1. A guide to cultural
2. Written by Jean Serge Mootoo
BSc(Hons), CertED, FAECT,
MIVA, CertIHSM, RGN, RMN,
RNLD, professional and 3 African/Caribbean
teacher at Somerset Academy, 3 Asian
East Somerset NHS Trust
Nursing Standard 9 Hinduism
The Heights, 59-65 Lowlands Road,
Harrow, Middlesex HA1 3AE 10 Islam
To subscribe call 08457726 100
www.nursing-standard.co.uk 11 Judaism
Cover picture by Corbis 13 Sikhism
14 Christian Science
14 Jehovah’s Witnesses
© Copyright RCN Publishing Company Ltd 2005.
All rights reserved. No part of this book may be
16 Seventh Day Adventists
reproduced, stored in a retrieval system, or trans-
mitted in any form or by any means, electronic, 17 Other faiths
mechanical, photocopying, recording or otherwise,
without prior permission of the publisher. 18 Contacts
2 nursing standard january 5/vol19/no17/2005
3. Given the immense diversity between different cultures and religions, this guide can
only offer general useful advice. Please refer to the list of contacts on page 18 to
find further information
or religious belief. It is customary among some
African/Caribbean cultures to express emotions
The term African/Caribbean is used here to freely when a relative dies; privacy should be
include people of African and Caribbean origin given whenever possible.
(for example, from Nigeria, Gambia, Uganda, Post-mortem Older members of the community
Jamaica, Trinidad, Tobago, St Lucia, Grenada or may believe the body must be intact for the
the Bahamas). Some cultural and traditional pat- afterlife and will be deeply offended by its dis-
terns are likely to be common among those with figurement. They are unlikely to give consent
roots in Africa and the Caribbean islands, but it for post-mortems except for coroner’s cases.
is important that patients are consulted indi-
vidually about how they wish to be referred to.
ASIAN – Indian Subcontinent
Religious days are important in the lives of many It is difficult to make broad generalisations about
African/Caribbean people; religions include Asian patients. We use the term here to include
Christianity, Islam and Rastafarian, among oth- people from Bangladesh, India and Pakistan.
ers, and ritual practices vary widely.
Modesty ■ Bangladeshis – majority Islam, some Hindus.
Patients are likely to have a strong preference ■ Indians – majority Hindus, Sikhs and some
for a doctor or nurse of the same sex when Muslims; also Christians.
being examined or treated. ■ Pakistanis – majority Islam.
Clinical procedures Diet
Blood transfusion There is no religious object- Neither Hindus nor Muslims will eat anything
ion to receiving blood (except for Jehovah’s that has come into contact with forbidden food
Witnesses or Rastafarians). or utensils (see specific religions). t
Organ transplantation There is not usually
religious objection to the reception of a trans- Personal care
planted organ, but those with belief in the Hygiene/cleanliness Handwashing is considered
sanctity of the body are unlikely to agree to essential before and after eating. Water for
organ donation. washing is needed in the same room as the
toilet, so patients should be provided with
Death and dying bowls, jugs of water or a bidet. Asian patients
At death, religious differences are likely to be prefer to wash in free-flowing water, as baths
minimal, and cultural identity is of paramount are considered unhygienic. If a shower is not
importance. Burial is preferred; funeral and available, the patient may like a jug to use in
mourning customs vary depending on culture the bath.
january 5/vol19/no17/2005 nursing standard 3
4. Modesty Asian patients, particularly women, discussion. Orthodox Muslims may refuse family
are likely to have a strong preference for a planning.
doctor of the same sex when being examined
or treated. Sensitivity and care are needed in Death
situations that may cause the patient embar- People from some Asian cultures may express
rassment, for example, wearing a gown that their emotions freely when a relatives dies.
the patient may consider too short. In some Wherever possible, they should be given privacy
Asian cultures, direct eye contact is avoided, to do so without unsettling other patients.
particularly with the opposite sex.
Family planning Ask patients for their family name and most
There is no objection to family planning from used personal name (Figure 1). Most Asians
a religious point of view. It is acceptable to ask are not Christians, so the term ‘Christian name’
the patient whether she wishes to involve her has no significance in most cases. Use the fam-
husband or any other family member in the ily name as a ‘surname’ for writing purposes.
