Burial rituals are symbolic activities that encourage the expression of grief as a positive way to heal while helping to confirm the reality of death. In the Caribbean, consisting of multiple distinct islands and histories of colonization, how individuals are buried on each island depends on the historical intermingling of the colonizer’s Christian religion and African (spiritual) rituals. Each island has distinct burial rituals that are a blending of Christian and African religious or spiritual cultures. This article highlights the distinct burial rituals on the Caribbean islands of Barbados, Haiti, and Trinidad and how its historical past has shaped present burial rituals and its significance to the African Caribbean grieving processes.
L'histoire est l'étude du rapport entre l'homme et le temps ou, plus précisément, le rapport entre les sociétés et la durée. Depuis plus de soixante ans, je suis donc professionnellement confronté au temps. Depuis plus longtemps, peut-être, parce que si l'histoire m'attirait dans ma jeunesse, c'est sans doute parce que déjà le temps m'obsédait : le temps de la vie, la vie hors du temps. Forcément, ce temps qu'étudient les historiens est un temps passé, qui a laissé des traces. Pour comprendre les vivants, l'historien fréquente inévitablement les morts.
Cet article présente, à l'aide de quelques positions célèbres, une vue d'ensemble de la réflexion sur le suicide dans l'histoire de la théologie chrétienne. Il abode notamment les positions d'Augustin, de Thomas d'Aquin, de Martin Luther et de Dietrich Bonhoeffer.
Developing the ethics of palliative sedation, particularly in contrast to terminal sedation, requires consideration of the relation between body and soul and of the nature of death and dying. Christianly considered, it also requires attention to the human vocation to immortality and hence to the relation between medicine (as aid for the body) and discipline (as aid to the soul). Leaning on Augustine's rendering of the latter, this paper provides a larger anthropological and soteriological frame of reference for the ethics of palliative sedation, organized by way of nine briefly expounded theses. It argues that palliative sedation, like other elements of medicine, is appropriate where, and only where, it properly orders care for the body to the requirements of care for the soul.
La maitresse annonce aux élèves que Nicole est morte, elle a été renversée par un camion. Voyant un dessin de Nicole accroché au mur de l'école, Rémi se souvient...
Ce livre aborde la mort et évoque les rites et coutumes propres à d'autres croyances.
Quel rôle joue exactement dans la foi chrétienne la croyance en une existence qui suit la vie présente ? Quelle importance et quelle valeur faut-il lui accorder ? Occupe-t-elle une place centrale, essentielle, déterminante ? Ou, au contraire, s'agit-il d'un élément périphérique, secondaire, voire superflu ?
[Début de l'article]
This special issue of Theoretical Medicine and Bioethics takes up the question of palliative sedation as a source of potential concern or controversy among Christian clinicians and thinkers. Christianity affirms a duty to relieve unnecessary suffering yet also proscribes euthanasia. Accordingly, the question arises as to whether it is ever morally permissible to render dying patients unconscious in order to relieve their suffering. If so, under what conditions? Is this practice genuinely morally distinguishable from euthanasia? Can one ever aim directly at making a dying person unconscious, or is it only permissible to tolerate unconsciousness as an unintended side effect of treating specific symptoms? What role does the rule of double effect play in making such decisions? Does spiritual or psychological suffering ever justify sedation to unconsciousness? What are the theological and spiritual aspects of such care? This introduction describes how the authors in this special issue wrestle with such questions and shows how each essay relates to the author's individual position on palliative sedation, as developed in greater detail within his contribution.
BACKGROUND: Patients' religious and spiritual values impact their goals and perception of illness, especially at the end of life (EOL). According to the Joint Commission, identifying spiritual beliefs may improve cultural competency and patient-centered care. However, clinicians may be uncomfortable discussing spirituality and unaware of basic religious teachings.
OBJECTIVES: To assess clinician understanding and knowledge of key Christian, Jewish, and Islamic teachings around EOL care before and after a one-hour educational intervention through video podcast.
DESIGN: After literature review and consultation with religious leaders, a pre- and post-test (10 questions per religion plus demographic questions) to assess knowledge of Christian, Jewish, and Islamic teachings and an educational video podcast were developed. The pretest was administered to healthcare providers, followed by a one-hour educational intervention through a video podcast. Next, a post-test was administered.
SUBJECTS: Seventy-three healthcare providers participated in this study.
MEASUREMENTS: Differences between pretest and post-test scores were analyzed employing paired t-test tests using SPSS software.
RESULTS: The median score on the pretest was Christian: 6 [2–9], Jewish: 6 [4–10], and Islamic: 6 [2–8]. After the educational intervention, the median Christian, Jewish, and Islamic scores improved to 8 [4–10], 9 [6–10], and 10 [3–10], respectively (p < 0.0001). Additionally, the total pretest median score improved from 17 [10–24] to 27 [16–30].
CONCLUSIONS: A one-hour educational intervention through video podcast significantly improved understanding of Christian, Jewish, and Islamic teachings around EOL care. The video podcast enabled easy distribution of the educational session to multiple facilities and providers. Additional research is needed to determine the longitudinal outcomes and impact on patient outcomes of this intervention.
OBJECTIVE: The objective of this study was to examine the religious/spiritual beliefs of followers of the five major world religions about frequently encountered medical situations at the end of life (EoL).
