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1 Cultural Clues For more information, click the link below & Sacred Practices A Manual of Religious and Cultural Beliefs for Healthcare Providers Scroll Below

2 SACRED PRACTICES A Manual of Religious and Cultural Beliefs for Healthcare Providers INTRODUCTION Our religious and spiritual beliefs often are among the most tightly held and highly treasured of our values. Respecting and accommodating patients beliefs is no longer simply a courtesy; it is now a requirement of hospital accrediting agencies. This respect for others means that no one attempts to persuade a patient to change his/her beliefs. It also means we try to accept a person s beliefs and understand how the beliefs contribute to that individual s total health body, mind, and spirit. This manual is intended to describe in general terms the major beliefs of religious groups in the High Country. To assure accuracy, a representative from each faith group (clergy when possible) has reviewed and approved respective chapters. Each chapter includes healthcare issues and basic religious information by category (eg., abortion, baptism, cleanliness, dietary needs, rituals) to provide a quick-reference guide. The information can help ease anxieties about caring for people of different faith groups and also explain certain requests patients may make about their spiritual practices. The manual is neither exhaustive nor prescriptive. Each individual practices his or her spirituality in unique ways that may not fit the general norms. We should never assume that we know another person s beliefs (even if a manual explains or we think we understand their particular religious tradition); the better approach always is to talk directly with the patient and/or family and respectfully inquire about their beliefs, needs and desires. Thank you for your interest in and sensitivity toward the sacred practices of people within your care. Please contact the Pastoral Care Department for further resources (including holy writings from various traditions), contacts in the community, or assistance with accommodating patients spiritual needs. As always, chaplains are also available to staff persons who may have spiritual questions or concerns of a personal or professional nature.

3 Baha i All healing comes from God Dress Not permitted as a birth control device, but may be used if medically advisable Permissible husband to wife with medical or legal need; respect to body required No rituals Can choose family planning method No restrictions for use No ritualistic cleansing required Not permitted Baha is believe in afterlife and therefore they treat the body with great respect after death. Burial should take place within an hour s journey from the place of death. The body should not be embalmed if permitted under local laws and requirements. A specific prayer for the dead may be recited. Alcohol and drugs forbidden (including alcohol in cooking) Healthy believers age 15 and up fast from sunrise to sunset March If a patient is fasting, arrangements need to be made to make food available before dawn and after dusk. The Baha is origin is in Iran, and is NOT linked to Islam; it stands alone as its own religious entity. No destruction of life. Life is unique & precious Do not destroy Harmony between religion & science Prayer is sometimes used on an individual basis Nine Holy Days in the Bah ai year include New Year, March 21; Declaration of the Bab, May 23; Declaration of Baha u llah, April 21-May 2; Birth of the Bab Oct. 20. Others are May 29, July 9, Nov. 12, Nov. 26, Nov. 28, The writings of the Bab, Baha u llah, and Abdu l-baha are regarded as Baha i sacred scripture. Narcotics with prescription No restrictions for vaccines No priesthood or clergy Both acceptable No formal public rituals No restrictions Community members assist & support; Patient may request a visitor from the Spiritual Assembly of Baha i. Teachings focus on the oneness of God and of religion, the unity of mankind, harmony of religion and science, equality of men and women, and universal peace.

4 Buddhist Churches of America To keep the body in good health is a dutyotherwise we shall not be able to keep our mind strong and clear Dress/Modesty Buddhists believe that conception occurs when consciousness enters a fertilized egg. This is considered the beginning of life and it is regarded as killing if the life of the future person is aborted after that point. However, the mother s condition does impact the allowance of abortion. Matter of individual practice Infant presentation; no baptism No restrictions No specific rituals mandated, although cleanliness believed to be of great importance Buddhists usually are cremated ( clean, quick and out of sight ) Buddhists believe that death is the actual time of movement from one life to the next. All rituals at death are aimed at promoting a favorable rebirth in the next life and avoidance of the lower forms of rebirth. When at all possible, a Buddhist monk or nun should preside over the death of a dying Buddhist. There should be no discussion or reference to God, prayer, or doctrines of other religions. A shrine, pictures, or statue of Buddha may be requested and time and space for meditation should be allowed. Once a Buddhist has lost consciousness, all medical apparatus should be removed and the person placed on a gurney. Once death has been pronounced, the body should be covered with a sheet, not moved any more than what must be done. Movement of the body should be done in silence. Restricted food combinations; extremes must be avoided. Discourage use of alcohol and drugs. Requirements vary greatly. Consult patient or family. Monks and nuns wear robes. Lay people are expected to dress modestly and appropriately for the culture in which they live. Maintaining a positive, caring attitude when interacting with the patient is the traditional cultural norm. May permit. With hope, all means of right to die encouraged Do not believe in healing through faith No restrictions Major holy day is Saga Dawa (or Vesak) which is the observance of Sakyamuni Buddha s birth, enlightenment, and parinirvana. The date varies, but falls during the months of May or June. Some Buddhists fast for part or all of this day. Sutras No restrictions; Buddhists may refuse pain medications in order to remain mindful Priests, monks, nuns Considered act of mercy; if hope for recovery, all means may be taken; matter of individual conscience Verbal prayers, mantra repetition (chants), and many types of meditation practices are used. Objects include prayer beads, burning incense, and images of Buddha. Permitted, with extremes avoided Family; community Central focus is the attainment of a clear, calm state of mind undisturbed by worldly actions or suffering and full or compassion and enlightenment. Generally favor an optimistic outlook; teach ways to overcome fears. Illness believed to be a trial to aid development of the soul.

