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Cultural Approaches to Pediatric Palliative Care in Central Massachusetts: Native American Spirituality

This subject guide is a collaborative project with the Children's Medical Center Pediatric Palliative Care Team, the Lamar Soutter Library, and Interpreter Services.

Native American Spirituality

Native American Spirituality

                        *No founder; tradition has evolved over centuries, passed down by storytelling

*More than 2 million people in 300-500 different American Indian tribal groups, each with its own culture and responses to specific situations 


  • Creator – some tribes use ‘God’ and ‘Creator’ interchangeably
  • Fundamental inter-connectedness of all natural things, all forms of life, with the land, or Mother Earth, are of primary importance
  • Basic sense of community or group/tribe

Daily practices

  • Prayers may include using sacred objects, usually private and without strangers present.

Dying and death

  • Belief and practices vary widely from tribe to tribe
  • Body is sometimes prepared for burial by family or tribe members
  • After person dies, some tribes will not touch deceased person’s clothes or belongings

Facilitating practices

  • Provide time, space, privacy, and include tribal spiritual leader
  • Do not pretend to be familiar with traditions and do not interfere with them


  • After ceremony or prayer, foods consumed will likely be provided by family


  • Health care practices intertwined with religious and cultural beliefs
  • May believe that ill health results from not living in harmony or being out of balance with nature and social and supernatural environments

Holy days and festivals

  • Closely related to seasonal changes, the moon, provision of food and other life essentials

Pregnancy and birth

  • Pregnant women included in religious ceremonies until delivery

Rituals or ceremonies

  • Performed with intent of seeing, understanding, or obtaining a vision of clarity of oneself and individual issues in order to relate to oneself and others
  • Prayer accompanied by burning of sacred plants, i.e. sweet grass, sage, cedar or tobacco

Spiritual instruments, structure, and symbols

  • No written scriptures; ceremonies and beliefs learned by word of mouth and experience
  • Sacred and should not be touched without permission. especially by stranger
  • Medicine bag: leather pouch usually worn around neck.  Do not open or question
  • Religious articles carried by elders must not be touched by anyone other than the elder; if inspection is required, an elder should be invited to provide inspection services
  • A woman should not come near sacred objects during menstruation

Social Structure

  • Respect for female and male elders
  • Medicine Man or Woman will probably  not have identification defining member
  • Include elder, medicine person, or spiritual leader as colleague to assist in healing process


  • A great variety of symbols which vary from one tribe to another

Reproduced by permission from George Handzo, BCC at 

Dictionary of Patients' Spiritual & Cultural Values for Health Care Professionals were developed by the Pastoral Care Leadership and Practice Group of HealthCare Chaplaincy, New York, NY. (Revision and update of earlier work by the Rev. Susan Wintz, BCC and the Rev. Earl Cooper, BCC)