Death with Dignity PDF
Preview Death with Dignity
DEATH WITH DIGNITY Dedicated to the illustrator Clare Passmore (1 964---1989) DEATH WITH DIGNITY by Jennifer Green Consultant in Public Health Medicine, Pontefract Health Authority Edited by Joanna Trevelyan, Features Editor,Nursmg Times Designed by Susie Lanni NT A NURSING TIMES PUBLICATION v © Nursing Times 1991 All rights reserved. No reproduction, copy or transmission of this publication may be made without written permission. No paragraph of this publication may be reproduced, copied or transmitted save with written permission or in accordance with the provisions of the Copyright, Design and Patent Act 1988 or under the terms of any licence permitting limited copying issued by the Copyright Licensing Agency, 33-4 Alfred Place, London WClE 7DP. Any person who does any unauthorised act in relation to this publication may be liable to criminal prosecution and civil claims for damages. First edition 1991 Reprinted 1993 Published by MACMILLAN MAGAZINES LTD 4 Little Essex St London WCZR 3LF ~ M MACMILLAN Companies and representatives throughout the world ISBN 978-0-333-54971-1 ISBN 978-1-349-12301-8 (eBook) DOI 10.1007/978-1-349-12301-8 vi CONTENTS INTRODUCTION 1 ISLAM 2 HINDUISM 4 SIKHISM 6 JUDAISM 8 BUDDHISM 10 BAHA'I FAITH 12 FUNERALS ABROAD 14 RESOURCE LIST 15 vii DEATH WITH DIGNI1Y INTRODUCTION These articles came to be written because the nursing staff in my health district asked for them. It was the Day of Atonement, the holiest day in the Jewish calendar, when a Jewish patient died unexpectedly in a small private nursing home. The family were not present. Nursing staff were unable to contact them, and were unsure of what should be done. This embarrassing incident led to a request for an operational policy for just such a situation. Subsequently this extended to cover the ethnic minority groups of the district. Our local policies include names and telephone numbers of community leaders who may be approached for help and advice at all times, and spaces are included in this booklet for the insertion of your appropriate local information. Within each religion and culture there is a wide spectrum of observance and belief, and, if possible, health care staff should always ask the patient and family members for their views. These policies were written for health care staff who may find themselves in unfamiliar circumstances and without relatives at hand. Iv ery much hope that readers will find them informative and helpful. I am aware that this booklet is not yet complete and I hope to include other religious and ethnic groups in a further series. Jennifer Green August 1989 1 These guidelines are intended to help bland English hospital food may seem health care staff in unfamiliar situa very unappetising. Nurses should dis tions, particularly if no immediate cuss dietary requirements with a family members are available. If pos Muslim patient to find out what is sible, the views of the individual or Muslims attach great importance to acceptable to him or her. family concerned should be sought. cleanliness. Hands, feet and mouth are During the month of Ramadan a always washed before prayer, and after Muslim fasts between sunrise and sun menstruation women are required to set, although those who are sick are not wash their whole bodies. In hospital the expected to fast. use of a shower rather than a bath will be Islam is the Arabic name for the appreciated. Mohammedan religion. The term Muslim women may prefer to be seen means 'surrender to God's will', and or treated by a female doctor, and includes acceptance of those articles of consideration should be given to their The dying Muslim patient may wish to faith, commands and ordinances reveal modesty if requested. sit or lie with his face towards Mecca, ed through the Prophet Mohammed. Most Muslims are accustomed to and moving the bed if necessary to make Over 800 million people profess having water in the same room as the this possible will be apreciated. Another Islam, three quarters of them are toilet. If a bedpan has to be used, then a Muslim, usually a relative, may whisper widely scattered from the Adriatic to bowl of water should also be provided for the call to prayer into the dying person's Malaysia. The rest live mostly in North washing. ear, and family members may recite Africa. probably There are 90 million prayers round the bed. If no relatives are Muslims inI ndia alone. available and the patient has requested Mecca, near the Red Sea coast of this service, any practising Muslim can Saudi Arabia, is the religious centre for give help and religious comfort, and Muslims and a place of pilgrimage from Some meat is permitted as long as it has advice should be sought from the local all parts of Islam. It was here that been slaughtered according to the Halal Muslim community. Mohammed was born and began his ritual which drains the meat of blood. teaching. Halallamb, beef and chicken are eaten, There are four chief religious duties but pork meat, carrion and blood are for a Muslim: prayer-five times a day forbidden. Fish and eggs are allowed, with associated purification rituals as but must not be cooked where pork and necessary preparation; alms giving; other non-Halal meat is cooked. Food is In Islam, the body is considered to fasting; a pilgrimage to Mecca. often well seasoned and spiced, and belong to God, and strictly speaking no 2 e part of a dead body should be cut out, Cover the deceased with a sheet with the head facing Mecca. Some harmed, or donated to anyone else. which conceals the whole of the body. families will wish to take their dead back Post-mortems are therefore forbidden Members of the local Muslim to their country of origin for burial. The unless ordered by the coroner, in which community may also be contacted for procedure for this is discussed on page case the reasons for it must be clearly help and advice. 