5 Roman Catholics The prayer of faith shall heal the sick, and the Lord shall raise him up Dress/Modesty Prohibited Illicit, even between husband & wife Permissible Infants are baptized. If newborn is in danger of death, call the priest immediately. However, anyone can baptize in emergency situations. Traditional Church teaching allows natural means only Permissible No ritualistic washing required A permissible option Call the priest immediately if death seems imminent. However, after death, do not call the priest for sacraments. Sacraments are given only to the living. Should the relatives request a priest for their own consolation, that is permitted. The Sacrament of the Sick (anointing, blessing by priest and Eucharist if possible) is very important Although many families may request Last Rites, the Sacrament of the Sick is actually what is offered now. The body is to be treated with respect and dignity and is embalmed if that is the cultural norm. Use foods in moderation; Catholics may fast during Lent or Advent, but most laws of fasting do not pertain to the sick. Abstaining from meat and meat products on Ash Wednesday and the Fridays of Lent does not oblige hospital patients. Modesty of the mind, body and soul are considered Christian virtues, but no legal mandates for modesty Try to have like-language parishioners and/or priests visit patients Direct life-ending procedures forbidden. Obligated for ordinary, not extraordinary Many within religious belief system Sacrament of the sick, laying-on-of-hands, anointing with oil Traditionally, Advent, Christmas, Epiphany, Ash Wednesday, Lent, Easter. Some may have particular days for observance for memorials, celebrations, feasts and fasting. The Holy Bible May take if benefits outweigh risks Priest (male only), addressed as Father morally and ethically acceptable to the Vatican; donation considered charitable. Rosary beads; sacrament of the sick; lighting candles; prayers. Most are permissible except abortion and sterilization Many outreach programs through church to reach the sick Roman Catholicism is a strong liturgical tradition, with a dedication to creeds and an emphasis on sacraments, including baptism, Eucharist, Sacrament of the Sick, marriage, confirmation, and confession.

6 Church of Christ, Scientist (Christian Science) Individual decision; always total respect for life, but not anti-abortion Unusual Objectionable unless required by law No baptism Individual judgment Not normally acceptable for adults; parents usually consent to transfusions for children if doctors consider it essential Usually preferred over burial A female body should be handled by female staff. No rituals are required at time of death Abstain from alcohol, tobacco, some from caffeinated drinks Dress/Modesty Contrary to teachings; unlikely to seek medical help to prolong life Accepts physical and moral healing; mind/body connection, prayer and spiritual understanding. Do not ignore health problems, but may interpret them uniquely according to beliefs about the origin of illnesses Prayer; Christian Science practitioners are full-time healing ministers and are listed in the Christian Science Journal Holy Bible Science and Health with Key to the Scriptures, by Mary Baker Eddy Immunizations/vaccines to comply with law No clergy; Christian Science practitioners are lay members who devote full time to the public Christian healing ministry of Christian Science. Lay Readers are elected by each local congregation to conduct church services Not normally encouraged, but individual decision. Prayers Individual decision Family, friends; Christian Science healers and nurses Christian Science teaches a reliance on God for healing, rather than on medicine or surgery; however, the Church does not attempt to control the actions of its members, and decisions about medical treatment are left up to the individual. Christian Science is a Christian religion based on the Scriptures, and it is a scientific system of spiritual healing. The basis for arriving at the best individual decision is Thy will be done.

7 Church of Jesus Christ of Latter Day Saints (Mormons) Forbidden except to save the life of the mother between husband & wife Permitted with consent of next of kin by immersion at 8 years; no baptism at birth (infant is blessed by church official in church at first opportunity after birth) Contrary to Mormon belief No restrictions Dress/Modesty Not encouraged, but left to family to decide. If cremated, regular services may be held. No special requirements Alcohol, tea (except herbal teas), coffee, tobacco are forbidden. Sparing use of meat. Moderation in all things is admonished. Fasting (24 hours without food and drink) is required once a month for healthy individuals Some Mormons who have been through a special temple ceremony wear a sacred undergarment. It is an intensely private item and is worn at all times, only removed for hygiene purposes. It may be removed for surgical operations or post-mortem care, but it must at all times be considered private and be treated with respect. Family unit is of great importance Humans must not interfere in God s plan. If death inevitable, promote peaceful & dignified means Power of God can bring healing Anointing with oil, sealing prayer, laying-on-of-hands The Book of Mormon and Holy Bible No restrictions; may use herbal folk remedies Mostly lay-led; all worthy males are ordained to a priesthood ; also have elders, high priests, and bishops Permitted Closed communion; baptism, laying on of hands Matter of individual choice Church members (elder & sister) family, friends. Relief society helps members Financial support for sick available through well-funded welfare system

