Cultural Approaches to Pediatric Palliative Care in Central Massachusetts: Sikhism

Beliefs

• God is formless, eternal and unobserved
• God is the supreme Guru, revealed as guide and teacher throughout the world
• Reincarnation as a cycle of rebirth
• Tension exists between God’s sovereignty and human free will
• Salvation is liberation from the cycle of rebirth…Salvation can be achieved through disciplined meditation and spiritual union with God
• Ideal life is one of work, worship and charity
• Equality of all people

Daily practices

• Private worship twice daily, morning and night
• Following the 10 Sikh gurus (enlightened leaders) and the holy scriptures

Dying and death

• Body is bathed, dressed and cremated
• Floor is washed and covered with white sheets; shoes taken outside the room

Facilitating practices

• Provide privacy
• Respect wearing of religious objects; do not remove without permission

Food

• Fasting not acceptable as a religious practice, although can be observed for medical reasons

Health

• Adult members have made a vow never to cut the hair on any part of their body

Holy days and festivals

• Meet as a congregation for prayer service and common meal on six primary holidays

Pregnancy and birth

• Child is often named by opening the Guru Sahib (book of collected religious writings) at random; the first letter of the first verse on the left-hand page becomes the first initial of the child’s name 
• There are no particular rituals connected with the birth of a child in the Sikh community. Some sections of the Sikhs recite the five verses of the Morning Prayer, Japji Sahib into the ears of the newborn child
• Gurthi: A respected intelligent and favorite member of the family gives a drop of honey to the newborn child so as to give the child his characters later in life.  This is not a ritual and it mostly takes place in the hospital itself
• Shushak: When a child is born into the Sikh fold, the maternal grandparents gift him a package called Shushak, which consists of clothes for the child and his family, a spoon, glass, and a bowl for the child, money and gold ornaments for the child according to their financial status. 

Rituals and ceremonies

• Sikh Baptisms (Amrit)
• Naming Ceremonies
• Birth Ceremonies

Spiritual instruments, structure, and symbols

• Guru Granth Sahib, collection of religious writings, is the ‘Living Word’ and the ‘Living Guru’, or teacher
• A turban may be worn as a symbol of personal sovereignty and responsibility to others
• Symbolic objects include wooden comb, cloth around chest, and iron bracelet which must never be removed
• Local leadership consists of elected committee of 5 elders
• Khanda, which reflects certain fundamental concepts of the faith (looks like two swords crossed with a circle overlapping)