METHOD: This was a systematic review of observational studies on the religious aspects of commonly encountered EoL situations. The databases used for retrieving studies were: Ovid MEDLINE In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid EMBASE, Ovid PsycINFO, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and Scopus. Observational studies, including surveys from healthcare providers or the general population, and case studies were included for review. Articles written from a purely theoretical or philosophical perspective were excluded.
RESULTS: Our search strategy generated 968 references, 40 of which were included for review, while 5 studies were added from reference lists. Whenever possible, we organized the results into five categories that would be clinically meaningful for palliative care practices at the EoL: advanced directives, euthanasia and physician-assisted suicide, physical requirements (artificial nutrition, hydration, and pain management), autopsy practices, and other EoL religious considerations. A wide degree of heterogeneity was observed within religions, depending on the country of origin, level of education, and degree of intrinsic religiosity.
SIGNIFICANCE OF RESULTS: Our review describes the religious practices pertaining to major EoL issues and explains the variations in EoL decision making by clinicians and patients based on their religious teachings and beliefs. Prospective studies with validated tools for religiosity should be performed in the future to assess the impact of religion on EoL care.
BACKGROUND: International guidance for advance care planning (ACP) supports the integration of spiritual and religious aspects of care within the planning process. Religious leaders' perspectives could improve how ACP programs respect patients' faith backgrounds. This study aimed to examine: (i) how religious leaders understand and consider ACP and its implications, including (ii) how religion affects followers' approaches to end-of-life care and ACP, and (iii) their implications for healthcare.
METHODS: Interview transcripts from a primary qualitative study conducted with religious leaders to inform an ACP website, ACPTalk, were used as data in this study. ACPTalk aims to assist health professionals conduct sensitive conversations with people from different religious backgrounds. A qualitative secondary analysis conducted on the interview transcripts focussed on religious leaders' statements related to this study's aims. Interview transcripts were thematically analysed using an inductive, comparative, and cyclical procedure informed by grounded theory.
RESULTS: Thirty-five religious leaders (26 male; mean 58.6-years-old), from eight Christian and six non-Christian (Jewish, Buddhist, Islamic, Hindu, Sikh, Bahá'í) backgrounds were included. Three themes emerged which focussed on: religious leaders' ACP understanding and experiences; explanations for religious followers' approaches towards end-of-life care; and health professionals' need to enquire about how religion matters. Most leaders had some understanding of ACP and, once fully comprehended, most held ACP in positive regard. Religious followers' preferences for end-of-life care reflected family and geographical origins, cultural traditions, personal attitudes, and religiosity and faith interpretations. Implications for healthcare included the importance of avoiding generalisations and openness to individualised and/ or standardised religious expressions of one's religion.
CONCLUSIONS: Knowledge of religious beliefs and values around death and dying could be useful in preparing health professionals for ACP with patients from different religions but equally important is avoidance of assumptions. Community-based initiatives, programs and faith settings are an avenue that could be used to increase awareness of ACP among religious followers' communities.
Point obscur de la réflexion et de la sensibilité contemporaines, la mort se tient pourtant à l'horizon de chaque existence humaine. Niée ou pas, il faudra bien qu'elle advienne... faudrait-il pour autant attendre le moment dernier pour y réfléchir ? De ce point de vue, les voies bouddhiste et chrétienne sont riches de toute une tradition réflexive, pratique et spirituelle. La mort n'y est pas taboue, bien au contraire : elle se présente dans toute son austérité ; dans toute sa capacité, aussi, à convoquer ce que chaque tradition porte en elle de plus important.
Réfléchir à la mort, c'est ainsi tenter une percée au coeur de chaque existence humaine tout autant que du christianisme et du bouddhisme en soi. Fruit d'un colloque présidé par Dennis Gira, théologien catholique et spécialiste reconnu du bouddhisme, le présent volume déroule son propos de manière pédagogique. Il part de considérations générales sur la mort pour envisager ensuite des aspects doctrinaux, éthiques, spirituels et liturgiques.
[Extrait résumé éditeur]
AIMS: Religious affiliation influences societal practices regarding death and dying, including palliative care, religiously acceptable health service procedures, funeral rites and beliefs about an afterlife. We aimed to estimate and project religious affiliation at the time of death globally, as this information has been lacking.
METHODS: We compiled data on demographic information and religious affiliation from more than 2500 surveys, registers and censuses covering 198 nations/territories. We present estimates of religious affiliation at the time of death as of 2010, projections up to and including 2060, taking into account trends in mortality, religious conversion, intergenerational transmission of religion, differential fertility, and gross migration flows, by age and sex.
RESULTS: We find that Christianity continues to be the most common religion at death, although its share will fall from 37% to 31% of global deaths between 2010 and 2060. The share of individuals identifying as Muslim at the time of death increases from 21% to 24%. The share of religiously unaffiliated will peak at 17% in 2035 followed by a slight decline thereafter. In specific regions, such as Europe, the unaffiliated share will continue to rises from 14% to 21% throughout the period.
CONCLUSIONS: Religious affiliation at the time of death is changing globally, with distinct regional patterns. This could affect spatial variation in healthcare and social customs relating to death and dying.