Cultural Approaches to Pediatric Palliative Care in Central Massachusetts: Hinduism

Beliefs

• A wide variety of beliefs held together by an attitude of mutual tolerance and belief that all approaches to God are valid.
• Humankind’s goal is to break free of this imperfect world and reunite with God
• Reincarnation and karma (law of cause and effect)
• One must perform his/her duties to God, parents, teachers and society

Daily practices

• Personal hygiene very important and bathing is required every day, but bathing after meal may be viewed as harmful
• Hot water may be added to cold, but not the opposite
• Removal of shoes before entering a room

Dying and death

• The atmosphere around the dying person must be peaceful
• The last thoughts or words are of God; the Gita (scripture) is recited to strengthen the person’s mind and provide comfort. Religious chanting before and after death is continually offered by family, friends, and priest.
• Prefer to die at home, as close to mother earth as possible (usually on the ground)
• Active euthanasia viewed as destructive
• No Custom or restriction on prolongation of life
• Immediately after death priest may pour water into mouth of deceased and family may wash the body
• Customary for body not to be left alone until cremated
• Autopsy and organ donation acceptable
• Cremation is common on day of death
• Fetus or children under age 2 may be buried; no rituals observed

Facilitating practices

• Provide supportive environment and privacy for rites
• Involve family members in plan of care and determine which member will provide personal care
• Father/husband is primary spokesperson to whom questions should be directed – women may not request special care
• Special respect for elders

Food

• Usually vegetarian
• If not vegetarian, may avoid beef or pork. According to dietary law, right hand is used for eating and left hand for toileting and hygiene
• May fast on special holy days

Health

• Prayer for health considered low form of prayer, stoicism is preferable
• Medications, blood and blood products, donation and receipt of organs:  See the following article--

           Thrane, Susan.  Hindu End of Life:  Death, Dying, Suffering, and Karma.  Journal of Hospice and Palliative Nursing.  2010;12(6): 337-342.

Holy days and festivals

• Several which are observed at home; some take place in a temple
• Must be barefoot during religious worship or any kind of religious celebration
• Must sit at a lower elevation than where the image of the deity has been placed

Pregnancy and birth

• Exact time of birth may be important to family
• Circumcision is uncommon
• May not want to name the newborn immediately
• May be against abortion
• Birth control, artificial insemination and amniocentesis acceptable

Rituals or ceremonies

• On 10^th or 11^th day after birth, priest performs naming ceremony
• Specific ceremonies vary according to local customs
• Praying, meditating, scripture reading, and recitation is common

Spiritual instruments, structure, and symbols

• Various sacred writings
• Various objects for rituals- including sandalwood, incense, candle, symbols or pictures, fresh flowers, prayer beads
• Not a church-based religion; no hierarchical structure religious practitioner is priest