8 Church of Scientology No restrictions. No restrictions. It is desirable, but not required, that a clergy person be present at the time of death. No restrictions. Dress Beliefs include a primary emphasis on Eastern religious perspectives. Oppose the treatment of mental illness in a non-religious context Scientologists believe that the soul controls the body. Teach that people are basically good and seeking to survive, but are hindered from doing so by painful past experiences and harmful acts against others. International Scientology Day (September 1) and International Auditors Day (September 14); at irregular intervals, Prayer Day is held as a time to reaffirm faith in the principles of Scientology, and to celebrate growth and progress. Dianetics: The Modern Science of Mental Health. Generally no restrictions. The Creed of Scientology, however, generally opposes the treatment of mental illness in a non-religious context. s perform weddings, naming ceremonies, and funerals, and conduct Sunday church services and deliver pastoral counseling to parishioners. Scientology is a religious philosophy which has roots in Eastern religious perspectives, which start with the concept of Man as a spiritual agent and deal with man s encumbrances, his aspirations, and the practical means through which he then attains individual salvation.

9 Christian Orthodox Dress/Modesty The Orthodox Church is opposed to abortion. All Life is precious. Depending upon the jurisdiction (Russian, Greek, Antiochian, etc.), there may be opposition or it may be permissible and determined by individual piety. Permissible In the Name of the Holy Trinity, Father Son, and Holy spirit; not any other names or formulas. is by immersion, but in emergencies may be done by sprinkling with water or even (in severe cases, such as burn victims) may be done by fanning the air three times in the Name of the Father and of the Son and of the Holy Spirit. Infants are baptized. Depending upon jurisdiction and individual piety. Many Orthodox are opposed but many believe it is being a responsible person. Usually not permissible. If, however, there are extenuating circumstances, such as disease, or a matter of law, then it is permissible. The dying person may request Holy Unction, with special service requirements for priests, bishops and ministers. A priest should be present at time of death or immediately afterward to provide prayers for the dead. A meat and dairy fast twice a week is practiced by many. However, there are no dietary restrictions for those who are ill, in fact fasting is prohibited when detrimental to health. Many Orthodox women, as a matter of personal piety, cover their heads while in church praying. Decency in dress is something to be done at all times. The Orthodox Church is made up of many races, nationalities, languages, cultures, and etc. The Orthodox Church is a diverse church and as such we take into account the culture when addressing any issues. Opposed, all life is precious God heals. He may use a Doctor, whom He has given to the world as a gift (Book of Sirach) or He may heal miraculously. All healing comes from God, ultimately. The Orthodox Church has a special service and special prayers for the cure of the ill and injured. The Orthodox Church has two calendars, the Old Calendar which is 13 days ahead of the New Calendar. The Church celebrates Christmas, usually on December 25 th, but the Old Calendar adherents celebrate Christmas on January 6 th. Easter is celebrated on a different day than in Protestant and Roman Catholic Churches and it is a very complicated matter to determine the date so it is best to check with the local Orthodox Church or visit one of the Archdiocesan websites. The Orthodox Church has 12 additional feast days. Other holidays such as, Thanksgiving, Independence Day, etc. are celebrated on the usual day and any fasting is suspended. The Bible, including the Deutero-canonical books. The Septuagint is the official Old Testament and the Byzantine text of the New Testament is preferred. The local Priest, Deacon, or Bishop are ministers. The Bishop and the Priest have the authority to perform the Sacraments and services required. Permissible but individuals may object. Of the many sacraments (the correct term is Mystery ), seven are considered primary:, Chrismation, Eucharist, Marriage, Holy Unction (healing. Unction in the Orthodox Church is not a death rite), Ordination, Confession. Any Christian may baptize in the name of the Trinity as stated above, but only the Bishop or the Priest may perform the rest. More information may be found at the following Web-sites:

10 Hinduism Enricher, Healer of disease, be a good friend to us Dress/Modesty Most Hindus do not approve, with no exceptions for rape, deformities, etc. No restrictions exist but not often practiced Generally disliked, but acceptable No All types acceptable Physical cleansing is associated with spiritual cleansing. Handwashing is essential for hygiene. Showers (running water) are preferred to baths. preferred Hindu patients very much want to die at home, and as close to Mother Earth as possible (perhaps lying on the floor). Death in a hospital can cause great distress. Accepting sickness and death philosophically is a trait of Hinduism. Hindus will often discuss it openly. The atmosphere around the dying should be peaceful and their last thoughts or words should be of God. The patient s family may wish to call in a Hindu priest to read from the Hindu holy books or perform holy rites, such as tying a thread around the wrist or neck, sprinkling the person with water from the Ganges, or placing a sacred tulsi leaf in his or her mouth. When preparing the body after death, wear disposable gloves, close the eyes and straighten the limbs. Do not remove jewelry, sacred threads or other religious objects. Wrap the body in a plain sheet. In most cases, the body should be washed by relatives. Services generally take place as soon as possible. Carefully explain any need for delay. If a body is to be left in a room overnight, a light or candle should be left burning throughout the night. Eating of meat is forbidden; some do not eat eggs or chicken. Dairy produce must be free of animal fat. Some Hindus are very strict vegetarians and will not eat food which has come into contact with prohibited food/utensils. According to dietary law, the right hand is used for eating and the left hand for toileting and hygiene. Women prefer to be treated by female medical staff where appropriate. Jewelry usually has a religious or cultural significance (eg., a woman s bangles are only removed on her husband s death). Some Hindu boys wear a Sacred Thread over the right shoulder and around the body. None of these items should be removed or cut without the permission of the patient or next of kin, and should be retained and given to the patient later. Hinduism is a social system as well as a religion, therefore customs and practices are closely interwoven. Practices vary a great deal, depending on the areas of origin. Consult the individual and/or family about particular requirements. Most Hindus in America speak English, but use their native language with others who speak it. In Hindu culture, it is common to remove one s shoes before entering a home or place of worship. In an American hospital setting, Hindu visitors may choose to remove their shoes before entering a patient s room. If the patient is older than the visitor, the visitor would be expected to stand unless invited to sit by the patient. Respect for one s elders is engraved in Hindu culture, along with warm, affectionate family ties. Not practiced. No right to die restrictions death is seen as one more step to nirvana Some believe in faith healing Traditional faith healing system Many religious observances are included on the Hindu calendar, but individuals observe these according to the particular aspect of the Divine worshiped. The Vedas is the sourcebook of all Hindus; the Upanishads form the concluding portion and

