Nursing with dignity. Part 7: Hinduism.
This article outlines the main beliefs and customs of Hinduism. It offers some guidelines to enable nurses to provide sensitive and appropriate nursing care to Hindu patients.
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This article outlines the main beliefs and customs of Hinduism. It offers some guidelines to enable nurses to provide sensitive and appropriate nursing care to Hindu patients.
Following the originally dominant matriarchate, patriarchy took over and still reigns in present-day society, although we are now in the midst of a period of transition towards a man/woman relationship on partnership basis. This principle of "two units combining to form one", this unification of two opposing and complementary principles has been depicted in a model manner in the iconography of Hinduism and Tantric Buddhism. The attributes of these religions are described with the help of characteristic pictures and sculptures.
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Hindus and Sikhs constitute important minority communities in Canada. Although their cultural and religious traditions have profound differences, they both traditionally take a duty-based rather than rights-based approach to ethical decision-making. These traditions also share a belief in rebirth, a concept of karma (in which experiences in one life influence experiences in future lives), an emphasis on the value of purity, and a holistic view of the person that affirms the importance of family, culture, environment and the spiritual dimension of experience. Physicians with Hindu and Sikh patients need to be sensitive to and respectful of the diversity of their cultural and religious assumptions regarding human nature, purity, health and illness, life and death, and the status of the individual.
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1. Nurses can help individuals more readily deal with death and dying by examining cultural variations in death reactions and rituals. This helps to humanize care. 2. Caring for a dying client is a complex and challenging responsibility and requires physical, emotional, and spiritual support to ensure a peaceful and dignified death. 3. Clients turn to religion for peace and comfort during times of crisis, such as serious illness and impending death. It is necessary to understand the impact of religious beliefs and practices to provide quality holistic care.
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Disability in the past of eastern religions has attracted little formal or comparative scrutiny. A range is sketched here of historical data, viewpoints and attitudes on disability in Hinduism, Buddhism and Islam, which continue to influence the thoughts of half the world's population. Approaches for more detailed studies are suggested, moving towards such global measures for understanding, remediating and accommodating disability as would be more appropriate and acceptable to the non-western majority. Popular notions associated with disabilities in these religions are discussed.
Meetings between an American guru and his followers were observed and 14 of the devotees were interviewed. Virtually all gave histories of chronic unhappiness and unsatisfactory parental relations. On involvement with the guru and a new 'family,' the experienced increased well-being and periods of bliss, and their acceptance of mystic Hindu beliefs was solidified. Factors relating to the devotees' psychological 'lift' are delineated, including ways that the bond to the leader possibly aided them in dealing with inner conflict. Earlier experiences with psychedelic drugs appeared to have influenced many of the subjects to Hinduism and the guru. It is postulated that a psychological characteristic of the devotees is a strong underlying wish for union with a powerful object,and that this bore on their susceptibility to the influence of certain regressive psychedelic experiences.
The saintly madman is a familiar character in South Asia. To outer appearances he is no different from a lunatic, but the mad saint comes to be revered because his idiocy is popularly believed to arise from a different cause than ordinary madness. The common psychopath neglects social conventions because his consciousness is dimmed by incapacity; the saintly madman also breaches convention, but does so because his heightened consciousness has liberated him from the bonds of convention that entrap ordinary people. In the terms of Hinduism, he has tasted the divine nectar of God-realization and has returned to the human realm intoxicated by the experience. In this paper two popular God intoxicated saints of Bengal are discussed. The question is posed whether 'God intoxication' can be considered a culture-bound syndrome of Bengal. The concept of 'culture bound syndrome' is found to be too narrow to encompass the most significant issues to arise from reflection on the characteristics of the God intoxicated. These larger issues have to do with the relationship between cultural practices and models and mental states (whether deviant, as implied by the term 'syndrome' although deviance does not always carry the negative connotation implicit in 'syndrome', or normal). It is suggested that all cultures culture a limited range of mental states and thus the questions posed by the notion of culture bound syndromes are subsumed by larger questions about the relationship of all mind-states to the socio-cultural environment which conditions them. The conclusion is that God intoxication is indeed a uniquely Bengali mental condition, with variants throughout South Asia and kinship to other mystical states, but that the concept of 'syndrome' is not useful.
