a head of family or elder
shows disrespect. The best course is to tread lightly and be aware until
discernment can be made of individual preferences.
Accepting the end of life is part of Hindu philosophy. Artificially
prolonging life is generally thought of as interfering with karma.
Interventions such as intubation, artificial feeding, or very aggressive
care in the face of a terminal illness would go against traditional
Hindu thinking. Palliative and comfort care are in line with Hindu
thoughts on karma and reincarnation, concepts that Western caregivers
need to be aware of.
Two other issues that relate to end of life include organ donation
and autopsy. Autopsy is avoided unless required by law. Hindus believe
that disturbing the body of the deceased is disturbing to their soul and
inhibits the soul from moving onward.[19]
Organ transplantation is another practice that is conditionally
discouraged. From the donor perspective, a part of the body lives on and
interferes with reincarnation. From the recipient perspective, part of
the donor's karma is transferred along with the organ especially a major
organ such as the heart, liver, or kidney.[19] Depending on the views of the family, donation of an organ other than the heart, liver, or kidney may be permissible.
Spirituality and culture go hand in hand for Hindus, and Western
medicine is beginning to acknowledge the importance of spirituality in
healthcare. Spiritual issues are now being addressed for patients,
especially at end of life. In a study of 560 nurses who cared for dying
patients in Ethiopia, Kenya, India, and the United States, nurses from
all four countries identified spiritual interventions such as praying
with or praying for the patient and reading from holy texts as helpful
or important to patients and families.[22]
The similarities between cultures speak more loudly than the
differences. Nurses from all four cultures stressed compassion, respect,
and individualizing care based on patients' needs. Specific culturally
based interventions mentioned by the nurses from India included allowing
family member to offer Tulsi leaves (a type of basil) for purity and water from the Ganges River for a peaceful death.[21,22]
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