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Religious Traditions in Health Care

A Primer for Health Care Providers

Keith F. Muccino, S.J., M.D.
Loyola University Chicago - Stritch School of Medicine

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Roman Catholicism

The Tradition

God,
The Cosmos &
The Human Condition

 

Sources,
Revelation,
Scriptures,
Holy Texts

 

Organization:

Hierarchy
Leadership Ministries

 

Calendar
Time Line
&/or
Feast Days

 

Prayer
Worship
Ritual

 

Views on the Moral Life

 

Trinitarian God:
One God, Three persons.

 

Creation:

God as source of all life Creation is good

 

 

God
grants freedom
to all of Creation

 

Humans
are responsible
for how they
exercise their Freedom

 

"Sin" is the
misuse of
human
freedom:

Choosing
death over life…

Choosing self
over the Other…

Choosing
hatred  over self-giving love.

 

Called to live
a life of: 
Faith
Hope
Love

 

God seeks
to reconcile and
redeem creation

 

God offers the
fullness of Life

 

Eternal Life:

Life lived no
longer in the
shadow of death

 

Faith in
Jesus assures
Life for the
believer

 

The fullness of God's  self-communication to Mankind is in Jesus

 

All of Salvation history points to this unique moment

 

Salvation/Jesus
foreshadowed  in the Old Testament

 

New Testament reveals God through/ in Jesus and God as Spirit animating the life of the Church

 

The N.T. traces the origins and spread of the Church. God's Holy Spirit alive in the community of believers

 

The Church carries forth Christ's teaching through its Magisterial Authority:

 Doctrine

 Encyclicals

 Social Teaching

            

Theological Reflection and
Scholarship serve to enrich the Church's self-understanding of its rich Tradition and assists in interpreting the tradition over time.


 

Lay Ministry:

Baptism calls all to discipleship & ministry of self-giving love.

 

Charism:

The grace of Baptism as it is individuated in the life/gifts of each believer

 

The Church is called to be a charismatic community which  carries forth Christ's mission of Love.

 

Ordained  Ministry:

The Church calls  individuals
to formal witness, leadership andservice:

     Pope
Bishops

     Priests:

 Diocesan priests

 Religious Orders

Women Religious

 

The Pope, as successor to St. Peter, presides over the life of the Church

 

Vatican Councils bring together Church leaders to reflect on and speak out to the needs of the Church.

 

See Time Line for Christianity in "Exploring  Religions"

Calendar: 

Gregorian Calendar
(Solar calendar)


Worship Cycle:

Daily Cycle:
Litany of  Hours


Weekly Cycle:

SundayEucharist
[daily Eucharist]


Annual Cycle:  

      Advent
Christmas
       Epiphany
       Lent
       Easter    
       Pentecost
Ordinary Time


Sanctoral Cycle-

Memorial Feasts
of  Saints


 Special Events in
Life of Mary & Jesus

Ascension  

Assumption

Immaculate
Conception

 

 

Prayer within
Catholicism   
takes many forms:

Formal/Public Prayer & Rites:

 

Eucharist Penitential Rites Stations of Cross

The Rosary
Novenas
Liturgy of the
Hours

 

Private Prayer:

Contemplative
Prayer
Spiritual 
Direction  

Retreat
Programs

 

Moral Life grounded in the call to Love.

 

The Great Commandment:

-Love God
-Love Neighbor
as Self

Covenant model:
God's Offer
Our Response

Persons are free to respond
to or reject the
call to Love

 

Exercise of human freedom must be grounded in
Right Reason

Conscience:
Knowing the Good vs Evil


Choosing our Actions

Guided by the Official Teaching of the Church

 

Natural Law: Order of Nature Order of Reason

 

   Commands

     Laws

     Norms

     Virtues

Character:
Who do I wish
to become?

Choices: What choices
will accomplish this?

