Interfaith: Treating Patients of Other Religions and Ethnicities

Table of Contents
Introduction
Chapter 1:
The Baha'i Patient
Chapter 2:
The Buddhist Patient
Chapter 3:
The Catholic Patient
Chapter 4:
The Christian Scientist Patient
Chapter 5:
The Church of Jesus Christ of Latter-Day Saints Patient
Chapter 6:
The Hindu Patient
Chapter 7:
The Jain Patient
Chapter 8:
The Jehovah's Witness Patient
Chapter 9:
The Jewish Patient
Chapter 10:
The Muslim Patient
Chapter 11:
The Orthodox Christian Church Patient
Chapter 12:
The Quaker Patient
Chapter 13:
The Shinto Patient
Chapter 14:
The Sikh Patient
Chapter 15:
The Unitarian Universalist Patient

Edited by: Barbara C. Dworkin with the kind assistance of Dr. Paul Dworkin, Dr. Mohammed Monzur and The Interfaith Alliance

With much appreciation to Lori Hammond and Michelle S. Dworkin


INTRODUCTION

One of the greatest resources in the United States of America are the people who live in this country, either by birth or through the process of immigration. Many Americans view our country as a “melting pot” of cultures, in which the great diversity of our population melds into one assimilated “pot.” I prefer to view our demographics as a “salad bowl” in which each religion and/or culture maintains its distinct characteristics. In this manner, when all of the “ingredients” are combined together, the resulting beautiful salad is composed of diversely rich flavors, with a multitude of colors, spices, and textures.

Due to various time constraints, physicians and other health care professionals are often unintentionally unable to deliver culturally-sensitive medical care to all of their patients. The purpose of this manual is to provide a brief overview of various religions and cultures within the United States and to effectively address specific medical issues concerning patient care. While I recognize that not all religions and cultures are included in this manual, I hope that the issues discussed will empower medical personnel to engage patients and their families in sensitive and honest dialogue regarding religious and cultural health care traditions.

Barbara C. Dworkin

Table of Contents
Introduction
Chapter 1:
The Baha'i Patient
Chapter 2:
The Buddhist Patient
Chapter 3:
The Catholic Patient
Chapter 4:
The Christian Scientist Patient
Chapter 5:
The Church of Jesus Christ of Latter-Day Saints Patient
Chapter 6:
The Hindu Patient
Chapter 7:
The Jain Patient
Chapter 8:
The Jehovah's Witness Patient
Chapter 9:
The Jewish Patient
Chapter 10:
The Muslim Patient
Chapter 11:
The Orthodox Christian Church Patient
Chapter 12:
The Quaker Patient
Chapter 13:
The Shinto Patient
Chapter 14:
The Sikh Patient
Chapter 15:
The Unitarian Universalist Patient

Chapter 1: The Baha'i Patient

Baha’u’llah
“Ascribe not to any soul that which thou wouldst not have ascribed to thee, and say not that which thou doest not.”

“Blessed is he who preferreth his brother before himself.”

1. Approximately how many followers are there worldwide? What is the geographic distribution of the members of your group?

There are more than five million followers worldwide, and over 160,000 in the US. Members of the Baha’i Faith come from virtually every country, class, color, race and religious tradition. According to the Encyclopedia Britannica, the Baha’i Faith is the second-most widespread religion in the world. The country with the most Baha’is is India, with well over a million. The Baha’i Faith began in Iran in 1844 and is the largest minority religion in that country today, with a population of approximately 300,000. The largest concentrations of Baha’is in the United States are in California, Texas, North and South Carolina.

2. Are there general education requirements for the leaders of your religious/ethnic community? Can males and females serve in this capacity?

There is no clergy in the Baha’i Faith. Elected bodies, known as Spiritual Assemblies, administer the affairs of the community at the local and national levels. The international governing body of the Baha’i Faith, the Universal House of Justice, is elected every five years by the members of the world’s 182 National Spiritual Assemblies. It administers the affairs of the worldwide Baha’i community from its seat at the Baha’i World Center in Haifa, Israel. There are no general education requirements for those who are elected to any of these governing bodies. Any member of the Baha’i Faith, male or female, over the age of 21 is eligible for election to their National or Local Spiritual Assembly.

3. Please discuss the specific beliefs and customs which are integral to guiding your followers in their worldview and decision-making. Please include various beliefs, attitudes, ideologies and dietary needs which distinguish your group from others.

The founder of the Baha’i Faith, Baha’u’llah (1817-1892), is regarded by Baha’is as the most recent in a line of messengers of God, who include Abraham, Moses, Buddha, Krishna, Zoroaster, Christ and Mohammed. Baha’is believe in the unity of humanity and the elimination of prejudices of all kinds. There are no particular dietary needs or restrictions for Baha’is. The Baha’i writings, however, point to nutrition as an essential factor in maintaining and restoring good health. During the fasting period (March 2-21), Baha’is between the ages of 15 and 70 do not eat or drink between sunrise and sunset, except in cases of pregnancy, travel or ill health. Individual Baha’is are free to use their judgment, depending on their illness, as to whether to participate in the various practices and commemorations (such as the fast) on the Baha’i calendar, and to seek the counsel of a competent physician in cases of uncertainty.

4. Are there any known ethnogenetic pathologies prevalent for members of your group?

There are no known ethnogenetic pathologies within members of the Baha’i faith.

5. How important is it for your followers to maintain their religious/ethnic identity while living in close proximity to and interacting with people of other backgrounds? Are there any issues regarding building relationships and trust, either within or outside the community?

Since the essence of the Baha’i Faith is the creation of unity among all people, Baha’is should have no issues regarding building relationships and trust with anyone. The Baha’i writings state, “Do not be content with showing friendship in words alone, let your heart burn with loving kindness for all who may cross your path.”

6. Please explain various cultural, language and racial differences among followers within your religion/ethnic culture.

Baha’is come from virtually every culture and race and the Baha’i sacred text has been translated into more than 800 languages. There is tremendous diversity within the Baha’i community.

7. Please explain familial roles and organization. What is the perception of old age? Are there differences between male/female roles? Please explain the role of religion/culture with regard to general health care. Describe the relationship among the medical practitioner, the patient and the patient’s family. Describe the view of the following: living wills, health care proxies, DNRs, end-of-life-philosophy, organ transplant, blood transfusion, nursing home and/or hospice care, psychiatry, birth control intervention, labor/delivery and circumcision.

One of the principles of the Baha’i Faith is the equality of women and men and consultation is used as a tool for problem-solving. The roles of husband and wife within a Baha’i family stress equality between the sexes. Women are free to pursue careers that interest them. Men are expected to share in household duties and child-rearing. With regard to old age, the Baha’i wirings say, “The old believers have to give up something of their old conceptions and ways of working in order to better adapt themselves to the changing social conditions and circumstances. The young too must learn to act with wisdom, tact and moderation, and to take advantage and benefit from the age-long experience of their older fellow-believers. The old and the young have each something specific to contribute to the progress and welfare of the Baha’i community. The energy of youth should be tempered and guided by the wisdom of old age.” The Baha’i Faith teaches that individuals should seek the assistance of competent physicians for medical treatment. Since the Baha’i Faith teaches that true science and religion cannot contradict each other, the application of medical and technological advances is in accordance with Baha’i beliefs. The decision to remove or withhold life support in medical cases where intervention prolongs life in disabling illness must be left to those responsible, notably the patient/surrogate and the physician. There are no restrictions regarding organ transplants, blood transfusions and the use of nursing homes or hospice care for Baha’is. Baha’is are encouraged to avail themselves of the best medicine has to offer, including psychiatry. There is no Baha’i law against the use of birth control. However, when exercised to deliberately prevent the procreation of any children, it is against the Spirit of the Law of Baha’u’llah, which defines the primary purpose of marriage to be the rearing of children. There is no specific guidance in the Baha’i sacred text on these topics. The Baha’i writings explain that we should look forward to death as we would any journey, “with hope and with expectation. It is even so with the end of this earthly journey. In the next world, man will find himself freed from many of the disabilities under which he now suffers. Those who have passed on through death have a sphere of their own. It is not removed from ours; their work, the work of the Kingdom, is ours; but it is sanctified from what we call ‘time and place.’ Time with us is measured by the sun. When there is no more sunrise, and no more sunset, that kind of time does not exist for man. Those who have ascended have different attributes from those who are still on earth, yet there is no real separation.”

8. Are there specific burial customs which must be observed by members of your group?

The body of the departed should be treated with honor and respect, and the family or local governing council of the Baha’is should be contacted. There are no formal last rites for Baha’is. However, family, friends or hospital clergy may offer prayers. The burial should take place within an hour’s travel time from the place of death, irrespective of the means of transport that is used to carry the body to the burial site. The place of death may be taken to encompass the city or town in which the person passes away, and therefore the one-hour journey may be calculated from the city limits to the place of burial. The spirit of this Baha’i law is for the deceased to be buried near where he or she dies. There is no provision as to the time limit before burial. However, the sooner it takes place, the more fitting and preferable. Embalming of the body is to be avoided. At their discretion, family members may participate in preparing the body for burial. It should be carefully washed and placed in a shroud of white cloth, preferably silk. When circumstances do not permit interment of the body soon after passing, or when it is a legal requirement, the body may be embalmed provided the process delays the natural decomposition of the body for a short time only. Autopsies are permitted. If the deceased Baha’i is of the age of 15 or older (considered the age of maturity), the Baha’i Prayer for the Dead should be recited at the funeral. According to Baha’i teachings, cremation is strongly discouraged and should be prevented when possible.

9. Please explain the spiritual/ethnic philosophy regarding miraculous intervention by the divine, holistic treatment, salvation, eternal life, redemption and healing.

The Baha’i writings state, “The prayers which were revealed to ask for healing apply both to physical and spiritual healing. Recite them, then, to heal both the soul and the body. If healing is right for the patient, it will certainly be granted; but for some ailing persons, healing would only be the cause of other ills, and therefore wisdom doth not permit an affirmative answer to the prayer.” In the early 1900’s, Abdu’l-Baha, son of the Founder of the Baha’i Faith, said, “The science of medicine is still in a condition of infancy; it has not reached maturity. But when it has reached this point, cures will be performed by things which are not repulsive to the smell and taste of man – that is to say, by aliments, fruits and vegetables which are agreeable to the taste and have an agreeable smell. For the provoking cause of disease – that is to say, the cause of the entrance of disease into the human body – is either a physical one or is the effect of excitement of the nerves. But the principal causes of disease are physical, for the human body is composed of numerous elements, but in the measure of an especial equilibrium. As long as this equilibrium is maintained, man is preserved from disease; but if this essential balance, which is the pivot of the constitution, is disturbed, the constitution is disordered, and disease will supervene.” “For instance, there is a decrease in one of the constituent ingredients of the body of man, and in another there is an increase; so the proportion of the equilibrium is disturbed, and disease occurs. For example, one ingredient must be one thousand grams in weight, and another five grams, in order that the equilibrium be maintained. The part which is one thousand grams diminishes to seven hundred grams, and that which is five grams augments until the measure of the equilibrium is disturbed; then disease occurs. When by remedies and treatments the equilibrium is reestablished, the disease is banished. So if the sugar constituent increases, the health is impaired; and when the doctor forbids sweet and starchy foods, the sugar constituent diminishes, the equilibrium is reestablished, and the disease is driven off. Now the readjustment of these constituents of the human body is obtained by two means – either by medicines or by aliments; and when the constitution has recovered its equilibrium, disease is banished. All the elements that are combined in man exist also in vegetables; therefore, if one of the constituents which compose the body of man diminishes, and he partakes of foods in which there is much of that diminished constituent, then the equilibrium will be established, and a cure will be obtained. So long as the aim is the readjustment of the constituents of the body, it can be effected either by medicine or by food. It is, therefore, evident that it is possible to cure by foods, aliments and fruits; but as today the science of medicine is imperfect, this fact is not yet fully grasped. When the science of medicine reaches perfection, treatment will be given by foods, aliments, fragrant fruits and vegetables, and by various waters, hot and cold in temperature.” The Baha’i writings state, “The progress of the soul does not come to an end with death. It rather starts along anew line. Baha'u'llah teaches that great far-reaching possibilities await the soul in the other world.” The Baha’i writings state that in the case of illness, we should always consult the most competent physicians. “For prayer alone is not sufficient. To render it more effective we have to make use of all the physical and material advantages which God has given us. Healing through purely physical forces is undoubtedly as inadequate as that which materialist physicians and thinkers vainly seek to obtain by resorting entirely to mechanical devices and methods. The best result can be obtained by combining the two processes, spiritual and physical.”

ACKNOWLEDGEMENTS:
Glenn Fullner, Director of Communications
Baha’is of the United States
1233 Central Street
Evanston, IL 60201

Table of Contents
Introduction
Chapter 1:
The Baha'i Patient
Chapter 2:
The Buddhist Patient
Chapter 3:
The Catholic Patient
Chapter 4:
The Christian Scientist Patient
Chapter 5:
The Church of Jesus Christ of Latter-Day Saints Patient
Chapter 6:
The Hindu Patient
Chapter 7:
The Jain Patient
Chapter 8:
The Jehovah's Witness Patient
Chapter 9:
The Jewish Patient
Chapter 10:
The Muslim Patient
Chapter 11:
The Orthodox Christian Church Patient
Chapter 12:
The Quaker Patient
Chapter 13:
The Shinto Patient
Chapter 14:
The Sikh Patient
Chapter 15:
The Unitarian Universalist Patient

Chapter 2: The Buddhist Patient

Udana-Varga 5:18
“Hurt not others in ways that you yourself would find hurtful.”

1. Approximately how many followers are there worldwide? What is the geographic distribution of the members of your group?

There are approximately 360,000,000 Buddhists worldwide. The vast majority of these practitioners live in Asia; however, there are Buddhists on every continent. Several countries have “state” Buddhism, including Sri Lanka, Thailand, the Russian Republic of Kalmykia, Bhutan and Mongolia. According to the Pew Forum survey, Buddhism is one of the largest religions in the United States, with between two and five million followers. There are numerous variations in beliefs, practices, and teachings within the Buddhist religion. A major distinction is that Buddhism is not an exclusive religion; many Buddhists are members of a second or third religious tradition, such as Shinto in Japan and Confucianism and Taoism in China and Korea.