11 contain the wisdom of the Vedas; Bhagavad-Gita is the special section of the Upanishads. Also considered holy is the Ramayana, the story of Lord Rama s life. Priest Emphasis on leaving the body intact. In more recent times, often left to individual decision. Hindus may utilize prayer, meditation, and reading of Scripture while at the hospital. A small picture or statue of a Deity may be used in prayer. A mantram (a sound vibration representing an aspect of the Divine) may be recited on a mala (prayer beads strung together) Must be barefoot during religious worship or any kind of religious celebration Amputations, loss of limb, viewed as sin in previous life Family, friends, and priest support

12 International Society of Krishna Consciousness Also called Hare Krishna Movement; ISKCON; Vaishnavism We are not this body No restrictions. Dress Usually encouraged. It is highly desirable for a priest to be present at the time of death, but the blessings of a qualified priest are not required for a person to go back to Godhead. No intoxication of any kind, including alcohol, drugs, coffee, teas, and cigarettes. No eating of meat, fish, eggs, garlic or onions. Religion comes out of India and Eastern belief system; derivative of Hinduism All holidays of Krishna Consciousness are based on the lunar calendar, and occur on different days each year. The eleventh day after the full moon each month (called Ekadaski) is a fast day from beans and grains. The annual calendar begins in the spring on the birthday of Lord Chaitanya (March or April). The major festivals are: Jaganatha or Rathayatra (July); Janamastami, Krishna s Birthday (August) and Vyasa Puja, the spiritual master s birthday (August). Vedic Scriptures which are up to 5,000 years old; Bhagavad-Gita Priests (pujaris) at each temple are responsible for worship, instruction, ceremonies, and preaching. Each local facility has a president who serves as spiritual leader and administrator. Each devotee is required to arise before sunrise for worship and chanting. The program includes chanting the holy names of God before the Deities. The evening ceremony is similar. Minimum equipment required for worship include japa (prayer) beads, kunti or sacred bead necklace and telok (clay marking on forehead). Krishna consciousness means to be conscious of God. Believers generally recognize those religions based on the recognized Scriptures of the world.

13 Islam The Lord of the world created me-and when I am sick, he healeth me Dress/Modesty Although not directly addressed in the Koran, abortion is believed to be forbidden unless the mother s physical and mental health are in danger Not addressed in Koran; generally believed to be permitted husband to wife This is not addressed in the Koran. Islam prohibits the mutilation of dead bodies because it shows lack of respect for the dead. Unless legally required, autopsies are not often performed. The Coroner should be informed that the patient was Muslim and be asked if the procedures can take place as soon as possible. No This is not addressed in the Koran. Strict orthodox Muslims do not approve of contraception. In practice, individuals vary widely in their approach and judgment of the procedure. God is the creator and protector of lives. No restrictions Hands, feet and mouth are always washed before prayer. It is not possible to pray without washing. Handwashing is considered essential before eating. Water for washing is needed in the same room; patients should be provided with bowls/jugs of water. If a bedpan has to be used, bowls/jugs of water should also be provided (Muslims need to wash their private parts after urination or defecation). Patients prefer to wash in free flowing water, eg., a shower, as baths are considered unhygienic. Koran [5:6] Not practiced but not prohibited (Muslims believe in the resurrection of the body after death) Death is a taboo subject among Muslims. Grief counseling is often not well accepted. The dying Muslim may wish to sit or lie with his/her face toward Mecca (West to Southwest in the US). Moving the bed to make this possible will be appreciated. The family may recite prayers around the bed. If no family are available, any practicing Muslim can help. The patient may wish the Imam (religious leader) to visit. After death the body should not be touched by non-muslims. Health workers who need to touch the body should wear disposable gloves. The body should be prepared according to the wishes of the family. If no family available, 1) turn the head toward the right shoulder (so the body can be buried with the face toward Mecca); 2) Do now wash the body, nor cut hair or nails; 3) wrap the body in a plain white sheet. The body will be ritually washed by the family and Muslim undertakers before burial, which takes place as soon as practicable. Carefully explain any reasons for unavoidable delay. No embalming unless required by law. Ref. Koran [3:185], [4:159], [2:28], [2:94], [2:133], [10:56] Pork & alcohol prohibited; other meat can be eaten but must be HALAL (killed in a special manner stated in Islamic law). Fish and eggs are allowed only if not cooked near pork or non-halal food. Fasting during the month of Ramadan (between sunrise and sunset, or reverse) does not impact essential drugs and medicines, and is not required of the sick, the traveler, or the nursing mother. Koran [2:173] Nakedness considered anathema. Women always covered head to foot, men from navel to knee. Devout men also cover their heads. Hospital gowns only (eg., for surgery) likely to be met by opposition. Female patients may wish to maintain full covering throughout hospitalization, or may ask staff to hang a Please knock sign on the door so they may cover their heads before a non-relative enters the room. Women should be treated by female staff, men by male staff. Many Muslims are reluctant to shake hands with the opposite sex, as a sign of personal modesty. A locket containing religious writing is sometimes worn around the neck in a small leather bag. These are kept for protection and strength and therefore never should be removed. Koran [24:31], [24:60] Many Muslim cultural groups have strict procedures concerning the discussion of medical information with family and patients. Second-degree male relatives of the patient, eg., uncles, cousins, should be informed of any diagnoses, procedure and prognosis. They in turn consider the wisdom or otherwise of telling the patient and immediate family. Western society and medical practice find this objectionable as it runs counter to the civil rights of