 

Roman Catholicism

Perspectives on Health Care Issues

Notions of Body & Spirit
Physician – Patient Relationship

 

Individual Autonomy vs
Community

 

Views on Rx:

Transfusion
Transplant
Organ Donation Autopsy

 

Views on

Suffering/Death:

Sustaining vs.
Withdrawal of LIfe
Support

 

Who's at the

Bedside –

Spiritual Care For the Patient &
Care for the Dead  

Primacy of
Patient Welfare

 

Covenant, not
Contract

 

Virtues:

Honesty,
Fidelity to Trust,
Courage,
Compassion, Prudence

 

Christ Healer and
Sufferer as Model

 

Special Solicitude
for the Poor

 

Pro Bono Work
an Obligation

 

Patient a Unity of Body, Soul, Mind, and Spirit

 

Concern for Both

 

Autonomy Limited by
Harm to Others

 

Solidarity Vs. Total
Individualism

 

Health Care as an
Obligation of a
Good Society

 

Health Care Not a
Commodity

 

Preferential
Option for the Poor

 

Transfusions are Licit

 

Transplantation is Licit

 

Organ Donation Licit, but NOT if Injurious to Donor or Causes Death of Donor

 

Autopsy Licit

 

Service to Others

 

 

 

Suffering has
Meaning Spiritually

 

Pain Relief to be
Maximized so long as Death Not Intended

 

Euthanasia and
Assisted Suicide
Never Permitted

 

Withdrawal of Life Support Licit if Rx is Futile, Patient is Terminal, and Patient or Surrogate Request

 

Brain Death Valid for Withdrawal

 

PVS Not Valid

 

Variable Views on
Withdrawal of Food/Hydration

 

A Good Death is to be
Sought in Context of Above

 

"Good" Death Requires Spiritual as well as Physical Care

 

Pastoral Counselor and Health Professional Work Cooperatively

 

Family and Community Participate in Act of Dying

 

Visit the Sick and Dying a Work  of Mercy

 

The Sacrament of
the Sick is offered to any gravely ill patient

   Anointing
   Reconciliation
   Communion

 

A "Mass of Christian Burial"  is celebrated as part of the funeral

 

Cremation of the body is acceptable alternative to burial

 

 

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Hinduism

The Tradition

God,The Cosmos & The
Human Condition

 

Sources,

Revelation,
Scriptures,
Holy Texts

 

Organization:

  Hierarchy
  Leadership
  Ministries

 

 Calendar

 Time Line
&/or
 Feast Days

 

Prayer
Worship

Ritual

 

 Views onThe
 Moral Life

 

One Supreme God called BRAHMAN

Many forms and hence multiple Gods and Goddesses.

Concept of Trinity:                                   

Brahma:
The Creator    

Vishnu

The  protector

Siva

The  destroyer

 

The Cosmos undergoes an endless cycle of birth and destruction.  It acknowledges millions of universes.

Humans are in a cycle of births and deaths called reincarnation, till they attain liberation called
Moksha by various yogas.

 

Karma yoga or the path of duty

Bhakti Yoga  or the
path of devotion

Raja Yoga or the path of penance

Jnana Yoga or the path of wisdom

Human suffers or enjoys in this birth depending upon his/her previous birth good and bad deeds (Karma),

And can be changed or modified by the present good or bad deeds.

 

 

Non-founded religion.

Many seers expounded the principles as revelations Religious scriptures are classified as the Sruti (that which is heard) and Smrti (that which is remembered)

 

Vedas are the ancient collections of hymns,rituals and prayers & forms the Sruti.

1.Rg Veda considered the oldest text book in any religion.

2.Yajur Veda

3.Sama Veda 

4.Atharva Veda are followed by the Smrtis
which includes the
Upanishads and Purana. Ramayana and Mahabharat considered as great epics.

The latter includes the famous teachings, by Krishna an incarnation of God, called Gita or Song of Gods.

 

Religion and Medicine are intertwined.

 

Texts available for the practice of Medicine are –

Atharva Veda (1500 b.c.e.)

Caraka Samhita(100 c.e.)

Sushruta Samhita (200 c.e.)

And Ashtanga hridaya Samhita (700 c.e.)