2. Are there general education requirements for the leaders of your religious/ethnic community? Can males and females serve in this capacity?

There are three major groups in Buddhism: Therevada, Mahayana, and Vajrayana. Each has specific requirements for its leaders. There are no specific educational requirements for leaders among the Therevada, who live in South Asian countries. The level of practice is perceived to be more important than formal educational training. For the most part, women are prohibited from serving as leaders in these countries. The Mahayana Buddhists live primarily in Eastern and Northern Asia and their leaders require a great deal of training. The Tendai Buddhist (Japanese) priests must have at least an undergraduate degree. In addition, Tendai priests are required to undergo extremely stringent monastic training. Both women and men may become Mahayana leaders. The Vajrayana Buddhists are somewhat similar to the Mahayana, in that a great deal of training is necessary to become a leader. While the indigenous populations in Asia do not consider women to be part of the leadership, there is wider acceptance of women as priests in the west.

3. Please discuss the specific beliefs and customs which are integral to guiding your followers in their worldview and decision-making. Please include various beliefs, attitudes, ideologies and dietary needs which distinguish your group from others.

Many Buddhists are vegetarian, though this is not required of the religion. Ultimately this is a personal choice. Those who take vows as monks or nuns and priests are required to eat whatever is offered them, vegetable or meat. There are some restrictions for monastic practitioners. One of the main practices of Buddhism is that of meditation. Buddhists do not worship a deity. By following the core Buddhist beliefs and teachings which are outlined below, Buddhists can reach a state of enlightenment, leading to nirvana.

THE FOUR NOBLE TRUTHS

A) Dukkha – Life is filled with discontent and suffering
B) Samudaya – Discontentment arises from spiritual ignorance, anger, and desires.
C) Nirodha – The end of discontent is possible.
D) Magga – The Eightfold Noble Path will lead to the end of discontent and suffering.

THE EIGHTFOLD NOBLE PATH

A) Right Views – Maintain a perspective that encourages loving-kindness, non-discrimination and openness.
B) Right Intention – Cultivate thoughts that are associated with renunciation of materialism, free from anger, violent intention and obscuration.
C) Right Speech – Cultivate truthfulness, avoid falsehoods and slander. Cultivate pleasant speech, and use meaningful, purposeful, and timely speech.
D) Right Action – Cultivate a life filled with compassion and love. Avoid dishonesty and sexual misconduct. Transform one’s actions from feeding an evil disposition to nourishing a life to assist other sentient beings. Abstain from violence
E) Right Livelihood – Pursue a morally acceptable means of livelihood which avoids hurting others through greed, false speech, taking of life, and unethical behavior. Invest one’s money in a socially responsible manner.
F) Right Effort – Prevent negative characteristics through the cultivation of healthy attitudes, and stabilization of wholesome dispositions. Avoid a fatalistic or deterministic perspective.
G) Right Mindfulness – Prevent the promotion of passions and anger. Live in the moment rather than in the future or past.
H) Right Contemplation – Avoid the primary causes of suffering. Strive for a clear and composed mind that will lead to moral perfection. This will result in the attainment of emancipating and self-transforming wisdom.

THE SIX PARAMITAS (Translation: That which has reached the other shore – transcendence)

A) Dana (Generosity) – Giving in the spiritual and material sense – this is compassion, and being dedicated to the liberation of all sentient beings.
B) Silla (Ethics and morality) – Proper behavior to ensure positive karma for oneself and others.
C) Ksanti (Patience) – Recognition that all sentient being’s problems have causes and tolerance of others.
D) Virya (Energy) – Resolute effort to liberate all sentient beings.
E) Dhyana (Meditation and contemplation) – Realization that one is not separate from others and the cosmos.
F) Prajna (Wisdom) – Realization of absolute truth, unity of self and others.

4. Are there any known ethnogenetic pathologies prevalent for members of your group?

There are no known pathologies for members of the Buddhist faith.

5. How important is it for your followers to maintain their religious/ethnic identity while living in close proximity to and interacting with people of other backgrounds? Are there any issues regarding building relationships and trust, either within or outside the community?

As explained previously, Buddhism is not an exclusivist religion. It is not necessary to be a Buddhist to be a Buddha. It is felt that it is better to be ethical, compassionate and wise than to promote a particular ideology.

6. Please explain various cultural, language and racial differences among followers within your religion/ethnic culture.

Buddhism has adapted to various social and ethnic cultures around the world. The Pali and Sanskrit languages are used for ceremonial ritual and canonical purposes but are not spoken languages.

7. Please explain familial roles and organization. What is the perception of old age? Are there differences between male/female roles? Please explain the role of religion/culture with regard to general health care. Describe the relationship among the medical practitioner, the patient and the patient’s family. Describe the view of the following: living wills, health care proxies, DNRs, end-of-life-philosophy, organ transplant, blood transfusion, nursing home and/or hospice care, psychiatry, birth control intervention, labor/delivery and circumcision.

In many nations, Buddhists often contact the local monk or priest for guidance with health care issues. Buddhists generally practice the local health mores, depending on the region. According to the Buddhist perspective, human consciousness is not located in the brain, but rather throughout each cell of the body. This has a direct impact on organ transplant and end-of-life issues. This is to note that there are many differences between Therevada and Mahayana views in this regard. The Therevada tend to be fundamentalists, while the Mahayana tend to be less strict. It is recommended that health care personnel consult the family about these matters.

8. Are there specific burial customs which must be observed by members of your group?

While cremation tends to be the usual burial custom, there is a great deal of diversity among Buddhist denominations.

9. Please explain the spiritual/ethnic philosophy regarding miraculous intervention by the divine, holistic treatment, salvation, eternal life, redemption and healing.

Buddhism is nontheistic. Followers do not believe in the concept of an eternal soul. In fact, some believe that rebirth occurs 40 days after one’s death. One of the basic tenets of Buddhism is that of impermanence; nothing lasts forever, with the possible exception of Buddha Nature. From an orthodox point of view, there is no divine intervention, eternal life, and no need for redemption since there is no original sin. Despite this perspective, some people might still pray to Buddhist deities for assistance during crises.

ACKNOWLEDGEMENTS:
Monshin Naamon, Jushoku and Executive Director
Tendai Buddhist Institute
Tendai-shu New York Betsuin
Secretary General of Tendai-shu in North America
PO Box 323
Canaan, NY 12029 USA
Email: tendai@msn.com
(518) 392-7963

Bard College at Simon's Rock
Division of Natural Sciences
Faculty of Asian Studies
84 Alford Rd.
Great Barrington, MA 01230
Email: pnaamon@simons-rock.edu
(413) 528-7220

Table of Contents
Introduction
Chapter 1:
The Baha'i Patient
Chapter 2:
The Buddhist Patient
Chapter 3:
The Catholic Patient
Chapter 4:
The Christian Scientist Patient
Chapter 5:
The Church of Jesus Christ of Latter-Day Saints Patient
Chapter 6:
The Hindu Patient
Chapter 7:
The Jain Patient
Chapter 8:
The Jehovah's Witness Patient
Chapter 9:
The Jewish Patient
Chapter 10:
The Muslim Patient
Chapter 11:
The Orthodox Christian Church Patient
Chapter 12:
The Quaker Patient
Chapter 13:
The Shinto Patient
Chapter 14:
The Sikh Patient
Chapter 15:
The Unitarian Universalist Patient

Chapter 3: The Catholic Patient

Matthew 7:12
“Therefore all things whatsoever ye would that men should do to you, do ye even to them.”

1. Approximately how many followers are there worldwide? What is the geographic distribution of the members of your group?

There are approximately 1,115,000,000 Catholics worldwide. According to the Center for Applied Research in the Apostolate (http://cara.georgetown.edu/bulletin/index.htm), there are 64,100,000 Catholics currently living in the United States.

2. Are there general education requirements for the leaders of your religious/ethnic community? Can males and females serve in this capacity?

Education requirements vary with ministry. Priests usually have four years of college and four additional years of theological education. Many subsequently obtain advanced degrees in various fields. Deacons will typically have 3+ years of training before ordination. Ordained ministry (bishop, priest, deacon) is restricted to men. Nuns may not be ordained but they are nonetheless an integral part of Catholicism. Both religious and lay persons of either gender may hold leadership positions (e.g., teaching, education, and administration) in parishes and Catholic service organizations. The educational requirements will vary with the nature of their service.

3. Please discuss the specific beliefs and customs which are integral to guiding your followers in their worldview and decision-making. Please include various beliefs, attitudes, ideologies and dietary needs which distinguish your group from others.

This response is necessarily incomplete; the reader is referred to the Catechism of the Catholic Church. Natural law figures prominently in Catholic and moral thought. Catholics believe that human life is a gift from God and we are created by and for God. Catholics believe that the human person is formed in the image and likeness of God and as such possess a dignity from conception until death. Human life is lived in solidarity with others and ordered to promoting the common good. We are redeemed by Jesus Christ, who is both God and human. Catholics observe some days of fasting and abstinence as penance.

4. Are there any known ethnogenetic pathologies prevalent for members of your group?

Because Catholics come from various nationalities, there are no specifically “Catholic diseases.”

5. How important is it for your followers to maintain their religious/ethnic identity while living in close proximity to and interacting with people of other backgrounds? Are there any issues regarding building relationships and trust, either within or outside the community?

Both religious and ethnic identities figure prominently for some Catholics in the United States and are often intermingled. Consequently, there are ethnic Catholic churches and religious celebrations. However, this has not precluded participation or assimilation of Catholics into the mainstream of social, political or business life in the United States.

6. Please explain various cultural, language and racial differences among followers within your religion/ethnic culture.

The cultural, language and racial differences among Catholic followers are due to the great ethnic diversity within the religion.

7. Please explain familial roles and organization. What is the perception of old age? Are there differences between male/female roles? Please explain the role of religion/culture with regard to general health care. Describe the relationship among the medical practitioner, the patient and the patient’s family. Describe the view of the following: living wills, health care proxies, DNRs, end-of-life-philosophy, organ transplant, blood transfusion, nursing home and/or hospice care, psychiatry, birth control intervention, labor/delivery and circumcision.

Familial roles and organization are less influenced by specific Catholic doctrine than by ethnic origins. However, Catholic teachings support strong family structures, honor the elderly and view children as a gift from God. Catholics believe that life is good and a gift from God. However, life is the penultimate good, with the ultimate good being communion with God in eternal life. Catholics have been concerned with medical moral issues for centuries, so a brief treatment of teaching on these subjects is impossible. Among the distinctive teachings are prohibitions on contraception, artificial birth control, euthanasia, and physician assisted suicide. Sexual intercourse should be restricted to heterosexual, monogamous couples joined in marriage. Reproductive technologies that separate the unitive and procreative aspects of intercourse are prohibited. Health care proxies, circumcision, psychiatry, organ transplantation, blood transfusions, and labor and delivery are not problems per se. Hospice care is encouraged as an appropriate care at the end of life. In end of life care, nothing may be done with the specific intention of hastening death. However, measures that may have the unintended but potential risk of shortening life are acceptable if there is a good reason. Life sustaining interventions, whether complex (such as respiratory support) or simple (such as antibiotics), may be forgone or discontinued if they are disproportionate or overly burdensome for the patient.

8. Are there specific burial customs which must be observed by members of your group?

Prior to death, Catholic rites for the sick and dying are in order. After death, the body should be treated with respect; this does not preclude autopsy.

9. Please explain the spiritual/ethnic philosophy regarding miraculous intervention by the divine, holistic treatment, salvation, eternal life, redemption and healing.

Briefly, miracles may happen by divine intervention, but these are exceptional and Catholics are obliged to seek appropriate medical care. Catholics believe in redemption and salvation by Jesus Christ and in an afterlife.

ACKNOWLEDGEMENTS:
Frank Thomas, M.D. and Deacon, Roman Catholic Diocese, Albany, NY
The above comments do not represent an official response of the Roman Catholic Church. I speak only for myself as one person within this tradition. Reliable sources for Catholic teaching include the Catechism of the Catholic Church (published by Doubleday in 1995), and the web site for the United States Conference of Catholic Bishops (http://www.usccb.org), which is particularly helpful for issues concerning family life.

Table of Contents
Introduction
Chapter 1:
The Baha'i Patient
Chapter 2:
The Buddhist Patient
Chapter 3:
The Catholic Patient
Chapter 4:
The Christian Scientist Patient
Chapter 5:
The Church of Jesus Christ of Latter-Day Saints Patient
Chapter 6:
The Hindu Patient
Chapter 7:
The Jain Patient
Chapter 8:
The Jehovah's Witness Patient
Chapter 9:
The Jewish Patient
Chapter 10:
The Muslim Patient
Chapter 11:
The Orthodox Christian Church Patient
Chapter 12:
The Quaker Patient
Chapter 13:
The Shinto Patient
Chapter 14:
The Sikh Patient
Chapter 15:
The Unitarian Universalist Patient

Chapter 4: The Christian Scientist Patient

The Book of Matthew 7:12
“Therefore, whatever you want men to do to you, do also to them, for this is the Law and the Prophets”

1. Approximately how many followers are there worldwide? What is the geographic distribution of the members of your group?

There are approximately 1800 Christian Science branch churches in some 71 countries worldwide. Churches, locations and times of services can be found in The Christian Science Journal, a monthly publication of the Christian Science Publishing Society. The church does not publish individual membership numbers.

2. Are there general education requirements for the leaders of your religious/ethnic community? Can males and females serve in this capacity?

The First Church of Christ, Scientist, Boston (aka the Mother Church) is governed by the rules and guidelines set out for it by its founder, Mary Baker Eddy in the Manual of the Mother Church. A five-member, self-appointing board of directors administers the rules of the Manual and conducts the business of the Mother Church. These individuals (currently three men and two women) are routinely selected from a category of Christian Scientists who have earned the title of “CSB” (authorized teachers of Christian Science) and who are Christian Science practitioners.

3. Please discuss the specific beliefs and customs which are integral to guiding your followers in their worldview and decision-making. Please include various beliefs, attitudes, ideologies and dietary needs which distinguish your group from others.