Figure 1. The procedure for recording Asian names
Request patient’s full name
Patient gives two or three names
Verify family name Verify personal name Verify religious/
Enter family name Enter as surname If it is the family
as surname name, enter as a
Inform patient of the If the family name
entry in the records is not verified, enter
religious titular name
4 nursing standard january 5/vol19/no17/2005
Recording unfamiliar names can be difficult Cheung), followed by a one or two-part per-
and may lead to serious errors. Staff should be sonal name (for example, Hung Yum, result-
aware of the different naming systems so that ing in Cheung Hung Yum). Family origin is
patients are accurately identified. important; hence women tend to keep their
maiden name. Many Chinese people have
reversed this order so that it corresponds to
CHINESE the British naming pattern.
Taoism, Buddhism and Confucianism are the Some women avoid cold drinks and do not
main religions, with some Christians. wash their hair for several days after childbirth.
The Chinese believe that equilibrium between Funeral and mourning customs vary widely
‘hot’ and ‘cold’ in terms of food, herbs or med- depending on culture or religious belief. Some
icines needs to be maintained for good health. people are buried; others are cremated.
Foods are classified as hot or cold – this does
not refer to temperature – and a special diet Special considerations
may be needed to restore balance: Traditional remedies are sometimes used for
■ Hot – most pulses, garlic, ginger, eggs, nuts, certain diseases – it is important to consult the
lamb, honey, onions, dates, tea and coffee. individual. The most important festival is the
■ Cold – cereals, rice, wheat, fruit, potatoes, New Year or Spring Festival, celebrated in
white sugar, chickpeas, green leaf vegeta- February; the dates will vary as they are based
bles and milk. on the lunar calendar.
Rice is the staple food, which is eaten with a
variety of meat, fish and vegetable dishes.
Hygiene/cleanliness Soaking in a bath is believed The general term ‘travellers’ includes several
to be bad for the body in later life; showers are ethnic groups such as Romany (‘Gypsy’), Irish
preferred. and New Age travellers. Romany travellers
Modesty In general, women prefer to be exam- trace their origins to the Indian subcontinent.
ined by a female doctor, although medical care Irish travellers likewise have a long history.
takes priority. Some women may find wearing New Age travellers emerged more recently
short, open-backed gowns unacceptable. as people who adopted a nomadic lifestyle
for reasons ranging from ecological concerns
Naming to enforced homelessness. The following
The family name tends to come first (for example, notes apply mainly to Romany people but
january 5/vol19/no17/2005 nursing standard 5
6. may suggest areas that could be of concern bedpans overcome some of these concerns in
to other travellers. hospital, but a sensitive discussion of hygiene
arrangements with the patient may be helpful.
Religion Modesty Strictly, a Romany woman may not
Many Romany travellers are Christian, and many remain alone in a room with a man who is not
Irish travellers are Roman Catholic Christians. her husband. Nor may another man look a
Superstition features strongly in Romany cul- Romany woman in the eye. However, many
ture. A wide range of religious beliefs is to be Romany women will consent to examination
found among New Age travellers, including by a male doctor. Below the waist, the body is
Christianity, Buddhism and Paganism, includ- considered ritually unclean and should there-
ing such affiliations as Druidism. To non-Gypsies, fore be covered, with implications for gowns
Romany culture appears very male-dominated, and some other clothing supplied by the hos-
which has implications for care in hospital. The pital. Romany men may feel extremely uncom-
Gypsy way of life is dominated by family con- fortable being directed by female staff, even
nections, and admission to hospital can create on such routine matters as when to eat, wash
an intensely painful sense of isolation. and sleep, and discouragement from smoking.
Valuables are typically kept on the person, which
Diet can present difficulties when disrobing is required.
Generally, all foodstuffs are acceptable, but the
method of preparation is important. Non-Gypsies Death and dying
are considered to be ritually unclean, and the When death is imminent, a Romany traveller
hygiene rules (see later) stipulate which washing must not be left alone. The immediate family
vessels must be used. For these reasons it is unlikely will usually summon the extended family and
that a strict Romany would find food prepared many friends to the bedside. It may become
in the hospital to be acceptable, and the patient’s necessary to explain sensitively to the family that
family may wish to prepare and supply food. visitor numbers need to be restricted for the
Sensitive review of the suitability of this food to wellbeing of nearby patients. Strictly, the dying
the patient’s medical condition may be needed. patient should be taken outdoors and a candle
lit under the bed to light the way to the after-
Personal care life. It may be possible to offer a substitute – for
Hygiene/cleanliness Romany households have example, the chaplaincy can supply an electric
several washing bowls, each for a specific pur- flicker candle. There may be a strong wish to
pose, such as the upper part of the body, the take a dying patient home. Death will usually
lower part, the interior of the mouth, and for be followed by burial rather than cremation.