 

 

 

 

No central organization or hierarchy. Many different Gurus or teachers over the last >5000 years. There are Temples with Priests to facilitate the individuals prayer or Puja.

 

 

Social organization:

 Four classes or Varnas/castes:

1.Brahmin or priest

2.Kshatriya or Ruler/warrior

3.Vysya or businessman

4.Sudra or workers.

Caste system (Portuguese for lineage) is outlawed now.

 

Concepts rapidly changing currently promoted by secularism.

 

The Hindu calendar is based on 27 stars and based on lunar cycles.


The Lunar year is roughly seven days short of the Gregorian calendar. Made up every three years as an added short month.

Concept of time is measured in Kalpas. Every Kalpa has 4.32 billion years and is divided into 4 Yugas.

We are currently in the last Yuga – 195588597th year !

 

Personal rites or celebrations

-Birth

-Naming

-First birthday

-First feeding

-First haircut

-Initiation in studies

-Home coming

-Wedding

-Funeral

 

Common :

Many festivals through out the year based on lunar calendar.

-Holi-spring festival

-Janmashtami or Lord Krishna's birthday

-Navarathri or nine nights for goddesses

-Dussehra  or Rama's win

-Deepavali or festival of lights

 

A congregation is not a must for worship.  Prayer and worship at all levels are considered important. The

Religion has

 Mantras for all occasions with rituals. Mantra itself is God.

Every stage in life from birth to death has a Samskara or ritual associated with it. These rituals are an exercise in self-control as well celebration. As an object of focus and concentration for prayer, paintings and figures are used.

Representative forms of God:

-Pratika- Image

-Linga - idol

YantraDiagram

Two types of prayers

1.External

2.Internal:

The worshipper meditates and concentrates on his ishta-devata or personal choice of form of God. They are

Japa is repetition of mantras.

Mudra or gestures by hands

Nyasa

 

Meditation is encouraged.

 

Four Obligations:

1.Salutations to ancestor once a month or once a year

2.Salutaions to Devas
or demigods

 

3.Salutaions to community

4..Salutations to all living beings

 

Four aims or goals in life:

1.DHARMA 
means " the privilege,duties

and obligations of person, a standard of conduct as a member of the community, as a member of the caste, and as person in a particular stage of life. Dharma laid down the rules and ordinances for actions in all situations.

Always steering away from absolutes, always sensitive to context, the laws allow qualifications for time, place & exceptional circumstances

 

 

2. KAMA:

Pleasure, usually understood as aesthetic pleasure of all kinds- art, music, dance,  drama,

literature, poetry and sex. All of this should be done, of course, within the realm of Dharma or in a virtuous manner

 


3.ARTHA:

Working for and achieving success, in terms of both wealth and power.

 


4. MOKSHA:

Attempting to get released from the bondage of the cycles of births and deaths due to Karma by realizing the GOD within.

 

 

Hinduism

Perspectives on Health Care Issues

Notions of
Body & Spirit

 

Physician – Patient Relationship 

 

Indiv. Autonomy

        Vs.

  Community

        

 

Views on Rx:

Transfusion
Transplant
Organ Donation
Autopsy

 

Views on
Suffering/Death:

Sustaining vs.
Withdrawal of
Life Support

 

Who's at the

  Bedside –

Spiritual Care 
for the Patient & Care for the

Dead

 

Concept of holistic medicine

(Vaidya) or physician should be

-Knowledgeable

-experienced

-friendly

-compassionate

-Virtuous

-Devoted to  learning

-rational

-ready to act

-clean

Patient should be

-endowed with good memory

-must follow directions

-Provide all relevant information without fear.

 

Concern for both

-Meaning of selfhood, "I"ness or Godliness encased in a body

-sense of continuity in all eventualities and all life tasks

-Material self (Ahamkara) human, public, negative and worldly / private

-Transcendent self (Atman) positive, nearer to and more like God

-self as witness, untouched by birth and death

-Godly SELF is the only  true reality. Physician should charge depending on the capability of the patient.

-Free care to poor is part of Dharma.