The Church was founded in 1879 by Mary Baker Eddy, with this purpose: “…to commemorate the word and works of our Master, which should reinstate primitive Christianity and its lost element of healing.” Seeking and finding God is central to the practice of Christian Science. This is a requirement and opportunity for all members of the Christian Science church. God is understood as the all-loving, omnipotent Father-Mother, and Christ Jesus as His Son. Jesus' human life characterized the kind of sonship that Christian Scientists believe is possible for all children of God. He is the “Way-shower.” The divine nature he expressed is the Christ, and the Christ, God's expression of Himself, is eternal and always present. The understanding of man's pure, indestructible relationship with God results in regeneration and healing. Christian Scientists study the Bible and Science and Health daily, with a focus on a specific biblical theme each week. The weekly sermon revolves around this theme and is read in Christian Science churches globally. Decisions concerning health and social issues are not dictated by the Church, but rather reflect the wishes of the individual. Christian Scientists frequently choose prayer as treatment for themselves and their families, but are not mandated to do so. Christian Science religious publications have provided thousands of accounts of healing through prayer and these testimonies often inspire members to follow suit.

4. Are there any known ethnogenetic pathologies prevalent for members of your group?

Due to the global diversity of members, there are no known ethnogenetic pathologies among Christian Scientists.

5. How important is it for your followers to maintain their religious/ethnic identity while living in close proximity to and interacting with people of other backgrounds? Are there any issues regarding building relationships and trust, either within or outside the community?

One of the main tenets of Christian Scientists is to live their daily lives according to the Golden Rule. They aim to see and treat all as they would like to be seen and treated, with compassion and respect. Their beliefs stress the desire to help meet the needs of all others.

6. Please explain various cultural, language and racial differences among followers within your religion/ethnic culture.

There are approximately 1800 Christian Science branch churches in 71 countries worldwide. Therefore, followers may have various cultural, language and racial differences.

7. Please explain familial roles and organization. What is the perception of old age? Are there differences between male/female roles? Please explain the role of religion/culture with regard to general health care. Describe the relationship among the medical practitioner, the patient and the patient’s family. Describe the view of the following: living wills, health care proxies, DNRs, end-of-life-philosophy, organ transplant, blood transfusion, nursing home and/or hospice care, psychiatry, birth control intervention, labor/delivery and circumcision.

There is no church mandate on any of the above, but rather, the decisions are left to the individual church member. The Bible is the foundation of Christian Science, and the biblical teaching found in Genesis that man is created in God's own image is a central precept of Christian Science. With this purely spiritual identity as a basis, focusing on aging tends to limit a person's capacities and to interfere with discovering who and what God has made each of us to be. Christian Science encourages people to shift their focus from material reference points such as age, family history, size of bank account, etc., to what God is revealing to them about their origin, identity and holy purpose. Some have found an understanding of their relation to God sufficient to overcome the limitations associated with age such as restricted mobility, deterioration, forgetfulness, weakness, faltering health, and declining mental faculties.

8. Are there specific burial customs which must be observed by members of your group?

No special arrangements are designated by the Church of Christ, Scientist, for its members. The funeral service itself is optional and, whether it consists of cremation or burial, is entirely up to the family or next-of-kin. The format or content is also left up to the family and the leader conducting the service.

9. Please explain the spiritual/ethnic philosophy regarding miraculous intervention by the divine, holistic treatment, salvation, eternal life, redemption and healing.

The teachings of Christ Jesus are central to Christian Science, and Jesus' healing work provides an example of how modern-day followers can also turn to God's omnipotent love and find healing. Over the years the Christian Science publications have provided thousands of accounts of healing through prayer. Healing is accomplished not merely through blind faith, but through a growing understanding of God and recognition of one's identity as God's child. Healing is a by-product of this spiritual understanding of the divine nature, laws, omnipotence, and God’s unconditional love for each one of us.

ACKNOWLEDGEMENTS:
Jan Maltbe and Dr. Steven L. Jeffers
The First Church of Christ, Scientist
210 Massachusetts Avenue
Boston, MA 02115-3195
Phone: 617-450-2000

Table of Contents
Introduction
Chapter 1:
The Baha'i Patient
Chapter 2:
The Buddhist Patient
Chapter 3:
The Catholic Patient
Chapter 4:
The Christian Scientist Patient
Chapter 5:
The Church of Jesus Christ of Latter-Day Saints Patient
Chapter 6:
The Hindu Patient
Chapter 7:
The Jain Patient
Chapter 8:
The Jehovah's Witness Patient
Chapter 9:
The Jewish Patient
Chapter 10:
The Muslim Patient
Chapter 11:
The Orthodox Christian Church Patient
Chapter 12:
The Quaker Patient
Chapter 13:
The Shinto Patient
Chapter 14:
The Sikh Patient
Chapter 15:
The Unitarian Universalist Patient

Chapter 5: The Church of Jesus Christ of Latter-Day Saints Patient

The Book of Mormon: Book of Mosiah 18:9
“Yea, and we are willing to mourn with those that mourn, yea, and comfort those that stand in need of comfort and to stand as witness of God at all times and in all things and all places.”

1. Approximately how many followers are there worldwide? What is the geographic distribution of members of your group?

The Church of Jesus Christ of Latter-day Saints has over 13.2 million members worldwide, with organized congregations in more than 160 countries. Less than half of the membership resides in the United States. Brazil and Mexico each have over one million members.

2. Are there general education requirements for the leader of your religious/ethnic community? Can males and females serve in this capacity?

The priesthood of The Church of Jesus Christ of Latter-day Saints is the power and authority of God delegated to man on earth. This includes the authority to preach, perform ordinances and direct the functions of the Church. Based on worthiness and age, men progress through various levels within the priesthood. The lower Aaronic Priesthood is conferred upon faithful male members beginning at age twelve, and includes the offices of deacon, teacher and priest. Aaronic Priesthood holders are able to baptize, prepare and offer the sacrament (communion) to church members during Sunday worship serves, visit and provide service to members in their homes and collect contributions for the poor. The Melchizedek Priesthood, the higher of the two priesthood levels, includes the commonly held offices of elder and high priest and is conferred upon worthy male members age 18 and over. Men who hold the Melchizedek Priesthood are able to bless the sacrament, give blessings of healing and ordination and bless those who are recently baptized with the Gift of the Holy Ghost. The Relief Society is one of the largest women’s organizations in the world. Women in the Church participate in weekly meetings to learn about the gospel and associate with one another. Additionally, they serve members of their communities and participate in global service projects such as knitting clothing, making quilts, cooking meals for the sick, gathering food and clothing to send to third-world countries or areas in disaster. The Society helps women become better wives, mothers and friends by learning more about Jesus Christ.

3. Please discuss the specific beliefs and customs which are integral to guiding your followers in their worldview and decision-making. Please include various beliefs, attitudes, ideologies and dietary needs which distinguish your group from others.

When Jesus Christ lived on the earth, He organized His Church so that all people could receive His gospel and return one day to live with God, the Father of all creation. After Jesus Christ ascended to heaven, His apostles continued to receive revelation from Him on how to direct the work of His Church. However, after the apostles were killed, members changed the teachings of the Church that Jesus Christ had established. While many good people and some truth remained, this “Apostasy,” or general falling away from the truth, brought about the withdrawal of priesthood (the power and authority to act in God’s name) from the earth. The apostle Peter prophesied that Jesus would restore His Church before His second coming (see Acts 3:19–21). In the spring of 1820, a fourteen-year-old boy named Joseph Smith went into a grove of trees near his home in Palmyra, New York, and prayed to learn which church he should join. In answer to his prayer, God the Father and His Son Jesus Christ appeared to him, just as heavenly beings had appeared to prophets like Moses in biblical times. Smith learned that the Church originally organized by Jesus Christ was no longer on the earth. Joseph Smith was chosen by God to restore the Church of Jesus Christ to the earth. During the next ten years, Smith was visited by other heavenly messengers, translated the Book of Mormon, and received authority to organize the Church. The Church was organized in Fayette, New York, on 6 April 1830, under the leadership of Joseph Smith.

Members of the Church of Jesus Christ believe that God is the Heavenly Father of all human beings. Jesus Christ is the Son of God and the Savior of all people. He redeems all from death by providing the resurrection. He saves individuals from sin as they repent, pray and ask Him for forgiveness. Through Christ’s atonement — His sacrifice, death and resurrection — all people can return to live with God if they keep His commandments. The Holy Ghost (also called Holy Spirit) helps individuals to recognize truth.

The first principles and ordinances of the gospel are faith in Jesus Christ, repentance, baptism and receiving the Gift of the Holy Ghost. The priesthood authority (the power and authority to act in God’s name) exists in His Church today, just as it did in the original Church. Both the Bible and the Book of Mormon are the word of God and are equally regarded as Holy Scripture. God reveals His will to prophets today, just as He did in antiquity. Life has a sacred purpose. Families can be together forever. Through serving others, people can experience joy and draw closer to God. The Church of Jesus Christ of Latter-day Saints has a living prophet who receives direct revelation from God. Through prayer, all of God’s children can grow closer to Jesus Christ and discover what choices will bring the most happiness into their lives and the lives of their families. Church members set Sunday aside as the Sabbath, or the Lord’s Day — a day to worship God and rest from their labors.

After attending worship services, members often spend the remainder of the day quietly at home, visiting family or friends and doing acts of service. The Lord commands that all are to be baptized by one having priesthood authority: children at age eight or adults when they commit to join the Church of Jesus Christ. Baptism symbolizes the death, burial and resurrection of Jesus Christ. When a person is baptized, he or she is fully immersed in water — just as Jesus was — to wash away sins. After baptism, an individual is confirmed a member of the Church through a blessing by priesthood leaders and receives the Gift of the Holy Ghost. At baptism a person’s sins are literally washed away and the person is made clean.

Young men and women generally serve voluntary missions for the Church when they are between 19 and 21 years old. Missionaries devote this time in their lives to serving Jesus Christ and spreading His gospel around the earth. Though their main objective is teaching the gospel of Jesus Christ to those who are interested, they also teach free English classes in many foreign counties, help the disabled and volunteer in genealogical research centers. Retired seniors are also encouraged to serve missions. As there is no paid ministry in the Church, missionaries serve from 18 months to two years, while being supported by themselves or their family.

The gospel of Jesus Christ teaches that people should bear one another’s burdens (see Galatians 6:2). Throughout the world, when communities suffer major disasters and face difficulties beyond their ability to meet, the Church is prepared to offer assistance contributed by its members. The aid helps people who are in need, without regard to religious affiliation, ethnicity or nationality. Church members distribute food, provide assistance in times of disaster, teach self-reliance, and fund and encourage projects that benefit stricken communities. The body is a precious gift from God.

To help keep bodies and minds healthy and strong, God gave a law of health to the Prophet Joseph Smith in 1833. This law is known as the Word of Wisdom. In addition to emphasizing the benefits of proper diet and physical and spiritual health, God has spoken against the use of tobacco, alcohol, coffee, tea and illegal drugs. God promises great physical and spiritual blessings to those who follow the Word of Wisdom. Today, the scientific community promotes some of the same principles that a loving God gave to Joseph Smith nearly two centuries ago. On the first Sunday of each month, Church members abstain from food or drink for two meals for the purpose of increasing their spirituality. They spend that time praying, reading the scriptures, attending church and otherwise strengthening their relationship with God. They donate the money saved from those meals — and more, if possible — to the Church to assist the poor and needy.

4. Are there any known ethnogenetic pathologies prevalent for members of your group?

There are no known ethnogenetic pathologies unique to LDS members, given the wide diversity of cultures and nationalities that make up its membership.

5. How important is it for your followers to maintain their religious/ethnic identity while living in close proximity to and interacting with people of other backgrounds? Are there any issues regarding building relationships and trust, either within or outside the community?

The Church teaches that people from all nations, cultures, races and ethnic backgrounds are children of the same Father in Heaven. While it is critically important to respect the linguistic, cultural and ethnic identities of all people, the Gospel of Jesus Christ seeks to unite everyone as brothers and sisters. For this reason, the Church encourages Missions and Humanitarian Service. Young men and women generally serve voluntary missions for the Church when they are between 19 and 21 years old. Missionaries devote this time in their lives to serving Jesus Christ and spreading His gospel around the earth. Though their main objective is teaching the gospel of Jesus Christ to those who are interested, they also teach free English classes in many foreign counties, help the disabled and volunteer in genealogical research centers. Retired seniors are also encouraged to serve missions. As there is no paid ministry in the Church, missionaries serve from 18 months to two years, while being supported by themselves or their family.

The gospel of Jesus Christ teaches that people should bear one another’s burdens (see Galatians 6:2). Throughout the world, when communities suffer major disasters and face difficulties beyond their ability to meet, the Church is prepared to offer assistance contributed by its members. The aid helps people who are in need, without regard to religious affiliation, ethnicity or nationality. Church members distribute food, provide assistance in times of disaster, teach self-reliance, and fund and encourage projects that benefit stricken communities. One evening each week, usually on Mondays, Church members gather their families together for spiritual instruction and activities such as playing games, doing service projects and conducting weekly planning meetings. Families are encouraged to use this time to grow closer together.

The Church encourages young men and women to receive education and volunteer in their communities. They are also taught to use clean language, dress modestly and be kind to others. The Church has a curriculum for youth ages 12 to 18 years old that includes achievement activities, spiritual instruction and sports programs. This curriculum teaches youth how to avoid alcohol, drugs, inappropriate materials and spiritually harmful behavior.

Temples are houses of the Lord, the most sacred structures on the earth. Temples should not be mistaken for chapels where members of the Church participate in Sunday worship services. In temples, Church members participate in ordinances designed to unite their families together forever and help them return to God. When a man and woman are married in the temple they are bound together for eternity. Children and parents can also be sealed for eternity. In the temple, Church members can also perform the necessary ordinances, such as baptism and eternal marriage, for ancestors, friends and loved ones who have passed away.

6. Please explain various cultural, language and racial differences among followers within your religion/ethnic culture.

The Church teaches that people from all nations, cultures, races and ethnic backgrounds are children of the same Father in Heaven and that people should bear one another’s burdens.

7. Please explain familial roles and organization. What is the perception of old age? Are there differences between male/female roles? Please explain the role of religion/culture with regard to general health care. Describe the relationship among the medical practitioner, the patient and the patient’s family. Describe the view of the following: living wills, health care proxies, DNRs, end-of-life-philosophy, organ transplant, blood transfusion, nursing home and/or hospice care, psychiatry, birth control intervention, labor/delivery and circumcision.