utensils. Non-Gypsies using the toilet facilities Post-mortem A strong belief in the afterlife
on a Romany settlement would render those dictates that the body must be kept whole. For
facilities ritually unclean and unable to be used this reason, post-mortem examinations will
by that community. Disposable bottles and generally be strongly resisted. If a post-mortem
6 nursing standard january 5/vol19/no17/2005
is necessary, reassurance that all body parts after death. They like to have full information
have been returned will be necessary. about their imminent death to enable them to
make preparation. Some Buddhists may not
Special considerations wish to have sedatives or pain-killing drugs at
Illiteracy is more widespread among Romanies this time. Peace and quiet for meditation and
than in the community at large. It may be nec- visits from other Buddhists will be appreciated.
essary to offer help and guidance in matters Some form of chanting may be used to influ-
such as the completion of consent forms and ence the state of mind at death.
the self-administration of medication. Procedure at death If other Buddhists are not
in attendance, a Buddhist minister should be
informed of the death as soon as possible. Routine
BUDDHISM last rites are appropriate. Cremation is preferred.
Buddhist faith centres on the Buddha, who is Special considerations
served not as a god but as an example of a way Vesak is a celebration of the enlightenment of
of life. Buddhists believe in reincarnation and Buddha and is held on a night with a full moon
so accept responsibility for their actions. The in May.
chief doctrine is that of ‘karma’ – good or evil
deeds resulting in an appropriate reward or
punishment either in this life or through rein- CHRISTIANITY
carnation along a succession of lives. Buddhism
has always been culturally adaptable, and a vari- The individual person’s denomination should
ety of forms and movements have developed, be recorded in his or her notes – for example,
each with different traditions. Ask the individ- Church of England or the Anglican (Wales,
ual and/or family and friends what is required. Ireland) or Episcopalian (Scotland) Church.
Diet All churches t
As Buddhism encourages its followers to practise Although the doctrines of Christian churches
non-violence, most Buddhists will be vegetarian. vary greatly both within and between coun-
tries, there are firm features of Christianity that
Family planning are almost universal: initiation (baptism), wor-
Buddhists believe life begins at conception and ship, ministry and ‘good works’. The sacred
so do not agree with contraception or abortion. writings of the Christian religion are in the Bible.
Death and dying Diet
Care of the dying Buddhists believe the state There are no general dietary requirements.
of mind of a person at the moment of death Some Christians observe Friday as a day when
is important in determining the state of rebirth they do not eat meat; some may wish to abstain
january 5/vol19/no17/2005 nursing standard 7
8. from food (fast) before receiving the ritual of Christmas and Easter are the most important
Holy Communion. This can also be referred to festivals or celebrations. Christians will usually
as the Lord’s Supper or mass, whereby bread wish to receive Holy Communion at these times.
and wine, symbolising the body and blood of
Christ, are taken in his memory. Some abstain Roman Catholic
from alcohol. The patient will probably wish to be visited by
a Catholic priest and to receive Holy Communion
Family planning and the Sacrament of the Sick. This is not only
Attitudes to family planning vary from denom- for the dying but also for the sick, especially
ination to denomination. before an operation. The sacraments are very
important. The Catholic priest must be called
Death to dying patients or, if the death is sudden,
Routine last rites are appropriate for all Christians. immediately afterwards.
Special considerations Church of England (Anglican)
Baptism/christening There is no age limit for Always ask the individual and/or family or friends
baptism. When babies or children are very ill, if they would like to see a chaplain or their local
baptism should be offered. In the absence of minister. Prayers may be said at the bedside of
a minister of religion, anyone may perform a the dying patient. Sometimes the family or the
baptism. To do this, the minister makes a sign patient will ask to receive the Sacrament of the
on the person’s forehead. A little water is poured Sick. This involves anointing with special oil.
on the forehead (or another accessible part of After death, some families may like to offer
the body), with the words ‘John Smith, I bap- prayers of thanksgiving for the person’s life.
tise you in the Name of the Father, and of the
Son, and of the Holy Spirit, Amen.’ The chap- Free churches
lain should be informed as soon as possible. If ■ Baptist.
a child dies unbaptised, the chaplain will offer ■ Independent churches and missions.
a blessing and naming service, and a certifi- ■ Methodist.
cate to commemorate this will be given to the ■ Moravian Brethren.
parents. This is particularly appropriate fol- ■ Plymouth Brethren.
lowing a miscarriage or stillbirth. ■ Presbyterian.