 

No contraindication to transfusion

-No impediment to transplantation (described in epic Mahabharata)

-No restriction of organ donation (described in Siva Purana)

-cremation is recommended

-No hurdles for autopsy (described in Sushruta Samhita), except time.  Cremation is recommended by sundown if person dies during day and by next sundown if one dies during night.

 

Suffering is considered part of ones Karma but it is okay to get relief.

-Death is opposite of birth and not of life and Hindu concept denies death's finality.

-since rebirth is almost certain; death is just a passage to next life.

-Pain medications can be given in adequate doses to control pain, but should not diminish patient's alertness or thinking capabilities.

-Withdrawal of life support is not contraindicated.

In fact artificial or mechanically sustained life is held to be of little value.

-Individual's choice and self-willed death be allowed in very elderly, suffering from incurable disease, great calamity etc. In these situations euthanasia could be classified as a self willed death.

-Currently suicide and euthanasia are illegal in India.

Brain death as well as PVS is valid for withdrawal of life support.

Withdrawal of food is permitted.  Fasting is indeed a form of self willed death and hence not contraindicated.

 

Death is private.

Only close relatives stay at the bedside.

-Most people prefer to die in their own bed/home. 
Hospice care usually rendered by relatives in home.

-to attain better next life spiritual readings or special mantras by self or others is encouraged

-Visiting the sick is only by patient's request.

 

 

 

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Islam

The Tradition

God,The Cosmos & The
Human Condition

 

Sources,
Revelation,
Scriptures,
Holy Texts

 

 

Organization:
  Hierarchy
  Leadership
  Ministries

 

 

Calendar
Time Line
&/or Feast Days

 

 

Prayer
Worship
Ritual

 

 

Views onThe
Moral Life

 

 

God the merciful,& compassionate

 

God the Creator of the
heavens and the Earth

 

Everything submits (aslama) to God, and will taste death, will be resurrected and judged

 

Humans are born with moral sense. They are perfectible, if they heed to the call of prophets, who have been sent to guide them.

 

Humans are not born in sin, but they are forgetful about the goal of their life. They need constant reminders through God's revelation

 

The Qur'an, the holy book of Muslims – God's revelation to

Prophet Muhammed

 

Muhammed's life is a perfect model for his followers, known as Sunna (tradition)

 

Sunna recorded in books of Hadith (narratives describing the patterns of prophetic behavior.

 

Most  important collection of  Hadith:

 

Sahih Bukhari
Sahih Muslim,for Sunni Muslims

 

Usul al-Kafi for Shiite Muslims.

 

No hierarchy;
no Church,
no clergy

 

Mosque =

Simply a place of   

Worship

 

Ulema =

Scholars of

Islamic law and theology, also recognized as leaders.

 

Imam =

Religious leader, functions as a pastor to the community, performs marriages and presides over funerals.

 

In Shiite Islam after the Prophet, Imam is a rightful successor

 

Ayatollah =

Surpreme legal authority emulated by believers in matters of  faith and practice

 

Muslim calendar =lunar (355 days) rotates in all seasons

 

No new year celebrations

 

Two feasts known as:

 

Id al-Fitr

(marking end of Ramadan, fasting month),

 

Id al-Adha

(marking the annual pilgrimage to Mecca)

 

 

Shiites commemorate

Ashura (Tenth day of the first month), a day of mourning for the Prophet's grandson, Husayn, killed in 680 CE

 

Sala t=

      Daily prayers

 

Five times:

 Before sunrise,
 Noon
 Afternoon
 Sunset
 Evening

 

Jumu'a
(Friday) service at Noon

 

Wudu =
Ablutions for       

prayers

 

Ghusul =

 Ritual bath after sexual intercourse, and following menstruation and child-birth for women

 

Life=
Struggle for moral perfection

 

 

Justice, truth and compassion

 

 

Human relationship is core of one's religious commitment

 

 

Rights in relation to obligations

 

Kindness to fellow humans as expression of obedience to God

 

 

Islam

Perspectives on Health Care Issues

 

Notions of
Body & Spirit

 

Physician – Patient Relationship 

 

 