A healthy lifestyle promotes a sense of well-being. Exercise, eating and sleeping properly all contribute to happiness and wellness. Modern medicine is a gift of God and should be used to cure diseases. Members are encouraged to seek the best medical care possible. When severe illness strikes, members should exercise faith in the Lord and seek competent medical assistance. The Church of Jesus Christ does not practice infant baptism. Little children do not need baptism because they are not capable of committing sin. Members are baptized into the Church at 8 years old, the age at which Church members believe a person is spiritually mature enough to discern right from wrong. Babies are given a special blessing shortly after birth where they are blessed with what attributes God would wish them to have to help them during their life. This blessing is given through the guidance of the Spirit by someone who holds the priesthood, which in many cases is the infant’s father or another priesthood holder close to the family. Only worthy Melchizedek Priesthood holders can perform this blessing and is normally conducted on the first Sunday of the month in a church building, though it can take place in a home or hospital if necessary. Circumcision of male infants is not a religious requirement; it is a decision for individual families.

In vitro fertilization using semen from anyone but the husband or an egg from anyone but the wife is strongly discouraged. However, this is a personal matter that ultimately must be left to the judgments of the husband and wife, with responsibility for the decision resting solely upon them. Members must not submit to, perform, encourage, pay for, or arrange for an abortion. The only possible exceptions are when: pregnancy resulted from rape or incest, a competent physician determines that the life or health of the mother is in serious jeopardy, or a competent physician determines that the fetus has severe defects that will not allow the baby to survive beyond birth. Whether or not to participate in blood transfusions is a decision left up to the individual and his or her family members.

Organ and tissue donation is a decision for the individual and his or her family. Hospital workers may provide healthcare for members of the opposite sex. Members should not feel obligated to extend mortal life by means that are unreasonable. These judgments are best made by family members after receiving wise and competent medical advice and seeking divine guidance through fasting and prayer. Priesthood holders and women in the Relief Society alike can be called on in times of need to give spiritual support to the sick, depressed or lonely. Patients may receive comfort from reading scriptures or other devotional material and listening to religious music.

8. Are there specific burial customs which must be observed by members of your group?

How bodies are cared for after death is a decision for the individuals and their family members. Disposition, embalming and autopsy are decisions for the individual’s family. Members of The Church of Jesus Christ of Latter-day Saints conduct funerals similar to traditional Christian funerals. A Latter-day Saint funeral is usually directed by the local congregational leader (the bishop) and held in a chapel. The tone of the funeral is generally peaceful, reflecting the religious belief that families can be reunited after this life. Funerals are conducted with a spirit of hope and sometimes joy.

9. Please explain the spiritual/ethnic philosophy regarding miraculous intervention by the divine, holistic treatment, salvation, eternal life, redemption and healing.

Death is not the end. There is no need to fear death. Death is really a beginning — another step forward in Heavenly Father’s plan for His children. When life on earth ends, the physical body will die, but each person’s spirit will not. At death, the spirit will go to the spirit world, where the spirit will continue to learn and progress. Death is a necessary step in progression, just as birth is. Some time after death, the spirit and body will be reunited — never to be separated again. This is called resurrection, and it was made possible by the death and resurrection of Jesus Christ. Family and friends grieve for their loss, but they know that they will be with their loved ones again. This understanding brings great comfort.

ACKNOWLEDGEMENTS:
Rodney H. Standage, President
Albany, New York Stake
Church of Jesus Christ of Latter-day Saints
411 Loudon Road
Loudonville, NY
Phone: 518-434-6931

Bishop Roberto de Rubular Briones, former Bishop of the Schenectady Ward
The Church of Jesus Christ of Latter-day Saints
52 Blue Barns Road
Rexford, NY
Phone: 518-399-5327

With much appreciation to Diana and Howard Carpenter, Schenectady, NY

Table of Contents
Introduction
Chapter 1:
The Baha'i Patient
Chapter 2:
The Buddhist Patient
Chapter 3:
The Catholic Patient
Chapter 4:
The Christian Scientist Patient
Chapter 5:
The Church of Jesus Christ of Latter-Day Saints Patient
Chapter 6:
The Hindu Patient
Chapter 7:
The Jain Patient
Chapter 8:
The Jehovah's Witness Patient
Chapter 9:
The Jewish Patient
Chapter 10:
The Muslim Patient
Chapter 11:
The Orthodox Christian Church Patient
Chapter 12:
The Quaker Patient
Chapter 13:
The Shinto Patient
Chapter 14:
The Sikh Patient
Chapter 15:
The Unitarian Universalist Patient

Chapter 6: The Hindu Patient

Mahatma Gandhi
“Be the peace you wish for the world.”

1. Approximately how many followers are there worldwide? What is the geographic distribution of the members of your group?

There are over one billion Hindus globally. It is the dominant religion in India, Nepal, and among the Tamils in Sri Lanka. Hinduism is the world's third largest religion, after Christianity and Islam.

2. Are there general education requirements for the leaders of your religious/ethnic community? Can males and females serve in this capacity?

While there is a great deal of diversity within Hindu practice, both males and females can serve in a leadership capacity. There are religious schools to learn Hindu scriptures.

3. Please discuss the specific beliefs and customs which are integral to guiding your followers in their worldview and decision-making. Please include various beliefs, attitudes, ideologies and dietary needs which distinguish your group from others.

Hinduism embraces a great diversity of beliefs, a fact that can be initially confusing to Westerners accustomed to creeds, confessions, and carefully-worded belief statements. One can believe a wide variety of things about God, the universe and the path to liberation and still be considered a Hindu. However, there are some beliefs common to nearly all forms of Hinduism that can be identified, and these basic beliefs are generally regarded as boundaries outside of which lies either heresy or non-Hindu religion. These fundamental Hindu beliefs include: the authority of the Vedas (the oldest Indian sacred texts) and the Brahmans (priests); the existence of an enduring soul that transmigrates from one body to another at death (reincarnation); and the law of karma that determines one's destiny both in this life and the next. Note that a specific belief about God or gods is not considered one of the essentials, which is a major difference between Hinduism and strictly monotheistic religions like Christianity, Judaism, Islam and Sikhism.

Most Hindus are devoted followers of one of the principal gods Shiva, Vishnu or Shakti, and others, yet all of these are regarded as manifestations of a single Reality. The ultimate goal of all Hindus is release (moksha) from the cycle of rebirth (samsara). Some Hindus view this as being in God's presence while others view it more metaphorically as uniting with God as a drop of rain merges with the sea. Most Hindus believe in an immense unifying force that governs all existence and cannot be completely known by humanity. Individual gods and goddesses are personifications of this cosmic force. In practice, each Hindu worships those few deities that he or she believes directly influence his or her life. By selecting one or more of these deities to worship, and by conducting the rituals designed to facilitate contact with them, a Hindu devotee is striving to experience his or her unity with that cosmic force.

The vast majority of Hindus engage in religious rituals on a daily basis. Most Hindus observe religious rituals at home and the observation of rituals greatly vary among regions, villages, and individuals. Devout Hindus generally worship at a family shrine and this worship often includes lighting a lamp and offering foodstuffs before the images of deities, recitation from religious scripts, singing devotional hymns, meditation, chanting mantras and reciting scriptures. Hinduism advocates the practice of non-violence and respect for all life and therefore, many Hindus observe a strict vegetarian diet

4. Are there any known ethnogenetic pathologies prevalent for members of your group?

There are no known ethnogenetic pathologies for members of the Hindu religion.

5. How important is it for your followers to maintain their religious/ethnic identity while living in close proximity to and interacting with people of other backgrounds? Are there any issues regarding building relationships and trust, either within or outside the community?

Hindus do not usually have any problems maintaining their religious identity while living in close proximity to people of other backgrounds. Hindus are generally very broadminded in their interactions with members of other religions and cultures and they generally speak the prominent language of the country in which they live. Hindus are often active members of their secular communities and build mutually trusting relationships with various religious and ethnic communities.

6. Please explain various cultural, language and racial differences among followers within your religion/ethnic culture.

Hindi and English are the two national languages of India; however, there are more than 15 different regional languages and over 400 dialects. The language, customs, food and dress vary from state to state and have largely been influenced by India’s ancient heritages and neighboring countries over the past five millenia.

7. Please explain familial roles and organization. What is the perception of old age? Are there differences between male/female roles? Please explain the role of religion/culture with regard to general health care. Describe the relationship among the medical practitioner, the patient and the patient’s family. Describe the view of the following: living wills, health care proxies, DNRs, end-of-life-philosophy, organ transplant, blood transfusion, nursing home and/or hospice care, psychiatry, birth control intervention, labor/delivery and circumcision.

Within the Indian Hindu culture, the elderly command a great deal of respect and honor within the family unit. It is expected that grown children will care for their aging parents and this responsibility rests more with the male children. For this reason, elderly Hindus generally reside with their grown children rather than a long-term residential nursing or hospice facility. Although the younger generation may trust modern medical care, many elderly Hindus prefer more traditional methods of medical treatment, such as Ayurveda and Homeopathy.

There is generally a stigma attached to psychiatric care and therefore, frequently a reluctance to seek treatment. There are no laws to prohibit organ and tissue donations/transplants and in fact, some Hindus believe that the recipients may assume the “karma” of the donor. Living wills are often pre-arranged with family members. Hindus maintain the importance of keeping the patient from suffering during illness and pain management is permitted, providing that the patient does not lose consciousness. Life support is permitted as long as it will hopefully result in a good quality of life for the patient. If it is deemed that the life support will only prolong the patient’s life with no chance of improvement, then palliative care is recommended. If the patient is conscious and understands that the end is near, the patient may choose to refuse food and water. Autopsies are to be avoided unless required by civil law.

While there are no prohibitions against birth control in the Hindu religion, abortion is only permitted in order to save the life of the mother. Artificial insemination with donor sperm other than from the husband is not accepted. It is important to note that circumcision is not practiced. It is very common for a Hindu woman to invite her mother to be present during the labor/delivery process.

8. Are there specific burial customs which must be observed by members of your group?

It is extremely important to recognize that Hindu burial practices vary greatly, not only due to geographical location, but also due to differences in caste. Generally speaking, Hindu funeral rites are performed by Temple priests and specific rituals may start to be performed when the patient is believed to be on his or her deathbed. The body may be either cremated or buried, depending upon the caste of the deceased. Rites are conducted to enable the soul of the deceased to transit successfully from the stage of a ghost (Preta) to the realm of the ancestors (Pitrs). Final rituals are then performed in honor of the Pitrs.

9. Please explain the spiritual/ethnic philosophy regarding miraculous intervention by the divine, holistic treatment, salvation, eternal life, redemption and healing.

The Hindu philosophy regarding death stresses the immortality of the soul and reincarnation. It is believed that a person’s actions/deeds (karma) actively create past, present and future experiences, thereby making each individual responsible for their own life and the resulting joy and/or pain it brings to themselves and others. The results of these actions are called karma-phala and these extend through one’s past, present and future lives. In some Hindu traditions, there is the belief that God might play a role as the dispenser of the karma or might, in rare instances, change the karma of an individual. Other Hindus might maintain that a Priest, Yogi, or a Guru (mentor) will act on behalf of God by influencing the karma of the individual.

ACKNOWLEDGEMENTS:

Rita Singh, President
American Hindu Association
P.O. Box 55405
Madison, WI 53705
Phone: 608- 835-5895
Email: aha@americanhindu.net

Suman S. Joshi
The Hindu Temple Society of the Capital District
450 Albany Shaker Road
Loudonville, NY 12211
Website: www.albanyhindutemple.org

Table of Contents
Introduction
Chapter 1:
The Baha'i Patient
Chapter 2:
The Buddhist Patient
Chapter 3:
The Catholic Patient
Chapter 4:
The Christian Scientist Patient
Chapter 5:
The Church of Jesus Christ of Latter-Day Saints Patient
Chapter 6:
The Hindu Patient
Chapter 7:
The Jain Patient
Chapter 8:
The Jehovah's Witness Patient
Chapter 9:
The Jewish Patient
Chapter 10:
The Muslim Patient
Chapter 11:
The Orthodox Christian Church Patient
Chapter 12:
The Quaker Patient
Chapter 13:
The Shinto Patient
Chapter 14:
The Sikh Patient
Chapter 15:
The Unitarian Universalist Patient

Chapter 7: The Jain Patient

Lord Mahavira, 24th Tirthankara
“In happiness and suffering, in joy and grief, we should regard all creatures as we regard our own self.”

1. Approximately how many followers are there worldwide? What is the geographic distribution of the members of your group?

There are different estimates of the Jain population — anywhere from three to ten million globally, with the majority located in India. Worldwide centers of Jain populations include Great Britain, Antwerp, Belgium, and the East African nations of Kenya, Uganda and Tanzania. There are also approximately 100,000 Jains in North America.

2. Are there general education requirements for the leaders of your religious/ethnic community? Can males and females serve in this capacity?

There are no specific education requirements necessary to attain a leadership role within the Jain religion. Both males and females can serve in that capacity.

3. Please discuss the specific beliefs and customs which are integral to guiding your followers in their worldview and decision-making. Please include various beliefs, attitudes, ideologies and dietary needs which distinguish your group from others.

Jains believe in the theory of Karma, which asserts that an individual is responsible for personal actions and which might be illustrated through the saying “As you sow, so shall you reap.”

Jains believe that all living things are in possession of a soul, and this belief extends to humans, animals, plants and insects. Since they believe that all souls are equal, Jains strive to lead a lie filled with gentle kindness and compassion so as not to cause any suffering to any living being. The five fundamental principles or vows of Jainism are Non-violence, Truthfulness, Non-stealing, Celibacy and Non-possession. Jains extend this philosophy to their choice of professions and generally enter those which do not have the potential to cause other people any physical or mental pain, such as medicine, education or trade.

Jains are strictly vegetarian. Therefore no meat, poultry, fish, eggs or their by–products may be consumed. Milk products and rennet-free dairy products are allowed. Honey is restricted. Meals are taken between sunrise and sunset. Cooked food left overnight is avoided. It is common for Jains to drink water that has been previously boiled and cooled. Some Jains restrict their fruit and vegetable intake to those fruits which have fallen to the ground rather than those which need to be plucked. Nuts and legumes are preferred to root vegetables.