14 the patient. Some Muslims, however, prefer it this way, since it enables them to proceed through the illness without resigned acceptance, disguised fear or guilt. Doctors and nursing staff would be wise to ascertain the family s desires in information sharing identifying the persons to be told and limiting their number to two or three. Not acceptable. Attempts to shorten life not acceptable Koran [4:29] Faith healing generally not acceptable. Preserving life is the supreme objective of Shari a, or Islamic law. Koran [10:57] Some use of herbs; Jesus is the only healing prophet in the Koran; Muslims receive illness with patience and prayers and consider it, like other life events, a test from God. The Prophet Muhammad taught that maintaining a healthy body is an individual s duty and urged Muslims to seek treatment whenever needed. Many Muslim festivals, all calculated by the lunar calendar. Ask the patient or family if any important occasions for their faith occur during their stay in the hospital. Ramadan is the most important a holy season celebrating the month during which the Koran was revealed, providing guidance for the peaple, clear teachings, and the statute book. During Ramadan, Muslims practice self-discipline in order to achieve tolerance, love, sacrifice and equality. They generally do not eat, drink, smoke, or have sexual intercourse from dawn to sunset. The Koran does specify exceptions for those who are ill or traveling. Koran [2:185] Quran (Koran) No restrictions. Physicians should avoid prescribing medical pills coated with porkextracted gelatin. Also, some types of medications, such as cough syrups, may contain alcohol and should be avoided. Koran [2:219] Imam; houses of worship are mosques Organ donation is permissible if there is a will or if the family permits it. is generally allowed after consultation with the patient or his/her guardians. Circumcision of male children after birth. Many Muslims bow toward Mecca (northeast in the US) for prayer five times daily (before sunrise, at noon, in the middle of the day, at sunset, and at night). Total privacy is not required. However, others should not walk in front of or interrupt the worshiper during the prayer. Doctors and nurses should wait to address the patient until the end of the prayer, except in emergency. Koran [17:78] Most permitted Family & friends provide support One should always remember that a person who calls him or herself a Muslim can come from a variety of religious backgrounds. Depending on the background, the dress code, praying times, and religious practices may differ. Here are major considerations to bear in mind: Contact prayers five times daily Preparation for contact prayers (washing hands, face, and feet) Not eating pork or taking medications with alcohol contents. Depending on the background, a Muslim may request to have specially prepared foods Men treated by male clinicians, women treated by female clinicians