OBJECTIVE: To promote greater sensitivity to and heightened awareness of the relevance and therapeutic potential of integrating medicine and spirituality in the healing process of patients cared for by our medical residents. Strategies for clear, effective, and empathetic communication are integrated into the curriculum. DESCRIPTION: With the support of The University of Massachusetts Medical School Macy Initiative in health communication, funded by the Josiah Macy, Jr. Foundation, we have fully implemented a medicine-spirituality curriculum as an integral aspect of our residency program. Current strategies include (1) new house officers participate in the workshop "Communicating Bad News," which is based on a videotaped interaction and experiential role-play about the challenging "art" of sharing bad and often traumatic news; (2) a monthly lecture series that looks at various aspects of religious and spiritual practices and their implications on science and health with topics including the following: taking a spiritual history, exploring world religious views from a Judeo-Christian perspective, studying Eastern philosophies such as Buddhism and Hinduism, and discussing cultural diversity's effect on how people understand and cope with illness; (3) residents receive a comprehensive, evidence-based syllabus that encompasses all of the medical literature relating to spirituality, religion and health; (4) local hospice professionals give end-of-life care lectures about pain management, palliation, advanced directives, and ethical implications; (5) our residents spend one or two days per year with our pastoral care leaders and one to two days per year with our hospice team; (6) monthly ward rounds with a faculty member who emphasizes the spiritual dimension of a particular case and the faith-based resources in our hospital and community. DISCUSSION: Traditionally, graduate medical education has not emphasized the importance of spirituality as a "target" for routine inquiry, understanding, and sharing in the context of patient care. We are beginning to see that residents need to be aware of the relationship between spirituality and health, as a consequence of this curriculum. Because the curriculum is seamlessly integrated into a preexisting infrastructure (e.g., noon conferences, ambulatory off-site experiences, walk-rounds, etc.), it has been relatively easy to implement. Focusing on the literature has also provided a "scientific door" that has made this more palatable. Over time, we will foster a growing alliance of the medical and faith communities in our rural area. This has potent implications for community health initiatives. Two of our residents have already volunteered to give talks at local congregations. Spirituality and religion are sensitive and personal areas that can be awkward to embrace and openly discuss. By remaining sensitive and respectful of all views, we strive to diminish the obstacles and enable a more provocative, enlightening residency experience. As a consequence, we are forced to reconsider what it is to be a "healer" and what it is to be "healed." Annual verbal and written feedback will allow us to refine our curriculum. I anticipate this to be a permanent aspect of our residents' training.
Indian and Chinese cosmologies are compared, each containing five cosmic elements. The Indian elements are Akasha, Air Fire, Water, and Earth. Akasha connotes Creative energy. As depicted it is substituted by reproduction projected as creation. Hence the male and female generative organs as Lingam-Yoni, already recognized in Hinduism as symbolizing the source of creative energy, have been depicted as such. The other four elements represent creation proper. In Chinese cosmology the full term is "Yin-Yang Wu-Hshing." Wu-Hshing signifies Five=Cosmic elements and these are Wood, Fire, Water, Earth, and Metal. They are taken from Iran. Since there is no element to represent creative energy this is expressed by the term Yin-Yang, or Black and White in lieu of male-female or Lingam-Yoni of Indian cosmology. The organs of reproduction have been projected as the opposites that generate creative energy. Virtually Yin-Yang=Lingam-Yoni=Creative energy generators.
Xenotransplantation faces the dilemma of an unlimited supply of cells, tissues and organs on the one hand and severe obstacles and limits on the other. One reason for the limitations is that the source animal of choice, the pig, and the human recipient separated 90 million years ago during evolution, a time in which biological characteristics such as anatomy, physiology and immunology have had much time to drift far apart. The acceptance of such an evolutionary widely divergent organ, especially the heart of a pig, could evoke refusal of xenotransplantation in conservative and religious patients. New legal aspects of allocation of xenografts have therefore to be reflected upon and appropriate guidelines developed. Inquiries show, however, that the acceptance of all types of porcine organs would be high if the quality of life after receiving such a xenograft is comparable to that after receiving the same allograft. This individual benefit of a xenograft could lead to a disregard of the collective risk in terms of xenozoonoses, often presented as a catastrophic scenarium. Therefore, transplantation societies and ethics committees have published comments and even guidelines for handling future clinical xenotransplantation. All three monotheistic religions and Hinduism support the idea of saving and improving human life with the help of an animal organ.
Advance directives are a way to communicate the kind of care that people desire at the end of life. Recent research shows that ethnic minorities have been found to complete advance directives significantly less often than Caucasians, and no information was available regarding advance directives in the Asian Indian population. To address this shortcoming, this descriptive exploratory design sampled a community sample of 45 Asian Indian Hindus. Being female and having an individualistic decision-making style were significantly positively correlated with advance directive completion. Having strong religious affiliation and a family decision-making style were significantly negatively correlated with advance directive completion. The results of this study provide needed information regarding the Asian Indian population and how Hinduism affects advance directives.