4. Are there any known ethnogenetic pathologies prevalent for members of your group?

There are no known ethnogenetic pathologies within members of the Jain faith.

5. How important is it for your followers to maintain their religious/ethnic identity while living in close proximity to and interacting with people of other backgrounds? Are there any issues regarding building relationships and trust, either within or outside the community?

Jains do not have issues in building relationships and trust, as long as religious principles are not compromised. They have good working relationships with people of all backgrounds.

6. Please explain various cultural, language and racial differences among followers within your religion/ethnic culture.

Jains adapt to the prevailing language and culture of the society in which they live. There is great cultural, linguistic and racial diversity among members of Jain.

7. Please explain familial roles and organization. What is the perception of old age? Are there differences between male/female roles? Please explain the role of religion/culture with regard to general health care. Describe the relationship among the medical practitioner, the patient and the patient’s family. Describe the view of the following: living wills, health care proxies, DNRs, end-of-life-philosophy, organ transplant, blood transfusion, nursing home and/or hospice care, psychiatry, birth control intervention, labor/delivery and circumcision.

Jains consider the living will a personal matter. If a member of the religion has written such a document, it must be respected. Jain philosophy maintains the importance of saving lives at the cost of one’s own. It is important to note that there may be differences in types of medical care accepted within the Jain community. While some Jains will accept surgery, some (especially the Sadhu/Sadhi monks/nuns) will not accept surgical procedures. Jains have no objection to giving of blood; however, there are restrictions on receiving blood transfusions, blood products and organ donations from others. For this reason, these medical procedures should be reserved for dire, life-saving measures. If it is determined that such procedure is necessary, it is of paramount importance that the blood or organ donor follow strict vegetarian customs.

The Jain philosophy of life is consistent with using every possible measure to keep terminally ill patients alive, provided that no non-vegetarian products are used for this purpose. However, some Jains may prefer to take the “Santharo,” which means that they will voluntarily abstain from any life-saving treatments in order to let nature take its course, thereby following Karmic principles.

Contraception is not favored among members of the Jain faith. Abstinence and self-control are the preferred methods of birth control. Since there is no specific prohibition against birth control devices, the decision is left to the discretion of each couple. Upon conception, any method of avoiding or preventing childbirth is perceived as killing and is therefore not permitted, unless there are medical grounds which indicate that the life of the mother or child is in danger.

The precise time (hour-minute-second) and place (longitude and latitude) of birth should be recorded. This is necessary for horoscope preparation and deciding the first name. No other ceremony (such as baptism) is required.

8. Are there specific burial customs which must be observed by members of your group?

Jains believe in reincarnation and the transmigration of soul. After death, the body is cremated according to the Jain ritual. Any knowledgeable person can perform the proscribed ritual. Prayers are continuously chanted and a lamp is placed on the right head side of the body and kept burning until the body is taken for cremation. The lamp has a cotton wick that is soaked in ghee (clarified butter) as a divine symbol.

Scriptures (such as Kalpasutra, Samayasar and Uttaradhyansutra) are read to comfort and console the patient. A patient may desire to do a Santharo, which in brief is a renunciation and which is either Sagari-Aagar (for a lay person) or Samadhimaran (for a monk or a nun). This ritual may be arranged or requested by the patient or the caretaker. The Namokar Mantra, Shantipath, Stavans and other prayers, devotional songs and mantras are chanted. After death, the body is cremated according to Jain ritual

9. Please explain the spiritual/ethnic philosophy regarding miraculous intervention by the divine, holistic treatment, salvation, eternal life, redemption and healing.

Jains do not believe in miraculous intervention by the divine. The Jain concept of God is not one of provider, sustainer, creator, judge, savior, punisher or Supreme Being. Jains believe that once the influence and attachment of Karma on the soul is expelled, the remaining soul is considered to be liberated from the suffering associated with birth, life and death. Life is of definite duration and the soul migrates from one form of life to another. Jains count approximately 8.4 million different lives in which each soul is believed to reside before achieving human life. It is believed that a person’s “bad” deeds (Karmas) belong to the individual and that these deeds can only be “eliminated” by performing “good” deeds. There is no person to whom a Jain can confess for redemption.

ACKNOWLEDGEMENTS:

Arvind Vora, Chair for Interreligious Affairs
Federation of Jain Associations of North America

Prakash Mody
37 Tuscarora Drive
North York, ON M2H 2K4
Canada
(Jain representative for Ontario Multifaith Council on Spiritual and Religious Care)
(416) 491-5560
Email: 4prakash@gmail.com

Table of Contents
Introduction
Chapter 1:
The Baha'i Patient
Chapter 2:
The Buddhist Patient
Chapter 3:
The Catholic Patient
Chapter 4:
The Christian Scientist Patient
Chapter 5:
The Church of Jesus Christ of Latter-Day Saints Patient
Chapter 6:
The Hindu Patient
Chapter 7:
The Jain Patient
Chapter 8:
The Jehovah's Witness Patient
Chapter 9:
The Jewish Patient
Chapter 10:
The Muslim Patient
Chapter 11:
The Orthodox Christian Church Patient
Chapter 12:
The Quaker Patient
Chapter 13:
The Shinto Patient
Chapter 14:
The Sikh Patient
Chapter 15:
The Unitarian Universalist Patient

Chapter 8: The Jehovah's Witness Patient

1. Approximately how many followers are there worldwide? What is the geographic distribution of the members of your group?

Our followers visit homes in communities throughout the world to engage people in Bible discussion. As of this writing, we have members in 236 countries who speak over 400 languages. Members are racially and ethnically integrated.

2. Are there general education requirements for the leaders of your religious/ethnic community? Can males and females serve in this capacity?

The Jehovah’s Witnesses headquarters is led by an all-male Governing Body, based at The Watchtower, in Brooklyn, NY. Each local congregation is served by appointed male elders, who govern the congregation, direct public preaching and decide on disciplinary action if necessary. Women may not serve in this capacity. Ministerial servants are responsible for clerical duties, as well as occasional teaching. None of the elders are paid, but rather “serve” the congregation.

3. Please discuss the specific beliefs and customs which are integral to guiding your followers in their worldview and decision-making. Please include various beliefs, attitudes, ideologies and dietary needs which distinguish your group from others.

According to the teachings of the Watch Tower Society, humanity is currently experiencing the last days of the present world order. Jehovah's Witnesses believe that after the current world order is destroyed, righteous survivors and resurrected dead individuals will have the opportunity to live forever on a paradisiacal earth ruled by Christ and 144,000 people raised to heaven. The Society had strong expectations that the Armageddon would occur in either the year of 1914, 1925 or 1975.

The Watch Tower Society has since changed its stance and currently teaches its followers that it is impossible to know precisely when Armageddon will occur. Jehovah's Witnesses are best known for their door-to-door preaching, distribution of literature such as The Watchtower and Awake! and for their refusal of military service and blood transfusions, even in life-threatening situations. They consider use of the name Jehovah one of the proposed pronunciations of the Tetragrammaton vital to proper worship; they reject Trinitarianism, immortality of the soul, and hellfire, which they consider to be unscriptural; they do not observe celebrations such as Christmas, Easter or birthdays, which they believe to have pagan origins, or national holidays, such as Independence Day. Members commonly refer to their body of beliefs as "the Truth", and adherents consider themselves to be "in the Truth".

The religion's positions regarding conscientious objection to military service and refusal to salute national flags has brought it into conflict with governments, particularly those that conscript citizens for military service; activities of Jehovah's Witnesses have been consequently banned or restricted in some countries. Persistent legal challenges by Jehovah's Witnesses' to such civic duties have had considerable influence on legislation and legal practice concerning civil liberties conscientious objection to military service in several countries including the United States.

Jehovah’s Witnesses are very religious and attempt to live their lives according to the commandments of God as written in the Old and New Testaments. They believe that Jesus was the Son of God; however, he is not equal to God. Jehovah’s Witnesses believe in the existence of the Devil, since the Scriptures portray the Devil as a real person. He is invisible to humans for the same reason that God is invisible to human eyes. The Bible identifies God as a Spirit and the Devil as a spirit creature. Today, demonic influence continues to promote human cruelty, as was foretold in the Bible: Man’s spiritual inclination has led him to explore the unknown. By exploiting man’s curiosity about what is strange and mysterious, Satan has used spiritism to bring many under his control. As a hunter uses bait to attract his prey, Satan employs such devices as fortune-telling, astrology, hypnotism, witchcraft, palmistry, and magic to attract and entrap people around the world. Based on the dangers of spiritism and occultism, Jehovah Witnesses keep clear of practices and beliefs that are rooted in false religion, such as yoga. They are also against the use of religious icons, for they believe that it is in the name of Jesus Christ that we should approach God. No other person, and certainly no lifeless icon, can substitute for him.

4. Are there any known ethnogenetic pathologies prevalent for members of your group?

Due to the widespread global membership, there are no known ethnogenetic pathologies among members of Jehovah’s Witnesses.

5. How important is it for your followers to maintain their religious/ethnic identity while living in close proximity to and interacting with people of other backgrounds? Are there any issues regarding building relationships and trust, either within or outside the community?

Jehovah's Witnesses regard secular society as a place of moral contamination and under the control of Satan, and limit their social contact with non-Witnesses. Members who violate the organization's fundamental moral principles or who dispute doctrinal matters are subject to disciplinary action, the most severe being a form of shunning they call “disfellowshipping.” Jehovah’s Witnesses proselytize their beliefs as they visit people from house to house to preach their Biblical principles. They consider this to be a humanitarian effort to help non-believers improve their lives. Witnesses devote a great deal of time to proselytizing and give reports to their congregations about their preaching activities. Jehovah’s Witnesses are opposed to interfaith activities within the community since their religion alone represents the true Christianity.

6. Please explain various cultural, language and racial differences among followers within your religion/ethnic culture.

Due to the widespread global membership, there are many cultural, language and racial differences among Jehovah’s Witnesses.

7. Please explain familial roles and organization. What is the perception of old age? Are there differences between male/female roles? Please explain the role of religion/culture with regard to general health care. Describe the relationship among the medical practitioner, the patient and the patient’s family. Describe the view of the following: living wills, health care proxies, DNRs, end-of-life-philosophy, organ transplant, blood transfusion, nursing home and/or hospice care, psychiatry, birth control intervention, labor/delivery and circumcision.

Women are very much respected by their husbands and other religious community members for their familial roles, including working outside the home to help support the family, and taking care of the physical and emotional welfare of her children.

Jehovah’s Witnesses accept medical and surgical treatment, however they believe that blood transfusion (whole blood, packed RBCs, plasma, WBC and platelet administration) is forbidden. Each witness must make their own decision about accepting components, such as albumin, immune globulins and hemophiliac preparations. Witnesses believe that blood removed from the body should be disposed of, so they do not accept autotransfusion of predeposited blood. Techniques for intraoperative collection or hemodilution that involve blood storage are objectionable. Some Jehovah’s Witnesses do permit the use of dialysis and heart-lung equipment (non-blood-prime) as well as intraoperative salvage, where the extracorporeal circulation is uninterrupted; the physician should consult with the patient as to what his conscience dictates. This is also the case regarding cornea, kidney, or other tissue transplants. Witnesses do not object to colloid or crystalloid replacement fluids, nor to electrocautery, hypotensive anesthesia, or hypothermia. Current and future applications of hetastarch, large dose intravenous iron dextran injections, and the sonic scalpel are promising and not religiously objectionable. Also, a fluorinated blood substitute, Fluosol-DA, is safe and effective and does not conflict with Jehovah’s Witness beliefs.

Witnesses readily sign the American Medical Association form relieving physicians and hospitals of liability, and most Witnesses carry a dated, witnessed Medical Alert card prepared in consultation with medical and legal authorities. These documents are binding on the patient (or his estate) and offer protection to physicians.

Care of minors presents the greatest concern, often resulting in legal action against parents under child-neglect statutes. Not desirous of shirking their parental responsibility or of shifting it to a judge or other third party, Witnesses urge that consideration be given to the family’s religious tenets.

There is no prohibition concerning the Witnesses use of birth control methods. Sexual relations between husband and wife are a God-given gift. But procreation is not their sole purpose. Sexual relations also allow a married couple to express tenderness and affection for each another. So if a couple should decide to exclude the possibility of a pregnancy by using some form of contraception, that is their choice to make, and no one should judge them.

8. Are there specific burial customs which must be observed by members of your group?

At a Witness funeral, mourners are expected to wear simple clothing in muted colors. The funeral services last between 15 and 30 minutes and are typically held at a Kingdom Hall or a funeral home. A congregation’s elder performs the service. A graveside service follows.

9. Please explain the spiritual/ethnic philosophy regarding miraculous intervention by the divine, holistic treatment, salvation, eternal life, redemption and healing.

Jehovah’s Witnesses believe that death is a state of non-existence with no consciousness. They do not believe in Hell. They believe in resurrection after the Armageddon or life after death in heaven for a limited number of 144,000 people. Jehovah’s Witnesses teach that the end of the world, as we now know it, is imminent. They do not predict a specific date for Armageddon, however they maintain that modern events correspond to Biblical prophecies. They believe that after Armageddon, God will extend his heavenly kingdom to include the earth.

ACKNOWLEDGEMENT:

Website: http://www.watchtower.org

Table of Contents
Introduction
Chapter 1:
The Baha'i Patient
Chapter 2:
The Buddhist Patient
Chapter 3:
The Catholic Patient
Chapter 4:
The Christian Scientist Patient
Chapter 5:
The Church of Jesus Christ of Latter-Day Saints Patient
Chapter 6:
The Hindu Patient
Chapter 7:
The Jain Patient
Chapter 8:
The Jehovah's Witness Patient
Chapter 9:
The Jewish Patient
Chapter 10:
The Muslim Patient
Chapter 11:
The Orthodox Christian Church Patient
Chapter 12:
The Quaker Patient
Chapter 13:
The Shinto Patient
Chapter 14:
The Sikh Patient
Chapter 15:
The Unitarian Universalist Patient

Chapter 9: The Jewish Patient

Rabbi Hillel
“If I am not for myself, who will be for me? If I am not for others, what am I? And if not now, when?”

1. Approximately how many followers are there worldwide? What is the geographic distribution of the members of your group?