15 Jehovah s Witnesses Dress/Modesty Holiday Observances Organ Donation & Surgical Procedures/ Medical Treatment Deliberately induced abortion simply to avoid the birth of an unwanted child is considered willful taking of human life and hence is unacceptable. In vitro fertilization involving the egg and sperm from persons not married to each other is considered comparable to adultery and thus unacceptable. The appropriate relative(s) can decide if an autopsy is advisable to determine cause of death. Water baptism serves as an outward symbol of a person s whole-souled dedication to Jehovah. Therefore, those being baptized not only must have gained a basic knowledge of Bible truth but should already be demonstrating by their life course that they understand and are conforming to God s righteous standards. Each couple privately and responsibly determines if they will employ appropriate methods of family planning. However, Witnesses avoid contraceptive methods that are abortive. Jehovah s Witnesses believe that blood transfusion is prohibited by Biblical passages, ruling out transfusion of whole blood, red blood cells, white blood cells, platelets, and plasma. Their religious understanding does not absolutely prohibit the use of blood fractions, such as clotting factors, hemoglobin solutions, interferons, and platelet-derived wound-healing factor. Blood samples for medical testing are a matter of personal conscience. Jehovah s Witnesses maintain a high standard of physical, moral, and spiritual cleanliness. The type of burial is a matter of personal choice. There are no special rituals that are to be performed for those who are sick or dying. Every reasonable effort should be made to provide comfort for the sick patient through medical assistance and spiritual care. Jehovah s Witnesses are required to abstain from eating blood and the meat of animals from which blood has not been properly drained. Aside from this injunction, there is no restriction on what is to be eaten. Dress and grooming should be modest and well arranged. Personal appearance should always reflect a reverent, honorable attitude. Jehovah s Witnesses believe that all races are equal. Jehovah s Witnesses are obligated to show a loving interest in others regardless of their race, nationality, or station in life. Life is sacred. For this reason, every reasonable and humane effort should be made to sustain and prolong life. However, this belief does not require that extraordinary, complicated, distressing, and costly measures be taken to sustain a dying person. Jehovah s Witnesses have faith in God but do not practice faith healing. Scriptures can offer comfort Jehovah s Witnesses do not participate in holidays and celebrations they consider linked with pagan gods (such holidays as Easter, New Year s Day, May Day, and Mother s Day). They usually do not observe birthdays or pledge allegiance to a country s flag. The Bible is considered God s infallible Word, upon which Jehovah s Witnesses base all their beliefs. The translation New World Translation of the Holy Scriptures. The medical use of drugs, including narcotics for severe pain, under the supervision of a physician is a personal matter. All are ministers, including women. Appointed qualified men in each congregation serve as overseers (elders) and as ministerial servants. But they do not form a clergy class. They do not receive a salary for their services. Meeting place is called Kingdom Hall. While Jehovah s Witnesses believe the Bible specifically forbids consuming blood, no Biblical command pointedly forbids the taking in of tissue or bone from another human. Therefore, whether to accept an organ transplant is a personal medical decision. No specific rituals Jehovah s Witnesses actively seek medical care when needed. Parents naturally make such decisions for their children. Medical alternatives to blood transfusion involve the systematic use of appropriate clinical strategies for managing hemorrhage and anemia. These strategies use combinations of drugs, equipment, and medical/surgical techniques to reduce or avoid blood loss and to enhance the patient s own blood production. Jehovah s Witnesses provide spiritual comfort and practical assistance to fellow Witnesses during periods of illness or hospitalization.

16 Jehovah is God s personal name. Jesus is God s Son and Jehovah s Witnesses accept him as the Messiah. They believe that God s Kingdom by Jesus is a real government that will restore true peace to the earth. Thus, they maintain a neutral stand toward political affairs of all nations. They do not use the cross as a symbol, nor employ icons in their worship.

17 Judaism O Lord, my God, I cried to Thee for help and Thou has healed me Dress/Modesty Therapeutic accepted; some sects accept on demand Permitted Permitted only under certain circumstances; all body parts must be buried together. A rabbi should be consulted prior to autopsy Not practiced Permissible except with orthodox Jews Discouraged; burial in the earth is required, especially in Orthodox branch. Consult Jewish community. The dying or deceased person must be treated with dignity and respect. Anyone in the presence of a dying person may guide him in the expression of Vidui (confession) and the affirmation of faith (the Sh ma), but the presence of a rabbi is important both for guidance and consolation. Family and community presence with a dying person is recommended, in keeping with the Jewish principle that one should not go into death alone. Reading the Psalms is appropriate. After death, the body is buried as soon as possible usually within 24 hours. Careful explanation needed for any necessary delay. Strict dietary laws for conservative Jews milk & meat not to be mixed; predatory fowl, shellfish, and pork products forbidden; kosher products only. For reformed Jews, diet is more a matter of personal choice. When praying, many Jewish men and some women wear kipot or yarmulkes (small head coverings) and prayer shawls, tallit. Generally orthodox women are more sensitive to needs of modesty, would like a woman doctor if possible, and require special attention after childbirth. Consult the patient/family and the Jewish community. Highly recommended to greet Jews with Happy New Year on Rosh Hashana and Yom Kippur, which is in the fall. Happy Hanukkah can be appropriate, since Hanukkah is in December. Hanukkah is not the Jewish Christmas, nor is Passover the Jewish Easter. It is generally poor taste to wish Jews a Merry Christmas. Sabbath is observed from Friday sundown until dark on Saturday. Under no circumstances should a belief in Jesus be professed or encouraged; this is considered disrespectful to the Jewish religion. Prohibited. If death inevitable, no new procedures need to be undertaken, but those ongoing must continue. Life-support decisions vary greatly. In general, consult the patient, family and Jewish community about these decisions. Jews consider physicians as instruments through whom God can effect a cure. Medical treatment is viewed as one means to help achieve good health. Suffering not seen as judgment from God, but by-product of the illness; anything to ease the suffering usually recommended. Prayers for the sick In addition to the Sabbath, religious holidays include Passover, Pentecost, Tabernacles, the New Year (Rosh Hashanah), the Day of Atonement (Yom Kippur), Hanukkah, and Purim. Work is forbidden on the Sabbath and most holidays. Torah, Hebrew Scriptures; (known to Christians as Old Testament ) No restrictions Rabbi is appointed spiritual leader who guides and represents the congregation. In addition, there are elected lay leaders in the congregation and in the Jewish community. Worship generally takes place in a synagogue at sundown on Fridays.

