- The time of death is often heavily invested with cultural and religious ritual (Koeing 1997).
- Such rituals frequently give rise to cross-cultural misunderstandings or frank conflict with standard hospital procedures. For example, in some cultures only same-sex workers should touch the body (Hallenbeck 1996; Hallenbeck 1999).
- When dealing with a family from an unfamiliar ethnic group or religion, the clinician should inquire, ideally in advance, if any special accommodations need to be made for cultural or religious reasons (Hallenbeck 2002).
- If not done previously, the clinician should ask if the family wishes to speak with a chaplain or other spiritual advisor.
- When in doubt, seek assistance from someone familiar with that culture or religion (Pickett 1993; Lo 2002).
- A tool developed by Pulchalski for addressing spirituality in patients or families is presented in the table below (Puchalski 2002).
|Faith||“Do you consider yourself a spiritual or religious person?” “What do you believe in that gives you meaning?”|
|Importance andInfluence||“How important is your faith (or religion/spirituality) to you?”|
|Community||“Are you part of a religious or spiritual community?”|
|Address or Application||“How can we help or be of assistance to you in the practice of your faith at this time?”|
|Adapted from Puchalski CM. Spirituality and end-of-life care: a time for listening and caring. J Palliat Med. 2002;5:289-294.|
In Mr. Stanton’s situation, a history of religious disagreement among members of his family caused him and his daughter guilt, anxiety, and anger.