There are about 15-18 million Jews worldwide, with about 5.5 million living in the USA and approximately six million in Israel. The remaining members of the Jewish community are located throughout Europe, South America, Africa, Australia and Asia.

2. Are there general education requirements for the leaders of your religious/ethnic community? Can males and females serve in this capacity?

Rabbis (teachers) are usually ordained after five or more years of study. Western-style seminaries offer the academic degree of ordination, whereas European-style seminaries offer semikha, a transference of authorization by the laying of hands of senior teachers. Orthodox Judaism, in all its iterations, does not ordain women, while the more liberal movements (denominations) do ordain females. It is important to note that while the congregation rabbi is essentially a “first among equals” in leading the religious community and is considered to be the authoritative voice on matters of religious standards, any educated Jew is qualified to teach, lead or officiate within the community.

3. Please discuss the specific beliefs and customs which are integral to guiding your followers in their worldview and decision-making. Please include various beliefs, attitudes, ideologies and dietary needs which distinguish your group from others.

The Jewish people believe that God is One and that they have a specific covenant with God. The record of that covenant is the Torah and the subsequent books of the Bible. The practice of the covenant has been interpreted and applied in each generation by the scholars and activists of the Jewish community, creating both halakha (law) and minhag (custom) that have fluctuated and evolved over time. A Jew is a Jew by birthright or choice, but maintains a Jewish identity even if alienated from faith and practice. The Jewish people believe that the Messiah or messianic era has yet to appear. Human beings, created in God’s image, enjoy life as a sacred gift; life in this world should be lived righteously, because that is God’s will.

Traditional Jews in all movements will limit their food to items they deem kosher (fit and proper) and the standards for kosher food vary among the movements. Traditional Jews in all movements will treat Friday twilight through Saturday darkness (when three stars appear) as Shabbat (Sabbath). Observances vary among the movements, but often include restrictions on writing, using motorized equipment, tearing (such as tearing toilet tissue), travel, conducting any business transactions, and using any electrical appliances and technological devices (including telephones). All physicians, nurses and technicians should take note that extremely Orthodox Jews will be very sensitive about physical contact between the sexes, even for medical reasons. In pursuit of preserving life and health, almost all Jews will relax any of the preceding restrictions. If there is resistance from the patient or family, a consultation with a rabbi from the individual’s particular movement would be beneficial to all parties.

4. Are there any known ethnogenetic pathologies prevalent for members of your group?

Some genetic conditions, including Tay-Sachs, Canavan’s, Gaucher Disease Type 1, Bloom’s Syndrome, Cystic Fibrosis, Familial Dysautonomia, Fanconi Anemia Type C, Glycogen Storage Disorder Type 1A, Maple Syrup Urine Disease, Mucolipidosis 4, Niemann-Pick Disease Type A and breast cancer markers occur disproportionately in the Jewish population. Diabetes and heart disease are diagnosed more frequently in Jews, though it is not clear if the reason can be traced to the history of endogamy that limits the gene pool or if the life styles of Jews in the United States create the environmental conditions for these diseases.

5. How important is it for your followers to maintain their religious/ethnic identity while living in close proximity to and interacting with people of other backgrounds? Are there any issues regarding building relationships and trust, either within or outside the community?

It is very important, in spite of the dominant trend to intermarriage, for Jews to feel affirmed as Jews in any situation. The history of exclusion and oppression, though virtually unknown in the contemporary USA, makes some Jews very sensitive to non-Jews, especially certain ethnic communities. An older Jew of European extraction is likely to respond negatively to a doctor with a German accent. Jews who live in isolated ultra-Orthodox enclaves may harbor a suspicion of anyone from outside their own community, including other Jews.

6. Please explain various cultural, language and racial differences among followers within your religion/ethnic culture.

On the one hand, Jews come from numerous cultural, ethnic and racial backgrounds; they may be Arab, Asian, Indian, African, Latin American, Western and Eastern European. Most Jews in the United States are of European extraction. Many consider Yiddish their linguistic heritage, though only a minority actually speaks more than a few words. All Jews share Hebrew as their “native” language, yet few can speak it fluently. One may be born a Jew, yet a Gentile may choose to convert to Judaism and is then considered to be as Jewish as any rabbi. The variety of Jewish religious and non-religious groupings is extremely diverse.

7. Please explain familial roles and organization. What is the perception of old age? Are there differences between male/female roles? Please explain the role of religion/culture with regard to general health care. Describe the relationship among the medical practitioner, the patient and the patient’s family. Describe the view of the following: living wills, health care proxies, DNRs, end-of-life-philosophy, organ transplant, blood transfusion, nursing home and/or hospice care, psychiatry, birth control intervention, labor/delivery and circumcision.

These roles are in flux not only in secular society, but in the Jewish community as well. According to Jewish tradition, the father is the breadwinner and religious authority in the home, while the Jewish mother is generally the authority on secular matters within the home. Jewish grandparents are revered and often referred to, even in death. The religious commandment to honor one’s parents is strictly adhered to within the Orthodox Jewish community, however it may be interpreted very differently among today’s modern Jews.

Jewish tradition places great importance on consulting with trained medical personnel when making health-care decisions; within the parameters of respect for basic values, the physician’s opinion is considered to be at least as authoritative as the rabbi’s judgment. The most Orthodox members of the community will continue to refer to traditional religious literature regarding the definitions of life and death, necessary interventions and therapeutic treatments. Non-Orthodox Jews tend to consider the wisdom of medical science to be the very standards which religious tradition recommends. Consequently, there may be some disparity within the Jewish community concerning preferred protocols for living wills, proxies, DNRs, transplantation and transfusion. Even if civil law permits proactive protocols that hasten death or outright euthanasia, it is unlikely that any Jewish authority will affirm them as appropriate.

According to Jewish tradition, circumcision is to be performed by a religious specialist (mohel, often pronounced “moyl”) on a healthy boy’s eighth day of life in a religious ceremony. Not all liberal Jews adhere to this tradition. Elective abortion is “prohibited without penalty” by Jewish law. However, early termination of pregnancy due to considerations of the life, health and/or well-being of the mother is permitted by all Jews, although some have stricter guidelines for what constitutes a genuine health threat to the mother. While most Jews practice birth control, is a very complicated subject within Jewish tradition. Some movements discourage it except to prevent a dangerous pregnancy; others recommend only certain types of control be used which are considered consistent with religious mandates; still others encourage previously prohibited forms of birth control to prevent the spread of STDs. The patient may choose to consult a rabbi to assist with making decisions about birth control.

8. Are there specific burial customs which must be observed by members of your group?

Traditional Jewish burial includes the washing and dressing of the body by a specially-trained cadre of volunteers called chevra kaddisha (holy society). When possible, burial should take place within 24 hours of death; in extreme circumstances when the burial must be delayed (the occurrence of a sequence of holidays and Sabbath), burial should take place within 72 hours. Jewish tradition places a strong emphasis on the sanctity of the body. Autopsies that are not required by law or that will not yield immediate specific medical insights that will save others are prohibited. An Orthodox Jew will not permit his or her remains to be used for research or as a medical cadaver. Cremation is an affront to both traditional Judaism and recent European Jewish history.

9. Please explain the spiritual/ethnic philosophy regarding miraculous intervention by the divine, holistic treatment, salvation, eternal life, redemption and healing.

Every time Scripture is recited during worship, a special prayer is offered for healing the ill and often, specifically by name. Each worship service contains a liturgical declaration that God’s healing power is accessible to all who call upon it. In the Jewish tradition, prayer is considered to be the partner of medicine, not its replacement; in fact, Jewish tradition forbids a Jew to live in a community without a physician. A rich spiritual life can augment the curative and palliative powers of modern medicine, but may not be a substitute for them. Judaism affirms life after death and speculation about its nature abounds, ranging from bodily resurrection to absorption of the soul by the cosmos. Eternal life, redemption and salvation are all in God’s hands, according to the tradition; those who describe a judgment process focus on the righteous acts of the individual during this life (including penitence for wrong-doing), but not on a particular tenet of faith or belief.

ACKNOWLEDGEMENT:

Rabbi Jack Moline, Alexandria, VA

Rabbi Moline is the religious leader of Congregation Agudas Achim of Alexandria, VA and on the Interfaith Alliance Board of Directors. He is the former President of the Washington Board of Rabbis and the Alexandria Interfaith Association. Rabbi Moline has served on the boards of the Faith and Politics Institute, the Rabbinical Assembly, Gesher Jewish Day School, the Cathedral College of Washington National (Episcopal) Cathedral and Operation Understanding DC, among others. He is an adjunct faculty member of the Virginia Theological Seminary and frequent contributor to radio, television and newspaper coverage of religious affairs.

Email: jmoline@usa.com

Table of Contents
Introduction
Chapter 1:
The Baha'i Patient
Chapter 2:
The Buddhist Patient
Chapter 3:
The Catholic Patient
Chapter 4:
The Christian Scientist Patient
Chapter 5:
The Church of Jesus Christ of Latter-Day Saints Patient
Chapter 6:
The Hindu Patient
Chapter 7:
The Jain Patient
Chapter 8:
The Jehovah's Witness Patient
Chapter 9:
The Jewish Patient
Chapter 10:
The Muslim Patient
Chapter 11:
The Orthodox Christian Church Patient
Chapter 12:
The Quaker Patient
Chapter 13:
The Shinto Patient
Chapter 14:
The Sikh Patient
Chapter 15:
The Unitarian Universalist Patient

Chapter 10: The Muslim Patient

Number 13 of Imam Al-Nawawi’s Forty Hadiths
“None of you truly believes until he wishes for his brother what he wishes for himself.”

1. Approximately how many followers are there worldwide? What is the geographic distribution of the members of your group?

Currently, there are approximately 1.5 billion Muslims worldwide. The majority live in Indonesia, India, Bangladesh and Pakistan. Arab populations comprise only 20% of Muslims globally. Anyone can be a member of the religion, regardless of race, ethnicity or language. In the United States, there are approximately five million Muslims. The global Muslim demographics are as follows:

27% Middle East
25% African-American
24% Bangladesh, India and Pakistan
22.4% Iran, Southern Asia
1.6% White American

2. Are there general education requirements for the leaders of your religious/ethnic community? Can males and females serve in this capacity?

While there are no specific education requirements necessary for a leader in the Muslim community to become an imam, most are highly educated. The position of imam is always relegated to a male leader. Females are very much respected in Muslim culture; however, they are not permitted to lead prayers.

3. Please discuss the specific beliefs and customs which are integral to guiding your followers in their worldview and decision-making. Please include various beliefs, attitudes, ideologies and dietary needs which distinguish your group from others.

The word “Islam” is derived from the Arabic root word “silm,” which means “peace.” The core aspects of the Muslim faith are based on monotheism (Allah is the Arabic word for God), prophets, Day of Judgment and submission to God’s will. While Muslims recognize all of the prophets of the Jewish and Christian faiths, they believe that Mohammed is the messenger of God. Good and bad events are challenges to one’s patience and faith. The length of life and time of death are predetermined by God.

Maintaining both spiritual and physical cleanliness is of utmost importance to Muslims. Ablution, which is the ritual washing (with water) of the hands, mouth, nose, face, arms and feet, is required prior to the act of prayer. The Muslim patient will request to be cleaned of unclean substances (urine, feces, vomit) prior to performing ablution and to repeat ablution after urinating, defecating, sleeping, losing consciousness or profusely bleeding. A complete bath is required after menstruation, intercourse, and post-partum before a Muslim performs prayer or recites passages from the holy Qur’an.

There are five “pillars” of Islamic belief and practice:

A) Muslims believe that there is nothing worthy of worship except God, and Mohammed is God's servant and messenger.

B) The five daily prayers are done at dawn, noon, mid-afternoon, sunset and night in any quiet and clean area. During prayers, Muslims face towards the direction of Mecca. The act of praying consists of mental and spiritual connection with God while assuming various physical positions, such as standing still, bowing, prostrating and sitting on the floor (or clean towel or prayer rug) as a sign of submission to God. The sick patient may pray either sitting or lying down. While engaged in the act of prayer, Muslims are totally absorbed in praying and will not interact with their surroundings. There should not be any idol, statue, picture or person in front of the praying individual. Friday is the Muslim Sabbath and on this holy day, Muslims join for congregational prayer at the mosque.

C) Muslims are obligated to give annual mandatory alms to the poor of at least 2.5% of their accumulated wealth.

D) Muslims fast during the lunar month of Ramadan from dawn to sunset and celebrate the end of the fast with a festival, “Eid-ul-Fitr.” They believe that the fast builds will power, compassion for the needy, and helps to strengthen community relations. Elderly and ill Muslims are exempt from fasting, as are pregnant and nursing women. Oral medicine and I.V. hydration are considered to break the fast, however eye/ear drops, inhalers, injections, rectal enemas and suppositories do not break the fast.

E) Muslims make every effort to go on a pilgrimage (haj) to Mecca at least once during their lifetime if they are physically and financially able. The purpose of this journey is to commemorate the trials of the Prophet Abraham through acts of worship, reflection, repentance and commemoration.

Proper diet is essential to most Muslims and there is a prohibition against all food which is not halal, such as alcohol (including medicines containing alcohol), pork and pork by-products (lard and gelatin) and blood (rare meat). Halal meat must be slaughtered according to Islamic law. Smoking tobacco is discouraged.

4. Are there any known ethnogenetic pathologies prevalent for members of your group?

Due to the multi-cultural diversities inherent in the Muslim faith, there are no specific ethnogenetic pathologies. The only exception might be due to genetic disorders resulting from marriages between close cousins.

5. How important is it for your followers to maintain their religious/ethnic identity while living in close proximity to and interacting with people of other backgrounds? Are there any issues regarding building relationships and trust, either within or outside the community?

Muslims live peacefully with members of other faiths. They are loyal to the governments of the countries where they reside, while maintaining their religious practices. Unfortunately, there have been frequent acts of discrimination against Muslims post-September 11, 2001. Many interfaith communities have worked with area Muslims to take steps to end discrimination within local communities.

6. Please explain various cultural, language and racial differences among followers within your religion/ethnic culture.

Various forms of dress, non-religious rituals, food and spoken language are not dictated by the religion, but rather are specific to particular regional cultures. Islam respects and values such diversity, providing that it does not transgress Islamic law.