 Individual Autonomy  Vs. Community

        

 

 

Views on Rx:

Transfusion
Transplant
Organ Donation
Autopsy

 

 

 

Views on
Suffering/Death:

Sustaining vs.
Withdrawal of
Life Support

 

 

 

 

Who's at the

Bedside –

Spiritual Care 
for the Patient & Care for the

Dead

 

 

NAFS = "person"

 

RUH =  "spirit"

 

 

God loves human beings and requires them to care for their total being

 

Human body a "trust" from God, to be cared for

 

 

Health = total well-being, health care is to be holistic in approach

 

 

Ailments =

Psychosomatic reasons and not simply physical

 

 

God the Healer, but human, as God's vice-regent on earth responsible to fulfill divine Will in matters of total well-being of society

 

Physician responsible for restoring  health, patient responsible for carrying out plans to improve health

 

 

Individual life seeks meaning in relation to others in family and society

 

Autonomy respected as long as collective interests are also taken seriously

 

Islamic ethics incline towards community, but does not ignore individual concerns of autonomy

 

Allocation of limited resources must take into consideration  poverty and beneficence of individual  and immediate family

 

Health care not a right but an obligation

 

 

Humans must not cause harm or injury to themselves

 

 

LEGITIMATE  MEANS of saving life are recognized

 

 

 

Blood transfusion -- permissible

 

 

Organ donation/transplant  is permissible if conditions permit and if consent available, even from surrogate decision-maker

 

 

 

Postmortem exam:

(autopsy) allowed to determine causes of  illness to improve methods of curing

 

 

Suffering not evil, educational, purifier of human spirit, test from God to purify

 

 

 

Pain killers allowed to treat pain, even if they lead to shortening of life

 

 

God gives life and determines death

 

 

 

Euthanasia and assisted suicide ar e prohibited

 

 

Withdrawal of life-support permissible if medical experts determine futility of extraordinary intervention

 

 

Obligation of medical professional is to cure not to prolong imminent death

 

 

Patient has right to refuse treatment that causes harm.

 

 

Brain death criteria are valid/acceptable

 

 

 

Prayers are encouraged at all times: God is the HEALER

 

 

Pastoral Care permitted if family members allow

 

 

 

Special care needed for Muslim women whose privacy must be protected at all time

 

 

 

Family and community participate in last moments of life

 

 

Patient is made to face Mecca

 

Visiting sick is like visiting God, highly meritorious

 

 

 

 

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Protestantism

The Tradition

 

God,
The Cosmos
& The HumanConditon

 

 

Sources,
Revelation,
Scriptures, Holy Texts

 

 

 

Organization:
Hierarchy
Leadership, Ministries

 

 

 

Calendar
Time Line
&/or Feast Days

 

 

Prayer
Worship Ritual

 

 

Views on the Moral Life

 

 

 

God is both transcendent and immanent.

 

 

God's primary attitude toward humanity is grace and forgiveness.

 

The world is created by God and is good: embodiment is good. (Celibacy is not valued)

 

While humans are

"sinners", God's grace overcomes sin.

 

We do not earn salvation but receive it as a gift.

 

 

Our task is to be channels of the divine love we have received from God.

 

 

Primary document is the Holy Bible whose authority is viewed variously.

 

Most see scripture as revealing both God and human inspiration, although some see scripture as a human document while others view it as infallible.

 

 

 

Various- from bishop-led, to     lay-centered leadership.

 

No one form of leadership or polity.

 

 Forms range from congregation in style

Baptists,

Disciples,

United Church of Christ

to more connectional

Episcopal

Methodist

 

 

Different from Catholicism no special spiritual status is given to clergy.

 

Clergy/bishops are considered as part of the "priesthood of believers."

 

Impossible for any human to claim infallibility:

  To do so is to be idolatrous.

 

Focus on conscience in matters of faith, along with the authority of scripture and tradition.

 

Varies.

Some follow traditional cycle of Christian seasons (Advent, Lent, etc.) while others follow the secular calendar, with few holidays (merely Christmas and Easter

 

Various, primarily congregational – both informal and formal.