Patients may wish to see a chaplain, priest or ■ Salvation Army.
minister from the local church, especially before ■ The Religious Society of Friends (Quakers).
an operation or anything else that is of con- ■ United Reform Church.
cern to them. They may wish to receive Holy Free Church patients may like to receive a visit
Communion and be prayed with. They may from a minister or a member of their own church
request a Bible or wish to attend services in the or the church chaplain. Ceremony or sacraments
hospital chapel. may not be observed as strictly as in the Anglican
8 nursing standard january 5/vol19/no17/2005
and Catholic Religions. However, patients may be used, bowls and jugs of water should also
welcome prayers being said with them. be provided. Hindu patients prefer to wash in
free-flowing water, as baths are considered unhy-
gienic. If a shower is not available, ask the patient
HINDUISM if he or she would like a jug to use in the bath.
Modesty Women prefer to be treated by female
Central to Hinduism is a belief in reincarnation, medical staff where appropriate.
in which the status, condition and cost of each Dress and jewellery Jewellery usually has a
life is determined by the behaviour in the last religious or cultural significance – for example,
life, making each person responsible for who a woman’s bangles are removed only on her
he or she is and what he or she does. Hindus husband’s death. Some Hindu boys wear a
believe that there is one god, who can be under- ‘sacred thread’ over the right shoulder and
stood or worshipped in many different forms. around the body – this is a symbol of a male
Every Hindu should pray, serve the old and offer Hindu’s second birth when he starts to learn
generous hospitality to any visitor. from his guru. None of these items should be
removed or cut without the permission of the
Diet patient or the next of kin. If the thread has to
Most Hindus do not eat beef and some will not be cut or removed it should be retained and
eat eggs or chicken. Dairy produce is acceptable be given to the patient later.
as long as it is free of animal fat. However, it is
best to ask each individual. Some Hindus are Family planning
strict vegetarians and will not eat food that has Hindus have no objection to contraception. It
come into contact with prohibited food or utensils. is advisable to ask the woman whether she
Tobacco and alcohol are not generally accepted. would like her husband or a family member or
‘Hot and cold food’ This relates to perceived friend to be present during any discussion.
medicinal properties of food and has nothing
to do with either temperature or spicy qualities. Death and dying t
Fasting This means eating only ‘pure’ foods, Care of the dying Hindu patients would very
such as fruit or yoghurt, rather than complete much want to die at home. This has religious
abstinence. However, very few would insist on significance, and death in hospital can cause
fasting when in hospital. great distress. The patient’s family may wish to
call in a Hindu priest to read from the holy
Personal care books and to perform holy rites. These may
Hygiene/cleanliness Handwashing is consid- include tying a thread around the wrist or the
ered essential before and after eating. Water for neck, sprinkling the person with water from
washing is needed in the same room as the the Ganges or placing a sacred tulsi leaf in his
toilet, so patients should be provided with bowls or her mouth. Their belief is cremation, and
and jugs of water or a bidet. If a bedpan has to the body being returned to nature may involve
january 5/vol19/no17/2005 nursing standard 9
10. a dying person asking to be placed on the floor was born and began his teaching. There are
during the final few breaths. four chief religious duties for a Muslim: prayer
Procedure at death Distress may be caused if (five times a day), alms giving, fasting and a
non-Hindus touch the body. The family will pilgrimage to Mecca.
usually want to wash the body at home. If no
family members are available, the following Diet
procedure should be followed: Some meat is permitted as long as it has been
■ Wearing disposable gloves, close the eyes slaughtered according to the Halal ritual, which
and straighten the limbs. drains the animal of blood. Halal lamb, beef
■ Jewellery, sacred thread and other religious and chicken are eaten, but pork meat and blood
objects should not be removed. are forbidden. Fish and eggs are allowed but
■ Wrap the body in a plain sheet. must not be cooked where pork and non-halal
In most cases the body should not be washed meat is cooked.
as this is part of the funeral rites and will usu-
ally be carried out by relatives later. If there is Personal care
a delay (for example, because death has to be Hygiene/cleanliness Muslims attach great
reported to the coroner) this must be carefully importance to cleanliness – hands, feet and
explained to the family, because it is their prac- mouth are always washed before and after
tice for the funeral to take place as soon as prayer. After menstruating, women are requested
possible. If a body is to be left in a room overnight, to wash their whole bodies. Muslims prefer the
a light or candle should be left burning through- use of a shower rather than a bath.