7. Please explain familial roles and organization. What is the perception of old age? Are there differences between male/female roles? Please explain the role of religion/culture with regard to general health care. Describe the relationship among the medical practitioner, the patient and the patient’s family. Describe the view of the following: living wills, health care proxies, DNRs, end-of-life-philosophy, organ transplant, blood transfusion, nursing home and/or hospice care, psychiatry, birth control intervention, labor/delivery and circumcision.

Males are considered to be the “head” of the family and bear financial responsibility for family members (even if the females are employed). Islam requires total respect for senior family members and it is common for aging parents to live with their children. Grown children may be involved in the medical decisions concerning their parents. Visiting the sick is highly encouraged in Islam. Due to frequent and numerous visitors expected during a patient’s hospital stay, it is generally appreciated if group prayer space is made available for the extended family. Modesty is very important to members of Islam, and women often cover most of their bodies, with the exception of face and hands. Therefore, it is extremely important for the physician to avoid exposing a Muslim patient unnecessarily, even if it is “just” an arm or leg. It is suggested that physicians seek permission from the patient before a physical examination. Gender segregation is common practice and it is forbidden for a patient to share a room with another patient of the opposite gender. It is highly advised for physicians/health care providers to knock before entering a Muslim patient’s hospital room. It is important for “opposite sex” health care providers to avoid unnecessary touching of patients, such as patting, hand-shaking and hugging.

Advanced medical directives are highly recommended. Blood transfusions, life support and analgesics are permitted. Terminal withdrawal of life support from a conscious person is prohibited, while withdrawal of support from a person in a vegetative state is controversial. Issues regarding organ procurement and transplantation are somewhat controversial and consultation with religious leadership is recommended. The right to refuse treatment is also controversial and needs to be discussed with a religious leader.

Female caregivers are preferred for prenatal and postnatal care. After birth, it is common to announce the call of prayer twice to the newborn. The new father customarily rubs a small piece of date or honey onto the infant’s upper palate. Muslim law sanctions male circumcision and in some families, the head of the newborn is shaven. Breastfeeding is encouraged for up to two years. While contraception is permitted, abortion is prohibited unless the life of the mother is in danger. Artificial insemination and contraception using donor eggs/sperm is forbidden.

8. Are there specific burial customs which must be observed by members of your group?

Immediately after death, the eyes and mouth should be closed, the limbs should be straightened and faced in the direction of Mecca. Family members or religious representatives perform the ritual washing of the body and shrouding it in a simple, unsewn, clean white cloth. This is followed by a quick burial, often in their birthplace. Cremation and embalming are forbidden and autopsy should be avoided unless required by law.

9. Please explain the spiritual/ethnic philosophy regarding miraculous intervention by the divine, holistic treatment, salvation, eternal life, redemption and healing.

Muslims believe that the length of life and time of death are pre-determined by God. They believe in a Day of Judgment on which all Muslims will be judged according to their deeds, observance of religious laws and repentance.

ACKNOWLEDGEMENTS:

Dr. Rasheed Ahmed, Executive Director
Islamic Medical Association of North America
101 West 22nd Street, Suite 106
Lombard, IL 50148
Phone: 630-932-0000
Email: hq@imana.org

Imam Djafer Sebkhaoui Al-Hidaya Mosque and The Muslim Community of Troy, NY
2339 15th St. Troy NY 12180
http://www.al-hidaya.com

Islamic Speakers Bureau of Albany, NY
http://www.isbalbany.org

Aziz, Sheikh and Gatrad, Abdul Rashid, ed. Caring for Muslim Patients. Radcliffe Medical Publishing. NY. 2008

Table of Contents
Introduction
Chapter 1:
The Baha'i Patient
Chapter 2:
The Buddhist Patient
Chapter 3:
The Catholic Patient
Chapter 4:
The Christian Scientist Patient
Chapter 5:
The Church of Jesus Christ of Latter-Day Saints Patient
Chapter 6:
The Hindu Patient
Chapter 7:
The Jain Patient
Chapter 8:
The Jehovah's Witness Patient
Chapter 9:
The Jewish Patient
Chapter 10:
The Muslim Patient
Chapter 11:
The Orthodox Christian Church Patient
Chapter 12:
The Quaker Patient
Chapter 13:
The Shinto Patient
Chapter 14:
The Sikh Patient
Chapter 15:
The Unitarian Universalist Patient

Chapter 11: The Orthodox Christian Church Patient

Matthew 22:39
“You shall love your neighbor as yourself.”

1. Approximately how many followers are there worldwide? What is the geographic distribution of the members of your group?

There are approximately 200-300 million members worldwide, with the greatest concentrations in central and Eastern Europe, the Middle East, Asia, Central Africa, North and South America, and Western Europe.

2. Are there general education requirements for the leaders of your religious/ethnic community? Can males and females serve in this capacity?

In the United States, parish clergy must complete seminary studies, which may lead to ordination. Women are not ordained.

3. Please discuss the specific beliefs and customs which are integral to guiding your followers in their worldview and decision-making. Please include various beliefs, attitudes, ideologies and dietary needs which distinguish your group from others.

These are summarized in the Nicene-Constantinopolitan Creed, which emerged in the early 4th century to provide a clear statement of the apostolic faith:

“I believe in one God, the Father Almighty, Maker of heaven and earth, and of all things visible and invisible. And in one Lord Jesus Christ, the Son of God, the only-begotten, begotten of the Father before all ages. Light of Light; true God of true God; begotten, not made; of one essence with the Father, by whom all things were made; who for us men and for our salvation came down from heaven, and was incarnate of the Holy Spirit and the Virgin Mary, and became man. And He was crucified for us under Pontius Pilate, and suffered, and was buried. And the third day He rose again, according to the Scriptures; and ascended into heaven, and sits at the right hand of the Father; and He shall come again with glory to judge the living and the dead; whose Kingdom shall have no end. And in the Holy Spirit, the Lord, the Giver of Life, who proceeds from the Father; who with the Father and the Son together is worshipped and glorified; who spoke by the prophets. In one Holy, Catholic, and Apostolic Church. I acknowledge one baptism for the remission of sins. I look for the resurrection of the dead, and the life of the world to come. Amen.”

4. Are there any known ethnogenetic pathologies prevalent for members of your group?

Due to the widespread global membership, there are no known ethnogenetic pathologies among members of The Orthodox Church.

5. How important is it for your followers to maintain their religious/ethnic identity while living in close proximity to and interacting with people of other backgrounds? Are there any issues regarding building relationships and trust, either within or outside the community?

Since most Orthodox Christians in North America are American-born and have been living in this country for several generations, most are fully assimilated within the general population.

6. Please explain various cultural, language and racial differences among followers within your religion/ethnic culture.

Within the United States, there are no significant cultural, linguistic, and racial differences from the rest of the general population.

7. Please explain familial roles and organization. What is the perception of old age? Are there differences between male/female roles? Please explain the role of religion/culture with regard to general health care. Describe the relationship among the medical practitioner, the patient and the patient’s family. Describe the view of the following: living wills, health care proxies, DNRs, end-of-life-philosophy, organ transplant, blood transfusion, nursing home and/or hospice care, psychiatry, birth control intervention, labor/delivery and circumcision.

The Orthodox Church of America maintains the importance of the nuclear family and monogamous marriage within society. Women are not seen as inferior to men and hold complimentary roles. There are no specific and/or unusual roles of religion/culture pertaining to the general health care of the Orthodox Christian patient.

Death is defined as the parting of the soul from the body. The soul continues to live beyond space and time. No extreme measures should be taken to hasten death, while no extreme measures should be taken to prolong life.

There is no problem with either health care proxies or living wills, providing that the practices of the Church are not violated. DNRs are permitted as long as there is no active euthanasia. Organ transplants are permitted if medically necessary and as long as the body is treated with the utmost respect and no money changes hands (organs cannot be “bought” or “sold”). No extraordinary measures should be taken to hasten death for the sole purpose of harvesting “fresh” organs. Nursing home and/or hospice care is permitted, although hospice should not be a cover for assisted suicide, nor should hospice workers encourage the use of extraordinary methods to hasten death. There is a great deal of discussion pertaining to psychiatric care and it is recommended that the local Church clergy be involved in making these types of decisions. Birth control may under certain circumstances be practiced; however, abortion is strictly forbidden. Unnecessary caesarean sections for the convenience of doctors, scheduling, etc. should be avoided. There is no prohibition against male circumcision.

8. Are there specific burial customs which must be observed by members of your group?

While practices vary by country, in North America there is generally an open casket during the funeral service.

9. Please explain the spiritual/ethnic philosophy regarding miraculous intervention by the divine, holistic treatment, salvation, eternal life, redemption and healing.

Since Orthodox Christianity is made up of countless ethnic groups, it is impossible to speak explain specific ethnic philosophies. Miraculous intervention may occur through God’s guidance of the medical team, family, etc. God can indeed perform miracles and provide cures and healing, but ultimately we pray, “Thy will be done.” There are no presumptions that when one prays for healing; it will automatically be “delivered.” It is difficult to address various types of holistic treatment, since it has a variety of implications. Generally speaking, it is crucial to treat the patient physically as well as spiritually and emotionally. Orthodox Christianity believes that the souls of the departed exist in God’s presence, beyond time and space, where they either experience the fullness of God’s glory or find that glory a torturous experience. The Orthodox Christian prayer of healing is “Thy will be done.”

ACKNOWLEDGEMENTS:

The Very Rev. John Matusiak,
Media Coordinator and Managing Editor
The Orthodox Church
Website: www.oca.org
(630) 790-1195
Email: tocmed@hotmail.com

The Orthodox Church in America
PO Box 675
Syosset, NY 11791-0675

Representation Church
The Orthodox Church in America maintains a Representation Church to its sister Church, the Russian Orthodox Church.

Table of Contents
Introduction
Chapter 1:
The Baha'i Patient
Chapter 2:
The Buddhist Patient
Chapter 3:
The Catholic Patient
Chapter 4:
The Christian Scientist Patient
Chapter 5:
The Church of Jesus Christ of Latter-Day Saints Patient
Chapter 6:
The Hindu Patient
Chapter 7:
The Jain Patient
Chapter 8:
The Jehovah's Witness Patient
Chapter 9:
The Jewish Patient
Chapter 10:
The Muslim Patient
Chapter 11:
The Orthodox Christian Church Patient
Chapter 12:
The Quaker Patient
Chapter 13:
The Shinto Patient
Chapter 14:
The Sikh Patient
Chapter 15:
The Unitarian Universalist Patient

Chapter 12: The Quaker Patient

George Fox
“Be patterns, be examples in all countries, places, islands, nations wherever you come; that your carriage and life may preach among all sorts of people, and to them; then you will come to walk cheerfully over the world, answering that of God in everyone; whereby in them you may be a blessing, and make the witness of God in them to bless you.”

1. Approximately how many followers are there worldwide? What is the geographic distribution of members of your group?

There are approximately 200,000 to 300,000 Quakers worldwide, with the largest community in Kenya.

2. Are there general education requirements for the leader of your religious/ethnic community? Can males and females serve in this capacity?

The Clerk of our monthly Meeting is selected by members of the Meeting. Both males and females can serve in this capacity and there are no specific educational requirements for this position.

3. Please discuss the specific beliefs and customs which are integral to guiding your followers in their worldview and decision-making. Please include various beliefs, attitudes, ideologies and dietary needs which distinguish your group from others.

Our major testimonies are the peace testimony and the testimony of equality of different genders and races. These testimonies are based on the belief that each person must be respected as containing part of God.

4. Are there any known ethnogenetic pathologies prevalent for members of your group?

There are no known ethnogenetic pathologies within the Quaker community.

5. How important is it for your followers to maintain their religious/ethnic identity while living in close proximity to and interacting with people of other backgrounds? Are there any issues regarding building relationships and trust, either within or outside the community?

We maintain our religious community through our Meetings (Meetings for worship and business) and our committee work. We often work with non-Quakers to achieve common goals.

6. Please explain various cultural, language and racial differences among followers within your religion/ethnic culture.

These differences are irrelevant to members of the Quaker community.

7. Please explain familial roles and organization. What is the perception of old age? Are there differences between male/female roles? Please explain the role of religion/culture with regard to general health care. Describe the relationship among the medical practitioner, the patient and the patient’s family. Describe the view of the following: living wills, health care proxies, DNRs, end-of-life-philosophy, organ transplant, blood transfusion, nursing home and/or hospice care, psychiatry, birth control intervention, labor/delivery and circumcision.

There are no differences between male and female roles in the Quaker family. Each individual is free to choose healing procedures of their choice. Quakers support living wills and health care proxies. Decisions such as DNR, organ transplants, blood transfusion, psychiatry and circumcision are personal and should be made by the individual.

8. Are there specific burial customs which must be observed by your members?

We have memorial services held at our Meeting House.

9. Please explain spiritual/ethnic philosophy regarding: miraculous intervention by the divine, holistic treatment, salvation, eternal life, redemption, healing.

There is no specific dogma in the Quaker community regarding miracles, salvation, eternal life and redemption.

ACKNOWLEDGEMENT:
Ms. Dorothy Richards, Co-Clerk
Ministry and Council Committee
The Religious Society of Friends
Quaker Meeting House
727 Madison Avenue
Albany, NY 12208

Table of Contents
Introduction
Chapter 1:
The Baha'i Patient
Chapter 2:
The Buddhist Patient
Chapter 3:
The Catholic Patient
Chapter 4:
The Christian Scientist Patient
Chapter 5:
The Church of Jesus Christ of Latter-Day Saints Patient
Chapter 6:
The Hindu Patient
Chapter 7:
The Jain Patient
Chapter 8:
The Jehovah's Witness Patient
Chapter 9:
The Jewish Patient
Chapter 10:
The Muslim Patient
Chapter 11:
The Orthodox Christian Church Patient
Chapter 12:
The Quaker Patient
Chapter 13:
The Shinto Patient
Chapter 14:
The Sikh Patient
Chapter 15:
The Unitarian Universalist Patient

Chapter 13: The Shinto Patient

Oracle of Temmangu
“The heart of the person before you is a mirror. See there your own form.”

1. Approximately how many followers are there worldwide? What is the geographic distribution of the members of your group?

There are approximately four million members of the Shinto religion globally.

2. Are there general education requirements for the leaders of your religious/ethnic community? Can males and females serve in this capacity?

