Cultural Approaches to Pediatric Palliative Care in Central Massachusetts: Roman Catholicism

Beliefs

• Strong tradition of liturgy (ceremony)
• Emphasis on practices (usually termed, sacraments), including: baptism, Eucharist, prayers for the sick, holy orders, marriage, confirmation and confession/penance
• Dedication to creeds (formulated statements of beliefs)
• Belief in Apostolic succession of leadership, meaning leaders should be male successors of the original apostles of Jesus

Daily practices

• Prayers at table, bedside and other times
• May desire daily Eucharist or attendance at Mass
• Use of sacramentals or aids in the spiritual life, such as rosary beads/prayer, holy images, candles, etc.

Dying and death

• Belief in life after death
• Persons experiencing grave suffering and/or approaching death are usually encouraged to pin their suffering to that of Christ’s.
• Sacrament of the Anointing of the Sick very important for the seriously ill, frail and elderly. Used to be called Last Rites.
• Autopsy and Organ Donation acceptable
• Body to be treated with respect
• Wakes encouraged- usually in a funeral home the day before the funeral.
• Funeral Mass is the norm but can be replaced with a funeral version of Liturgy of the Word
• Graveside service is also typical

Facilitating practices

• Ask patient and family about preferred practices
• Ask about rituals and needs such as Eucharist/Communion or anointing
• Provide for privacy as needed

Food

• Traditional Catholics may fast and/or ask for sacramental confession prior to receiving Eucharist and may wish to avoid meat on Fridays, especially during season of Lent; offer to provide fish instead
• No general dietary restrictions

Health

• Blood and blood products acceptable
• May wish major amputated limb to be buried in consecrated ground
• Sacrament of the sick (anointing by a priest) may be very important
• May believe suffering is part of one’s fate or punishment from God

Holy days and festivals

• Traditional Christian holidays as well as observance of special holy days when attendance at Mass is viewed as an obligation.
• Holidays such as Christmas and Easter are celebrated as a season, not only for one significant day.

Pregnancy and

birth

• Natural means of  birth control
• Abortion and sterilization prohibited
• Artificial means of conception are discouraged
• Baptism of infants may be required and urgent if prognosis is grave

Rituals or ceremonies

• Attending Mass on Sunday and Holy Days, sometimes daily
• Observing sacraments
• Praying the rosary (beads to aid in saying prayers)
• Lighting candles
• Be aware of cultural differences in observance and practice, especially in the large and growing number of Spanish speaking communities.

Spiritual instruments, structure, and symbols

• Rosary (prayer beads)
• Holy water
• Incense
• Saints, especially Mary the mother of Jesus and saints associated with healing
• Jesus pictures and statues; crucifix (cross with corpus of Jesus)
• Name of Jesus is important
• Only (male) priest can offer Sacraments
• Leadership includes priest (‘Father’) deacon (‘Mr.’ or ‘Deacon’), nuns ‘(Sister’) and brothers (‘Brother’), whom all have taken vows, as well as Eucharistic ministers (lay-men and women who bring Eucharist /Communion); chaplains, both men and women, who are specially trained and certified.