out the night. If the family wishes to view the Modesty Muslim women may prefer to be
body, staff should ask the mortician to ensure seen or treated by a female doctor.
the room is free of any other religious ‘sym-
bols’. All adult Hindus are cremated Organ transplantation
Post-mortem This is generally disliked. There are no specific rulings prohibiting trans-
plantation, but strict Muslims will not agree to
organ transplants, and the subject should not be
ISLAM raised unless the family initiates the discussion.
Islam is the Arabic name for the Muslim reli- Death and dying
gion. The term means ‘surrender to God’s will’ Care of the dying Dying Muslims may wish
and includes acceptance of those articles of to sit or lie facing Mecca. Moving the bed to
faith, commands and ordinates revealed through make this possible will be appreciated. The
the Prophet Mohammed. Mecca, near the Red family may recite prayers around the bed. If
Sea coast of Saudi Arabia, is the religious cen- the patient’s family is not available, any prac-
tre for Muslims and a place of pilgrimage from tising Muslim can help. The patient may wish
all parts of Islam. It was here that Mohammed the Imam (religious leader) to visit.
10 nursing standard january 5/vol19/no17/2005
Procedure at death After death, non-Muslims family if any important dates for their faith
should not touch the body. Health workers occur during their stay in hospital.
who need to touch the body should wear dis- During the month of Ramadan, Muslims fast
posable gloves. The body should be prepared between sunrise and sunset, although those
according to the wishes of the family. If the who are sick are not required to fast.
family is not available, the following procedures
should be followed:
■ Turn the head towards the right shoulder before JUDAISM
rigor mortis begins. This is so that the body
can be buried with the face towards Mecca. In Judaism, religion and culture are entwined.
■ Do not wash the body, or cut hair or nails. Judaism is based on the worship of one god,
■ Wrap the body in a plain white sheet. carrying out the Ten Commandments and the
Muslims believe in the resurrection of the body practice of charity and tolerance towards one’s
after death, so they are always buried and fellow human beings. There are different groups
never cremated. The family and Muslim under- within Judaism:
takers will ritually wash the body. Muslim funer- ■ Orthodox Jews are usually more traditional
als take place as soon as practicable. If a delay and observant of the religious and dietary laws.
is unavoidable, explain the reason carefully to ■ Non-Orthodox Jews (including Conservative,
the relatives. Liberal and Reformed) make their religious
If the death has to be reported to the coro- observance fit into modern society.
ner, he or she should be informed that the
patient was a Muslim and be asked if the pro- Diet
cedure can take place as soon as possible. If Many Jews will ask for kosher food – that is,
the family wishes to view the body, staff should meat that has been prepared in a special way
ask the mortician to ensure that the room is according to Jewish Law. Shellfish, pork, rabbit
free of any religious ‘symbols’. and their derivatives are strictly prohibited
Post-mortem In Islam the body is considered (treifu). Milk and meat products are not eaten t
to belong to God; strictly speaking, no part of at the same meal, which means that they do
the dead body should be cut or harmed. Post- not have milk in their drinks or cream with their
mortems are therefore forbidden unless ordered desserts after their meat meal and do not use
by the coroner. This should be clearly explained butter on meat sandwiches. The patient should
to the family. The family may request that organs be consulted about his or her level of dietary
removed should be returned to the body after observance and the necessary arrangements
examination. made. Orthodox Jews may not be happy to
take non-kosher meat.
Special considerations Fasting See special considerations below. If
There are many Muslim festivals, all calculated fasting would be a danger, even Orthodox
by the lunar calendar. Ask the patient or the patients will accept medical advice.
january 5/vol19/no17/2005 nursing standard 11
12. Modesty The body should be covered with a clean
Orthodox Jewish women prefer to have their white sheet. The family may wish for the body
bodies and limbs covered. They may also prefer to be placed with the feet pointing towards
to keep their hair covered with a headscarf. the doorway and to light a candle. Some
Orthodox men keep their head covered with Orthodox Jewish groups may wish to appoint
a hat or skull cap (kappel). someone to stay with the body from the time
Family planning of death to the burial, which usually takes place
Jews forbid contraception or family planning within 24 hours. This person is called a ‘watcher’,
unless the woman’s health is at risk. and he or she may need to stay with the body
throughout the night. In this instance, or if the
Birth family wish to view the body, staff should ask
Nearly all Jewish boys are circumcised, usually the mortician to ensure that the room is free
eight days after birth. This is performed by a from any religious ‘symbols’.
trained and medically certified religious func- If the death has to be reported to the coro-
tionary called a Mohel. If there is a doubt about ner, he or she should be informed that the
the child’s health the circumcision is delayed. patient was Jewish and be asked if the proce-
dures can take place as soon as possible.