 

Focus on personal experience of God.

 

Personal prayer is important

 

Worship of God in everyday life.

 

We worship God in our secular professions as well as in our ordained.

 

Both loose and strict constructionist in terms of Biblical authority.

 

Our moral life gives glory to God.

 

Various views on abortion, euthanasia, etc. (Strict pro-life and pro-choice positions are idolatrous.

 

Neither suffering nor death are the greatest evils.

 

Morality must be updated to respond to the times.

 

Interplay of absolutes and concrete moral situations.

 

The Church is constantly reforming.

 

Protestantism

Perspectives on Health Care Issues

 

Notions of Body & Spirit
Physician – Patient Relationship

 

 

 

Individual Autonomy vs
Community

 

 

Views on Rx:

Transfusion
Transplant
Organ Donation Autopsy

 

 

 

Views on
Suffering/Death:

Sustaining vs.
Withdrawal of Life Support

 

 

Who's at the
Bedside –

Spiritual Care
For the Patient &
Care for the Dead

 

 

Covenant oriented.

 

Love oriented ethic.

 

Living in the style of Jesus as model:

   Embracing God's   

    suffering and  

    redemption.

 

Care for the poor.

 

Holistic spirituality, embracing body, mind, spirit, and relationships.

 

As we give to the poor, we give to God.

 

Polar and complementary.

 

We are individuals in community.

 

Health care is a social as well as a personal issue.

 

Ethics are communal as well as individual.

 

Concern for the poor.

 

No prohibition to any of these provided that they reflect personal choice.

 

Suffering is meaningful, may be a source of spiritual growth.

 

Palliation is always appropriate.

 

Various views on euthanasia, suicide…

Strong prohibition by some…others see freely chosen euthanasia as a reflection of God's compassion and God's will in certain situations.

 

God may be the supreme relativist in the concrete expression of love.

 

Brain death valid for withdrawal of live support

 

Good dying embraces body, mind, spirit, and relationships.

 

Pastoral and medical care should complement each other.

 

Openness among some to alternative healers.

 

Death as communal as well as individual.

 

Strong support for hospice movement as human care of the dying.

 

 

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Judaism

The Tradition

 

God,
The Cosmos
& The Human Condition

 

 

Sources,
Revelation,
Scriptures, Holy Texts

 

 

 

Organization:
Hierarchy
Leadership Ministries

 

 

 

Calendar
Time Line
&/or Feast Days

 

 

 

Prayer
Worship
Ritual

 

 

Views on the Moral Life

 

 

 

God is one:

"Hear O Israel, the Lord is our God, the Lord is one."

 

Human beings as God's central creation.

 

Human beings created in the image of God.

 

Human beings endowed with free will, inclination to do good/inclination to do evil.

(Yetzer hatov /

yetzer hara)

 

 Process of teshuva

(repentance /  return )

to right our path

 

Path to God through action, not faithful contemplation

 

Experience of Sinai:  God's words, human accounts of the experience, human beings interpretation of how God works in the world.

 

Revelation through word of the Hebrew Bible, interpretive tradition of the Rabbis, our interpretations today.

 

Interpretive tradition (oral law / "unwritten Torah"):

  Mishnah,

  Talmud,

  Midrash,

  Biblical   

  commentaries

   Legal codes

 

The above are the constitution, statutes and cases of the halakhic legal system

 

Decentralized leadership.

 

Nothing comparable to Pope.

 

Different rabbinic authorities recognized by different movements/sects

 

Sectarianism/

Disunity –

 Ultra Orthodox

 Mod. Orthodox

 Conservative

 Reform

Reconstructonist

 Non-affiliated

 

Religious leadership vs.

Secular leadership

(fund-raising, fund allocation)

 

Half of rabbis in non-pulpit positions.

 

No vows taken by rabbis.

 

Integration of lunar and solar calendars:

 New month –

   New moon

 

Holidays –must occur in their seasons.

 

Shabbat – at core of Jewish life, day of rest and celebration of the essences of Life.