18 Complex issue; some practiced. Personal practices vary; some may like regular Jewish prayer services, or the Jewish/Hebrew prayer book Siddur. Common to light two candles on the Sabbath. Most permitted Family, friends, Rabbi, many community services. Tending the sick is important role of community Three major branches of Judaism include Conservative, Orthodox, and Reform. Among the Orthodox, a rabbi or representative from the faith is extremely necessary in all decisions regarding the body. The life of the person is valued above all else in questions of Jewish health, medicine, and ethics.

19 Mennonite Therapeutic acceptable, but All life is valuable Individual conscience; husband to wife Believer s baptism practiced by and in the church. No infant baptism. A minister is encouraged to be present at the time of a member s death, but this is not a requirement. No specific restrictions Dress/Modesty Not condoned. Do not believe that life must be continued at all cost Part of God s work Prayer & anointing with oil All Christian holidays observed Bible No restrictions Church ordains pastors, deacons, and elders; any member can conduct services., communion, ordination, foot washing No restrictions Family, community Mennonites are known for emphasis on issues such as peace, justice, simplicity, community, service, and mutual aid. A Christian group that rose out of the reformation, the denomination has more than 1 million members in 62 countries.

20 Native Peoples No restrictions. Beliefs vary. Native peoples place a high value on physical cleanliness. In addition, smudging ceremonies are used for spiritually purifying/cleansing spaces No restrictions; beliefs vary. Dress Alcohol and dangerous drugs are forbidden by some. Value system includes different attitude toward time and materialism. Time is understood in a larger context than individual appointments, meetings, or organizational concerns. They also have a community-oriented emphasis on sharing material possessions, not saving them. In addition, many American Indians have strong family/clan loyalty as well as respect for diversity. When Indian people become nervous, they frequently become quiet. Confrontation is usually not helpful, as American Indians carry a strong sense of an inner world and will withdraw and appear passive to the outside observer. Some may wear a medicine bag (a leather pouch) around the neck; this is not to be disturbed Often an unspoken understanding that patience and nature will heal. Health care practices intertwined with religious and cultural beliefs Closely related to seasonal changes, the moon, provision of food and other life essentials. Some groups celebrate Thanksgiving, Easter, Christmas, New Year s, and Armistice Day. Traditionally, no holy Scriptures, as these groups relied on the oral tradition; the Great Spirit reveals itself in miracles of natural life and visions of the people. Shamans or medicine men and women Items for worship include peyote (of peyote cactus containing mescaline, a sacrament), fire (often in the form of live coals), pipes, sweat lodges (purification rites), water drum, gourd rattle and staff. Smudging, or sweeping the smoke, serves as a simple but powerful purification method; Vision Quest Native Peoples covers a broad range of religious practices of the native peoples on every continent. Traditional Native cultures are dynamic and foster a sense of identity and pride. Native spirituality is founded on the belief in a Creator or Life Force and in the fundamental inter-connectedness of all natural things, all forms of life; with primary emphasis being attached to Mother Earth.

21 Protestant Groups Generally considered acceptable for Protestants. Some church teachings prohibit. If abortion/miscarriage occurs, relevant religious practices such as prayer, baptism, blessing, burial, may be healing rituals Most accept, husband to wife No general rule is generally practiced. Some traditions baptize only adults, others baptize infants. Some traditions baptize by immersion, others by sprinkling Generally considered acceptable for Protestants. Some church teachings prohibit. Generally considered acceptable No specific rituals or requirements May be chosen. Some liturgical traditions have religious practices of prayer, anointing of oil, liturgies. Varies with traditions. Some are vegetarian. Some eat or fast for particular religious days. Dress Withdrawal of treatment and end of life decisions vary. Most will place a high value on living as long as the valued quality of life is possible. Most Protestants believe strongly in the power of prayer to heal. Some may seek exclusively spiritual healing without intervention of Western medicine; however, most traditions believe in spiritual healing as both an end in itself and as the source of medical/scientific knowledge Some traditions have healing services, prayer services, or anoint with oil. Traditionally, Advent, Christmas, Epiphany, Ash Wednesday, Lent, Easter and other days. Some may have particular days for observance for memorials, celebrations and/or fasting. Holy Bible, books of prayer, spiritual/religious writings. Hymnals often are considered unofficial sacred texts Generally no opposition to Western medicines. Generally, the minister is called Pastor; Episcopal ministers are priests, referred to as Father. Organ Donation is increasing and decisions vary. Few Protestants oppose either transplantation or donation. Spiritual practices may include readings, prayer, study, fasting, almsgiving, anointing, and eucharist (or communion). Generally no opposition The sick often expect the minister to visit, and also welcome visits from family, friends, and congregation members. Includes Baptist, United Church of Christ, Pentecostal, Methodist, Presbyterian, Lutheran, Episcopal, Advent Christian, Assembly of God, Mennonite Brethren, and nondenominational groups.