Death and dying Orthodox Jews are always buried, but non-
Care of the dying The patient may wish to Orthodox Jews allow cremation.
recite or hear special psalms or prayers, espe- Post-mortem Post-mortems are not permit-
cially psalm 23 (The Lord is my Shepherd) and ted unless legally required.
may appreciate being able to hold the page
on which it is written. The relatives may say Special considerations
prayers and they may wish a Rabbi to be called The Sabbath (Shabbat) begins at sunset on
to help the dying person with their formal con- Friday and lasts until sunset on Saturday. On
fession and to bring comfort. the Sabbath, ‘work’ is prohibited and includes
Procedure at death In some cases the son, if things such as writing, travelling and switch-
present, may wish to close the eyes and mouth. ing on lights or electrical appliances.
The body should be handled as little as possi- During Passover (in March or April), some
ble by non-Jews. Depending on the sex of the Jewish patients may require special foods.
patient, a fellow male or female washes and The Day of Atonement or Yom Kippur (in
prepares the body for burial. Usually three mem- September or October) is a special day of fast-
bers of the community are present. Traditionally, ing. A Jewish patient will normally wish to keep
Jews will arrange for this to be done by the that day for prayer and be quiet. It is the holi-
Jewish Burial Society. If members of the family est day of the Jewish calendar and is considered
are not present, however, most non-Orthodox to set the path for the year to follow. Orthodox
Jews would accept the usual washing and last patients must be offered alternatives to oral
rites performed by hospital staff. medication, such as injections or suppositories.
12 nursing standard january 5/vol19/no17/2005
Granth Sahab, the Sikh Holy Book. The family
or any practising Sikh may help with this.
Sikhs, as an act of faith, wear the five signs of Procedure at death Generally, Sikhs are happy
Sikhism, known as the 5Ks. for non-Sikhs to attend to the body. However,
■ Kesh – uncut hair, kept under a turban. many families will wish to wash and lay out the
■ Kangha – a small comb worn in the hair.
body themselves. If members of the family are
■ Kara – a steel wrist band or bangle (or ring). not available, the following procedures should
■ Kirpan – a sword or dagger. be followed, in addition to the normal last rites:
■ Kaccha – white shorts worn as an under- ■ Special regard should be given to the 5Ks;
garment. these should be respected and should be
These symbols should not be disturbed unless left intact.
it is absolutely necessary, in which case the ■ Do not trim the hair or beard.
necessity should be explained to the patient ■ If the family wishes to view the body, staff
and/or his or her family. should ask the mortician to ensure that the
room is free from all religious ‘symbols’.
Diet Apart from stillbirths and neonates, who may
Many Sikhs are vegetarian. Some may not eat be buried, Sikhs are always cremated. This
eggs or fish. A few who eat meat will not eat should take place as soon as possible.
beef. It is helpful to explain the ingredients of
dishes with unfamiliar names, such as ‘hot pot’. Special considerations
Sikhs do not smoke, and alcohol is forbidden. Sikhs do not have a specific holy day; British
Sikhs have adopted Sunday as the holy day.
Names Prayers are said up to five times daily and patients
Most Sikhs have three names – a first name, a may like to have an early bath or shower before
religious middle name and a family name. The saying prayers; perhaps as early as 3am.
religious middle name is always Singh for men
and Kaur for women. Some Sikhs use just this t
religious title – for example, Mr Singh. The wife BAHA’I FAITH
of Mr Singh is never Mrs Singh but Mrs Kaur,
and vice versa. Although it began in a Muslim country, the Baha’i
faith is a distinct religion, based on the teachings
Family planning of its founder, Baha’u’ LLah. It is not a cult, a
Contraception can be used, but is not openly reform movement or a sect within any other faith,
spoken about. nor is it a philosophical system. It recognises the
unity of God and of his prophets, and teaches
Death and dying that the fundamental purpose of religion is to
Care of the dying A dying Sikh may receive promote concord and harmony. The Baha’i faith
comfort from reciting hymns from the Guru promotes the principles of equal opportunity, with
january 5/vol19/no17/2005 nursing standard 13
14. rights and privileges for both sexes, and advo- prayer. The patient will appreciate privacy for
cates compulsory education and universal peace. prayer and access to the ‘holy’ books of the
Christian Science faith.