 

The Holidays-

Religious, national, penitential, (High Holidays),

Israeli

 

Rosh Hashana,

Yom Kippur,

Succot,

Hanukkah, Purim, Passover,

Yom Ha'tzmaut,

Yom Hashoah, Shavout, 

Tisha, B'av

 

The year 5760 since creation

 

Calendar date begins in evening after sunset.

 

 

Fulfilling the Mitzvot -

Commandments

Intersection of the ethical and ritual.

 

Halakha frames this religious life

 

Torah, Avoda, vigimeeloot chasadim –study, service, prayer, and good deeds.

 

"Study is more important than action, because study leads to action"

Naaseh vinishma, (Do then understand)

 

3 required daily prayer services –

core blessings, some medieval liturgical poetry

 

Community is vital

 

Maimonides:

"The Golden Mean"

 

Moderation, the middle path between

Humility/pride

Anger/repress

   Etc.

 

Anti-ascetic.

 

 

Family, self-sustenance, education, ethical and ritual precepts.

 

Primacy of human life.

 

 

Land of Israel

 

Judaism

Perspectives on Health Care Issues

 

Notions of Body & Spirit
Physician – Patient Relationship

 

 

 

 Individual Autonomy vs Community

 

 

 

 

  

Views on Rx:

Transfusion
Transplant
Organ Donation Autopsy

 

 

Views on
Suffering/Death:

Sustaining vs.
Withdrawal of Life Support

 

 

Who's at the
Bedside –
Spiritual Care For the Patient & Care for the Dead

 

 

 

 

 

G-d is the ultimate healer, the physician is his agent

 

Maimonides as Model of Physician

 

Maimonides Prayer

 

Individual welfare is generally paramount, though there are situations where the welfare of the community is placed above the individual.

 

All people have free will and make autonomous decisions.

 

Many will make important decisions in consultation with rabbinic authority (Rav).

 

There is an understanding that the person asking will abide by the decision of the Rav.

 

 

Transfusions are licit

 

Organ transplant and donation are allowed for vital organs. There is a question about cornea donation.

 

 

Autopsies are only permitted if they will be of direct benefit to specific living people.

 

Autopsies, when done, are as limited as possible.  As much tissue and blood as possible are buried with the body.

 

 

 

 

It is not necessary to prolong suffering simply to extend the life of a patient with a terminal condition.

 

 

Treatments including life-support, do not have to be instituted, even if this will shorten survival.

 

Euthanasia and

Suicide

(assisted or not) are not permitted.

 

There are methods by which life support can, in effect, be withdrawn in some circumstances.

 

It is a religious commandment (Mitzvah) incumbent upon all to visit the sick.

 

 

Many communities have organizations dedicated to meeting the needs of the sick and their families.

 

 Bodies should not be left unattended from the time of death until burial.

 

 

Members of the community make up an organization

(Chevra  Kaddisha) which prepares bodies for burial

 

 

 

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Buddhism

The Tradition

 

God,
The Cosmos & The Human Condition

 

 

 

Sources,
Revelation,
Scriptures, Holy Texts

 

 

 

Organization:
Hierarchy
Leadership Ministries

 

 

 

 

Calendar
Time Line
&/or Feast Days

 

 

 

Prayer
Worship Ritual

 

 

 

Views on the Moral Life

 

 

 

Karma is the ultimate principle of universal justice --not a "creator God."

 

Living beings are burdened with varying degrees of suffering or Dukkha – with potential for genuine happiness

 

 

Happiness or peace stems from

Kindness, Charity, and Insight

 

 

Cosmos has diverse types of living beings—

All with the capacity for Liberation from the cycle of rebirths or Samsara

 

 

Triple Gem

or Buddha, Dharma and Sanghi is interactive source of aid.