22 Rastafarians Allowed only if required by coroner Dress Majority do not accept Likely to raise anxieties because of concerns about contamination of the body; emphasize safety checks; give assurances Avoid contamination of the body Burial is preferred No specific rites or rituals before or after death All forms of pork and shellfish are forbidden. Most are vegetarians, eat only natural foods (termed I-Tel foods) fruits, grains, roots, and vegetables -- and avoid bleached flour and dairy products. Alcohol is avoided but Ganja (marijuana) is freely used. Some do not drink milk or coffee. Women dress modestly, required to wear skirts or dresses (no pants) and to keep their heads covered in public. A taboo on wearing second-hand clothing may prompt some patients to prefer disposable gown to hospital garments previously worn by others. Distinctive hairstyles (dreadlocks or locks) are a symbol of the Rastafarian faith. Orthodox members may not permit their hair to be cut. For some, legal marriage is unnecessary; thus, extended families may be complex. Most Rastafarians are pacifists. The most important holiday is Haile Salessie s birthday (July 23 rd ). Other holidays are Marcus Garvey s birthday (August 17 th ) and Jamaican Independence Day (1 st Monday in August). Old and New Testaments (However, they do not consider themselves Christian); the Twenty- One Points, other statements and moral codes No restrictions; however, herbal rather than chemical medication is preferred. No official clergy; groups are loosely organized into circles, each headed by several brethren who assume leadership because of their charisma. Group worship is not required. Transplants generally not acceptable Rastafarianism is more a personal religion, therefore community rituals not emphasized Cosmetic surgery, even oral-dental, is forbidden. Strongly object to sharp implements used in the desecration of the figure of man, e.g., trimming and shaving, tattooing of the skin, and cutting of the flesh. Visiting the sick is important; visits often made in groups. The Rastafarian Movement grew out of one phase of the Black Nationalist movement of the 1920s and 1930s. Rather than Christian, it is a more personal religion placing emphasis on personal dignity and a deep love for God. Rastafarians believe in one God, Rastafari.

23 Religious Society of Friends in the U.S. There is a Light that lighteth every man that cometh into the world John 1:9 Views vary; some believe abortion violates the Quaker commitment to nonviolence; others support the woman s right to choose. No restrictions. No baptism of infants. Friends believe in baptism of spirit, not of flesh. Dress No restrictions. No specific requirements. Total abstinence from narcotics and alcoholic beverages, as well as tobacco, is encouraged. Religious community given authority for group decisions over/above individual decisions. Quakers object to oaths, pledges or sworn statements. Belief in pacifism and non-violence may affect the ways a person responds to certain experiences in the hospital or the modes of expressing grief (ie., may not want to get angry ). Encourage obedience to the light of Christ within each person. Sometimes hold Meetings for Worship with Attention to Healing. Christian holidays generally observed; however, some Friends hold that no day is more important than another. Holy Bible, but is not considered the absolute word of God. No restrictions. All members are ministers; Quaker pastors have generally the typical Protestant pastoral duties, but their role is that of servant, not authoritative in the sense of conferred power. Some congregations do not have pastors; leadership is exercised by the Clerk. Both Quakers value highly the virtue of silence. Also called Quakers. Some Friends are universalists and do not use Christian terminology.

24 Seventh-day Adventists Therapeutic acceptable Permitted husband to wife Believer s baptism by immersion Individual choice No restrictions Dress/Modesty No specific rituals other than prayers that may be said. not required at the time of death. Individual preferences are honored. Encourage vegetarian diet, although clean meats may be added to the diet by individual decision (eg., beef, lamb). No alcoholic beverages or smoking are accepted. Observe the Sabbath on Saturday (from sundown Friday to sundown Saturday); life saving and life preservation activities, as well as the alleviation of suffering, are allowed on the Sabbath Not practiced. Follow the ethic of prolonging life Believe healing can be accomplished both through medical intervention and divine healing. Anointing with oil and prayer Christian holidays observed; Sabbath observed on Saturday Holy Bible; writings of Mrs. Ellen G. White. May not wish to receive narcotics or stimulants Ordained ministers, called Pastors, may perform all ecclesiastical duties. Licensed ministers may perform duties only in the local church to which they are assigned. Ordination is limited to males. Any member may conduct worship services. Both encouraged, but left to individual decision No restrictions; oppose use of hypnosis Pastor & elders anoint & pray

25 Unitarian/Universalist Church Liberty and justice for all Dress/Modesty Not generally practiced; dedication ceremony for infants is a local option All types acceptable No restrictions Yes Most favor memorial services; support advance directives and right-to-die No restrictions No restrictions Unitarian-Universalists tend to be socially active; they champion human rights causes and the use of reason; generally exhibit almost complete nonjudgmentalism in regard to issues such as abortion, birth control, and termination of life. No restrictions; may withdraw therapies if death is imminent. Right to die up to individual conscience Faith healing seen as superstitious, but some are attracted to New Age therapies None specific to the faith Some follow the Christian calendar; others do not consider themselves Christian Draw inspiration from a variety of sacred texts. Generally, there is a respect for all sacred writings, but none is considered infallible or unique. Ordained pastors or lay leaders who serve as paraministers Both Some congregations light a Flaming Chalice as a part of each service; prayer is common in many, but not all congregations No restrictions Family & friends; patients request no proselytizing Christians Many Unitarian-Universalists adhere to a humanist philosophy (a philosophy that asserts the dignity and worth of people and their capacity for self-realization through reason; often rejects supernaturalism). Others follow Buddhist, Earth-centered, mystic or New Age spiritualities.