Death and dying
Care of the dying No ritual to be performed Diet
before or after death. Alcohol and tobacco are not allowed. Strict
Death/funeral arrangements According to Christian Scientists may not drink tea or coffee.
Baha’i law, two conditions must be fulfilled:
■ Baha’i are always buried, never cremated. Clinical procedures
■ The place of interment should be within one Organ transplantation It is not normally accept-
hour’s journey of the place of death. able for adults to donate or receive organs.
Any undertaker may be used. Certain prayers Blood transfusion It is not normally accept-
and observations will be arranged either by the able for adults, but parents usually consent to
family or by the local Baha’i community. blood transfusions if doctors consider this appro-
priate for their child.
CHRISTIAN SCIENCE Death and dying
Routine last offices are appropriate. Only female
Established in the US in 1879, Christian Science staff should handle a female body, and cre-
teaches reliance on God for healing, rather than mation is normally preferred.
on medicine or surgery. It is unusual, therefore, Post-mortem Christian Scientists object to
for Christian Scientists to be patients in ordinary post-mortems, unless required by law.
hospitals. They will usually seek nursing care at
home or in a Christian Science nursing home.
They may, however, be admitted to hospital fol- JEHOVAH’S WITNESSES
lowing accidents, or during pregnancy and child-
birth, and because of family or legal pressures. Jehovah’s Witnesses try to live their lives accord-
They will accept medical care for their children ing to the commands of God, as written in the
where the law requires it. The church does not Old and New Testaments. They regard Jesus
attempt to control the actions of its members, Christ as the Son of God.
and the decision about whether to accept med-
ical intervention lies with the individual. Diet
A Christian Scientist will appreciate the nor- Food containing blood or blood products is not
mal care of the hospital if it is necessary for acceptable. Jehovah’s Witnesses do not smoke.
him or her to be admitted, but will normally
wish to be totally free of drug treatment. He Clinical procedures
or she will probably wish to contact a Christian Blood transfusions Jehovah’s Witnesses believe
Science practitioner for treatment through that taking blood into one’s body is morally
14 nursing standard january 5/vol19/no17/2005
wrong; it is therefore prohibited. This includes 1830. Mormons follow a strict health code, known
whole blood or its components, such as packed as the word of wisdom, which advises against the
red cells, plasma, white cells and platelets. use of tea, coffee, alcohol and tobacco, and advo-
Jehovah’s Witnesses can choose whether to cates healthy living. Family unity is very important.
accept products such as albumin, immuno-
globins and clotting factors. Blood samples Diet
may be taken for pathological testing, provided Mormons eat sparingly and avoid products that
that any unused blood is disposed of. Dialysis contain a lot of blood. Some Mormons will
will usually be accepted. avoid all hot drinks; milk, water and fruit juices
Organ transplantation This is generally not are acceptable.
permitted, but components where blood is not
involved (for example, a cornea) are more likely Death and dying
to be acceptable. Jehovah’s Witnesses are not Care of the dying There are no rituals for the
likely to be willing to either donate or receive dying, but spiritual contact is important. The
an organ through which blood flows. They will church has ‘home teachers’ who offer support
want reassurance that blood will not be used and care by visiting church members in hospital.
against their wishes. Procedure at death Routine last rites are appro-
priate. The sacred garment, if worn (see ‘Special
Death and dying considerations’), must be replaced on the body
Care of the dying There are no special rituals after the last rites. Church burial is preferred.
for the dying, but patients will usually appre- Post-mortem There are no religious objec-
ciate a visit from one of the elders of their faith tions. It is a decision for the individual family.
(there are no separate clergy).
Procedure at death Routine last rites are not Special considerations
appropriate. Some Mormons who have been through a spe-
Post-mortem This is a matter of individual cial temple ceremony wear a sacred undergar-
choice for the family. ment. It is an intensely private item and is worn t
at all times. It is only removed for hygiene pur-
Special considerations poses. It may be removed for surgical operations,
Jehovah’s Witnesses do not usually celebrate birth- but it must at all times be considered private and
days or Christmas. The only festival celebration be treated with respect.
is the annual memorial of the death of Christ.