 

Yogic – not prophetic – model of religious knowledge

 

 

Buddha's  "Ehi passika" – "Come and see" --  invites one to seek awareness

 

 

Scriptures include Three Baskets or

Tripitaka including Buddha's discourses –

Sutra

*Rule of Life –

Vinaya

*Systematic

Psychology –

Abhidharma

 

Philosophical Commentary enhances the three part canon

 

"Skillful Means"

renders scripture interpretable rather than absolute

 

No universal Buddhist hierarchy

 

 

Clergy are, in theory, "as free as birds" to go about

 

 

Society is split between clergy and laity

 

Political connection varies with historical time and culture

 

 

Buddhism is universal – "for the benefit and happiness of the many"

 

Present-day Buddhist leaders include

Dalai Lama-Tibet

Thich Nhat Hahn-

            Viet Nam

Mahaghosananda-

Cambodia

 

Branches:

   Theravada

       (South Asia)

 

   Mahayana

       (East Asia)

 

Monthly:

Uposatha obsevance days are four according to lunar phases.

Monastics recite vows, confess sins, fast, meditate, and teach. 

Laypeople fast, meditate, take part in devotions listen to a dharma talk, and observe the Eight Precepts

 

Yearly on full-moon:

*April/May is

Vesak for Buddha's birth, enlightenment and

passing away

*February is  "Sangha Day" for Buddha's promulgating Monastic Code

 

*Others

 

Devotions in Temple on observance days

 

 

Make offerings, chant, pray, meditate, at Domestic altar daily

 

Traditionally monastics beg alms once per day.

In west, laypeople bring food to temples.

 

 

Ritual acts include:

(i)Preparation –remove shoes, bow down, make offerings of incense, food, water, flowers, etc.

(ii) Take refuge, chant scripture, meditate, etc.

 

(iii) Dedicate merit for all.

 

  Respect not worship Buddha and Saints

 

Practice the

Eightfold Path, i.e. the Fourth Noble Truth or way to end suffering by doing these "right"

 

Morality

-speech

-action

-livelihood

Concentration

-effort

-mindfulness

-meditation

Wisdom

-thought

-understanding

 

 

Belief in cause and effect of actions through many lifetimes of

Rebirths

 

Compassion and Wisdom –

"two wings of a bird

 

Loving Kindness for all sentient beings

 

Buddhism

Perspectives on Health Care

 

Notions of Body & Spirit
Physician – Patient Relationship

 

 

 

 

Individual
Autonomy vs Community


 

 

 

Views on Rx:

Transfusion
Transplant
Organ Donation Autopsy

 

 

 

 

Views on

Suffering/Death:

Sustaining vs.
Withdrawal of Life Support

 

 

Who's at the
Bedside –
Spiritual Care
For the Patient & Care for the Dead

 

 

 The Five Skandhas

(the body,
feelings/emotions,
perceptions/ thought,
intentions,
consciousness)
come together at
birth and fall apart at death.

 

 

 

 

Suffering is universal and the goal of beings is to be free of suffering. 

 

The physician is a means by which physical or emotional suffering that is due to a medical illness can be reduced or stopped.        

 

Theravada Buddhism

Only goal is to obtain enlightenment through meditation

 

 

 

 

Mahayana Buddhism

Those who obtain enlightenment then help others. These individuals are called 'bodhisattvas.'

 

 

 

 

            

 

Each of these are methods that can reduce suffering and are acceptable.

 

 

Organ donation is considered karmically to be a very positive act

 

Suffering from a medical condition is recognized as a combination of factors:

An external event (i.e., the illness) and personal desires (i.e., the desire to become well or be restored to a previous level of health or activity).  Suffering is greater the desires are not realistic.

 

Suffering can be viewed as the result of karma, from this life or previous ones. Suffering also makes us more aware of our one-ness with all beings.

Suffering that is not done in this life will have to be done in a subsequent one. However there is no point to endless suffering (that the individual cannot modify) and with-drawing life support is acceptable.

 

Goal of being at the bedside prior to death is to relieve or reduce suffering.  This can be done by the laity or by monks.

 

 

Care of the dead is highly variable.

Some forms of  Buddhism believe nirvana can be obtained between death and re-birth, making after death rituals extremely important (some funerals can last for many days.)

 

For other forms of Buddhism the after death rituals are not nearly so elaborate