Males and females may serve as Shinto priests, the majority affiliated with the Association of Shinto Shrines. Training programs are followed by a certification examination. Priests may marry and have children.

3. Please discuss the specific beliefs and customs which are integral to guiding your followers in their worldview and decision-making. Please include various beliefs, attitudes, ideologies and dietary needs which distinguish your group from others.

The Shinto religion originated approximately 2,500 years ago in Japan. It is interesting to note that there are many overlapping traditions with Buddhism. While Shinto does not recognize an official founder of the religion, each of the 13 sects claims its own founder. There is not one central deity, religious text or doctrine on which Shino is based; however, the Kojiki, Nihonshoki and Rituryo are considered by some to be sacred literature. In contrast to many monotheist religions, there are no absolutes in Shinto. There is no absolute “right and wrong,” and nobody is perfect. Shinto is an optimistic faith, as humans are thought to be fundamentally good. Evil is believed to be caused by evil spirits. Consequently, the purpose of most Shinto rituals is to keep away evil spirits by purification, prayers and offerings to the Shinto gods, which are called kami.

The kami are sacred spirits which take the form of things and concepts important to life, such as wind, rain, mountains, trees, rivers and fertility. Humans become kami after they die and are revered by their families as ancestral kami. The kami of extraordinary people are even enshrined at some shrines. The Sun Goddess Amaterasu is considered Shinto's most important kami. Shrine worship, ritual ceremonies and rites are very important and to maintain purity of body and spirit. Each shrine focuses on a different kami.

Homes are also used for worship and usually have a special altar used for prayer twice per day for shared family prayer. In Shinto, a sin committed by person who has a “good” nature (responsible to the community) is considered to be caused by impurity. Since impurities routinely accumulate in our bodies and minds, it is essential for us to receive purification rites on a regular basis. There are various kinds of purification rites for this purpose. These rites may be performed either individually or by a Shinto priest. There are no dietary restrictions in Shinto. It is important for medical personnel to note that Shinto suicide is justifiable in order to maintain one’s honor in the community.

4. Are there any known ethnogenetic pathologies prevalent for members of your group?

There are no known ethnogenetic pathologies for Shinto followers.

5. How important is it for your followers to maintain their religious/ethnic identity while living in close proximity to and interacting with people of other backgrounds? Are there any issues regarding building relationships and trust, either within or outside the community?

Shintoists are easily able to be active secular members of the global community and still maintain their religious identity. Shinto is a non-exclusive religion and people may practice Shinto along with a second religion, since the beliefs of Shinto do not usually conflict with other faiths.

6. Please explain various cultural, language and racial differences among followers within your religion/ethnic culture.

While the Shinto religion originated in Japan, the demographics are rapidly changing as more Asians are immigrating to the United States and other countries.

7. Please explain familial roles and organization. What is the perception of old age? Are there differences between male/female roles? Please explain the role of religion/culture with regard to general health care. Describe the relationship among the medical practitioner, the patient and the patient’s family. Describe the view of the following: living wills, health care proxies, DNRs, end-of-life-philosophy, organ transplant, blood transfusion, nursing home and/or hospice care, psychiatry, birth control intervention, labor/delivery and circumcision.

Abortion is permitted in case of rape or other socially unacceptable causes of conception. Blood transfusions are permitted, but organ transplants are not favored. Circumcision is not desirable. DNR is not permitted. Every possible measure should be taken to prolong life.

8. Are there specific burial customs which must be observed by members of your group?

Generally, Shinto followers are buried with Buddhist rites and buried in a Buddhist temple.

9. Please explain the spiritual/ethnic philosophy regarding miraculous intervention by the divine, holistic treatment, salvation, eternal life, redemption and healing.

Throughout the years, Buddhist and Shintoist beliefs have often complemented each other with regard to various life-cycle practices. While the Shinto religion places more emphasis on happiness in the present, Buddhism focuses on the afterlife and rebirth.

ACKNOWLEDGEMENT:
Ms. Nobuyo Otagaki, Priestess
International Shinto Foundation
300 West 55th Street
New York, NY 10019
Email: newyork@shinto.org
Phone 212-686-9117

Table of Contents
Introduction
Chapter 1:
The Baha'i Patient
Chapter 2:
The Buddhist Patient
Chapter 3:
The Catholic Patient
Chapter 4:
The Christian Scientist Patient
Chapter 5:
The Church of Jesus Christ of Latter-Day Saints Patient
Chapter 6:
The Hindu Patient
Chapter 7:
The Jain Patient
Chapter 8:
The Jehovah's Witness Patient
Chapter 9:
The Jewish Patient
Chapter 10:
The Muslim Patient
Chapter 11:
The Orthodox Christian Church Patient
Chapter 12:
The Quaker Patient
Chapter 13:
The Shinto Patient
Chapter 14:
The Sikh Patient
Chapter 15:
The Unitarian Universalist Patient

Chapter 14: The Sikh Patient

Guru Arjan Devji 259
“Don’t create enmity with anyone as God is within everyone.”

1. Approximately how many followers are there worldwide? What is the geographic distribution of members of your group?

There are approximately 25 million Sikhs worldwide, 21 million in the Punjab, the Sikh homeland, and 4 million distributed across other parts of Asia, Europe and North America. There are 500,000 Sikhs in the United States.

2. Are there general education requirements for the leader of your religious/ethnic community? Can males and females serve in this capacity?

There is no hierarchy in the Sikh community and no ordained priestly class. Therefore, there are no specific educational requirements to qualify for a leadership position within the Sikh community. Anyone who expresses interest and is selected by the community can become a leader. Both males and females can become leaders without restrictions.

3. Please discuss the specific beliefs and customs which are integral to guiding your followers in their worldview and decision-making. Please include various beliefs, attitudes and ideologies and dietary needs which distinguish your group from others.

The Sikhs are an egalitarian community that seeks social welfare of all people and have a strong sense of social justice. They pray for the welfare of the humankind (sarbat da bhala) in their congregational prayer daily. Given their lack of hierarchical structure as a community, almost all decision making takes place at a local congregational level, especially in the modern context, and requires consensus of the entire community through an institution known as the gurmatta (lit., the resolution of the Guru). What distinguishes Sikhs from others is that they are organized as a political organization, known as the Khalsa Panth. The members of the Panth wear conspicuous articles of faith such as turbans, uncut hair and the kirpan (sword). The Sikhs have no dietary restrictions, except that they cannot consume sacrificial meat (halal) and they cannot consume intoxicants such as alcohol and tobacco.

4. Are there any known ethnogenetic pathologies prevalent for members of your group?

Most Sikhs are of South Asian origin, and like the group, they share a high rate of heart disease and diabetes.

5. How important is it for your followers to maintain their religious/ethnic identity while living in close proximity to and interacting with people of other backgrounds? Are there any issues regarding building relationships and trust, either within or outside the community?

The external identity of the Sikhs, which comprises of conspicuous articles such as turbans, uncut hair and the kirpan (sword) have been integral to the practice of the Sikh religious tradition for the past three hundred years. These articles are often seen by the mainstream public with suspicion and there is a strong pressure on the individual Sikh to conform by shedding his or her identity. The Sikhs, however, are relatively new to the United States and have not begun building bridges with other communities in any serious manner. The Sikhs have been interacting with interfaith groups with a high rate of success.

6. Please explain various cultural, language and racial differences among followers within your religion/ethnic culture.

Most of the followers of Sikhism are from the Punjab and speak the Punjabi language. A small minority, less than one percent, of the total population comprises of Caucasians and Latinos. The dominant language and culture of the Punjabi Sikhs are largely uniform with some subtle differences stemming from urban and rural origins of the followers.

7. Please explain familial roles and organization. What is the perception of old age? Are there differences between male/female roles? Please explain the role of religion/culture with regard to general health care. Describe the relationship among the medical practitioner, the patient, and the patient’s family. Describe the view of the following: living wills, health care proxies, DNRs, end-of–life philosophy, organ transplant, blood transfusions, nursing home and/or hospice care, psychiatry, birth control intervention, labor/delivery, circumcision.

While doctrinally there no ordained male or female roles, the South Asian culture influences the ways in which these roles are carried out, especially among first-generation Sikh immigrants. The men are seen as breadwinners of the family, while women are seen as the managers of household affairs. Circumcision and euthanasia are understood to be taboos. Female infanticide, a practice widespread among South Asians because they desire a male child, is also a taboo and results in ostracization by the Sikh community. Medical practices such as organ transplant, blood transfusions, nursing home and hospice care, psychiatry, birth control and procedures surrounding labor/deliver are permitted and medical best-practices are recommended.

8. Are there specific burial customs which must be observed by your members?

The Sikhs have a strong preference for cremation of the dead body over burial. The cremation generally takes place in an incinerator at a funeral home. There are very specific religious requirements concerning the death ceremony. These are detailed in the Sikh Rahat Maryada, which describes the Sikh rites de passage.

9. Please explain spiritual/ethnic philosophy regarding: miraculous intervention by the divine, holistic treatment, salvation, eternal life, redemption, healing.

The Sikh tradition discourages belief in miracles and any intervention that violates the laws of nature. Therefore, the medical best-practices are seen to be most efficacious. Many Sikhs, however, see prayer to be indispensable during times of crisis and many believe in its power of healing.

ACKNOWLEDGEMENT:

Rajdeep Singh
Director of Law and Policy
The Sikh Coalition
Washington, DC
Phone: (202) 747-4944
Email: rajdeep@sikhcoalition.org
Website: http://www.sikhcoalition.org

Harpreet Singh, Trustee
The Sikh Coalition
40 Exchange Place, Suite 728
New York, NY 10005
Phone: (212) 655-3095
Email: harpreet@sikhcoalition.org

Table of Contents
Introduction
Chapter 1:
The Baha'i Patient
Chapter 2:
The Buddhist Patient
Chapter 3:
The Catholic Patient
Chapter 4:
The Christian Scientist Patient
Chapter 5:
The Church of Jesus Christ of Latter-Day Saints Patient
Chapter 6:
The Hindu Patient
Chapter 7:
The Jain Patient
Chapter 8:
The Jehovah's Witness Patient
Chapter 9:
The Jewish Patient
Chapter 10:
The Muslim Patient
Chapter 11:
The Orthodox Christian Church Patient
Chapter 12:
The Quaker Patient
Chapter 13:
The Shinto Patient
Chapter 14:
The Sikh Patient
Chapter 15:
The Unitarian Universalist Patient

Chapter 15: The Unitarian Universalist Patient

Unitarian Principles
“We affirm and promote respect for the interdependent of all existence of which we are a part.”

1. Approximately how many followers are there worldwide? What is the geographic distribution of members of your group?

There are over 800,000 members of the Unitarian Universalist Church and most of them are located in the United States.

2. Are there general education requirements for the leader of your religious/ethnic community? Can males and females serve in this capacity?

To be an accredited UU minister, a man or woman first must be approved by the UUA's Ministerial Fellowship Committee. This is the body which appraises the credentials and abilities of prospective ministers. A candidate must have earned an undergraduate degree and a Master of Divinity degree or higher degree from an accredited theological seminary.

3. Please discuss the specific beliefs and customs which are integral to guiding your followers in their worldview and decision making. Please include various beliefs, attitudes and ideologies and dietary needs which distinguish your group from others.

The 7 major affirmations which are the cornerstone of the Unitarian Universalist faith are as follows:

A) The inherent worth and dignity of every person;
B) Justice, equity and compassion in human relations;
C) Acceptance of one another and encouragement to spiritual growth in our congregations;
D) A free and responsible search for truth and meaning;
E) The right of conscience and the use of the democratic process within our congregations and in society at large;
F) The goal of world community with peace, liberty, and justice for all;
G) Respect for the interdependent web of all existence of which we are a part.
H) Regarding specific dietary needs, Unitarian Universalists believe in eating ethically and study the impact of food choices on local and global communities.

4. Are there any known ethnogenetic pathologies prevalent for members of your group?

There are no ethnogenetic pathologies prevalent for members of our group.

5. How important is it for your followers to maintain their religious/ethnic identity while living in close proximity to and interacting with people of other backgrounds? Are there any issues regarding building relationships and trust, either within or outside the community?

Our ecumenism and tolerance of diversity and recognition of the interdependent web of existence is at the very core of the belief system of our religious organization.

6. Please explain various cultural, language and racial differences among followers within your religion/ethnic culture.

Every minority group in the United States is represented in our Association, though by reason of its origin in the United States, the majority of members are white and the diversity continues to increase.

7. Please explain familial roles and organization. What is the perception of old age? Are there differences between male/female roles? Please explain the role of religion/culture with regard to general health care. Describe the relationship among the medical practitioner, the patient, and the patient’s family. Describe the view of the following: living wills, health care proxies, DNRs, end-of–life philosophy, organ transplant, blood transfusions, nursing home and/or hospice care, psychiatry, birth control intervention, labor/delivery, circumcision.

There is no distinction regarding gender, nor any precedence respecting age. Reverence for our Judeo-Christian heritage and respect for the aged is an increasing awareness in our Association accompanying its Humanist grounding at the core. Health care decisions are left to the discretion of the patients and their families and physician and in some cases, the Unitarian Universalist minister may be consulted in this regard.

8. Are there specific burial customs which must be observed by your members?

There are no specific burial customs in the Unitarian Universalist tradition.

9. Please explain spiritual/ethnic philosophy regarding: miraculous intervention by the divine, holistic treatment, salvation, eternal life, redemption, healing.

Unitarian Universalism today is a theologically diverse religion in which many different answers to the question "Is there life after death?" are welcome. Some members may believe in divine intervention but at best, it would be metaphorical in its essence and certainly not a core principle or belief. Many members believe in a holistic approach to medical problems and to problems of our society. In a philosophical sense, salvation can be found in a reverence for the past and maintenance of human relationship with concern for the welfare of others, including recognition of the interdependence of the web of existence. Eternal life is only considered in a sense of one’s contribution to society. Redemption is not viewed as a component of the divine, but rather as a consequence of adaptation and growth. Healing is a quality of a surviving, adaptive and interactive system.

ACKNOWLEDGEMENT:
Richard C. Bozian, M.D.
The Interfaith Alliance of Greater Cincinnati
HUUmanists-Unitarian Universalist Religious Humanists
Email: rcbozian@hotmail.com
Website: http://www.uua.org