14. explained to the family. In abnormal circumstances, where Strict Muslims will not agree to organ the attending doctor is unable to transplants, and the subject should not complete the death certificate, or where be raised unless the family initiated the for some reason the death must be discussion. notified to the coroner, the immediate family should if possible be informed. If no family members are available, advice can be sought from the local Muslim community. The local police station After death the body should not be should. then be contacted. The duty touched by non-Muslims, and for this inspector has a list of coroner's officers reason health workers who need to on call for each area and will arrange for touch the body should wear disposable the appropriate coroner's officer to gloves. communicate with the doctor in charge AM uslim funeral should take place as of the case. soon as practicable, preferably within 24 Reporting to the coroner does not hours. Delay can cause distress to the necessarily involve a post mortem, and, relatives and if unavoidable, the reasons even if a post mortem has to be carried should be explained carefully to the out, the funeral need not be unduly relatives. delayed. Under normal circumstances, where The coroner's officer needs to be a death certificate has been issued by the informed that the patient was a Muslim a~tending doctor, the body should be and should be asked if: prepared according to the wishes of the e The autopsy can be arranged for later family. However, if no family are pre that day or early next morning. e sent, the following steps should be The result of autopsy may be made taken: available by the pathologist, by tele e Wearing disposable gloves, close the phone, to the coroner. eyes. e The death certificate can be issued as e Bandage the lower jaw to the head, so soon as possible for burial, preferably that the mouth does not gape. within 24 hours. e Normal Muslim procedure is that the If the body needs to be moved, the family body is straightened immediately may want to use their chosen funeral after death. This is done by flexing the director, if not, the coroner's officer will elbows, shoulders, knees and hips arrange transport. BIBLIOGRAPHY first before straightening them. This is Ritual preparation of the body is Henley A. Asian patients in Hospital and at Home. thought to ensure that the body does commenced after completion of the London: King Edward's Hospital Fund for London, not stiffen, thus facilitating the wash autopsy. 1979. ing and shrouding of it. Henley, A. Asians in Britain. Caring for Muslims and e Tum the head towards the right their families: Religious aspects ofc are. Cambridge: ational Extension College of the Health Education shoulder. This is so the body can be Council, DHSS and the King Edward's Hospital Fund buried with the face towards Mecca. for London, 1982. e Do not wash the body, nor cut hair or Polson, C. J., Marshall, T. KT. he Disposal oft he Dead. nails. 3rd edition. London: English Universities Press, 1975. 3 many different forms. Every Hindu female doctor, and consideration should pray, revere the old, and offer should always be given to their modesty generous hospitality to any visitor. when, for example, being dressed for Many are vegetarian, refusing to take X-ray or surgery. the Jives of animals for food. In India, Most Hindus are accustomed to hav where a caste system exists, castes vary ing water in the same room as the toilet. in how strictly they follow the laws of If a bedpan has to be used, then a bowl of diet, prayer, and ritual purification. water should also be provided for There is also a belief in reincarnation washing. in which the status, condition and caste Hinduism, the title given to the religion of each life is determined by the of the vast majority of the population of behaviour in the last life-making each India, is inextricably bound up with person responsible for who he is and culture and social structure. It encom what he does. Many Hindus do not eat meat, and some passes a great tolerance of beliefs and will not eat eggs. However, milk from practices, and different Hindu commu cows is acceptable to most Hindus. nities have different ways of expressing Vegetarian Hindus cannot eat off a plate their faith, and usually have their own on which meat has been served, so local temple. nurses need to find an acceptable Hindus believe there is one God, who alternative - such as plastic plates - can be understood and worshipped in where requested. 4
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