Rastafarians are followers of a movement that
The Mormon Church, also known as the Church began in the 1930s in the West Indies among
of Jesus of Latter Day Saints, began in America in the descendants of slave families who had
january 5/vol19/no17/2005 nursing standard 15
16. come from Africa. The Old and New Testaments Post-mortem A post-mortem will only be
are still regarded as scriptures, but Rastafarians agreed to if the coroner has ordered it.
do not consider themselves to be Christians.
Rastafarianism is a personal religion; it places Special considerations
emphasis on personal dignity and a deep love Rastafarians will be unwilling to receive any
of God. There are no churches, services or treatment that will contaminate the body. They
clergy. For some, legal marriage is unnecessary will prefer alternative therapies, such as herbal-
and thus extended families may be complex. ism or acupuncture. However, those who seek
the advice of doctors are likely to accept some
Diet conventional treatment.
All forms of pork and shellfish are forbidden. The distinctive hairstyles (dreadlocks or locks)
Many Rastafarians are completely vegetarian. are a symbol of the Rastafarian faith. Orthodox
Some do not drink milk or coffee. members may not permit their hair to be cut.
Rastafarian women dress modestly. There is a SEVENTH DAY ADVENTISTS
taboo on wearing second-hand clothing, so
the patient may be unwilling to wear hospital Seventh Day Adventists are a worldwide Christian
garments that have been worn by others. A denomination whose members very much believe
disposable theatre gown may be preferred. that their faith is a way of life. They have strong
health principles, worship weekly from Friday
Family planning sunset to Saturday sunset and live daily in serv-
Most Rastafarians do not believe in contraception. ice to God and humanity.
Seventh Day Adventists believe in caring for
Clinical procedures the body God has given them. They uphold
Blood transfusion There will probably be anx- health principles, which has on occasion singled
ieties about this because of concerns about con- them out as a group for health studies. Hundreds
tamination of the body. Assurance will be necessary. of health clinics and hospitals around the world
Organ transplantation Not generally acceptable. have been founded by Adventists, and they are
noted for their holistic attitude to life.
Death and dying
Care of the dying Among Rastafarians, visit- Diet
ing the sick is important. Visits are often made Many Seventh Day Adventists are ova-lacto
in groups. Family members may wish to pray vegetarians, which means they eat no meat
at the bedside. Apart from this there are no products but do eat eggs, cheese and milk foods.
rites or rituals, before or after death. Others are not vegetarian but do not consume
Procedure at death Routine last rites are pig products, and some also avoid red meats.
appropriate, and burial is preferred. A few are vegans, eating only fruits, pulses, nuts
16 nursing standard january 5/vol19/no17/2005
and grains. Most Adventists avoid stimulants Baptist Church:
■ The centrality of the Bible and the import-
such as tea and coffee. Adventists also promote
an alcohol-, nicotine- and drug-free lifestyle. ance of personal prayer and sharing in fel-
Death and dying ■ The baptism of believers on profession of
There are no death rituals as regards to the faith in Jesus Christ.
body. Calling the minister, next of kin and fam- ■ A gathered community of believers who
ily members would provide an opportunity for meet regularly to discern the mind of Christ.
acceptance and goodbyes. ■ The whole church of God expressed in sev-
For Seventh Day Adventists the funeral serv- eral distinct ways, wishing to be committed
ice is one of celebration of the person’s life, and to the ecumenical life of God’s people, as
they believe the body remains in the grave until well as associating with fellow Baptists locally
the second return of the Saviour Jesus Christ. and internationally.
■ Supporting the Baptist Missionary Society and
the work of Christian Aid, believing that every-
one has a responsibility to live out the call of
Christ in their own daily lives.
■ Religious freedom for everyone and a toler-
WICCA ance of differences of outlook and practice
of the spiritual life.
Wicca has its roots in old, pre-Christian earth-
based religions, Goddess traditions and witch-
craft. At the core of Wiccan beliefs is the last
line of the Wiccan Rede: ‘An it harm none, do
what thou will.’ In other words, do whatever
you please, as long as it does not harm anyone,
including yourself. They also believe that what Acknowledgements t
you do comes back to you three times as intensely. Thanks to all those who contributed to
Wiccans also believe in reincarnation. They this guide: James Scott, chief executive;
believe the soul goes to Summerland between John Rothwell, chaplain; John Ward,
death and rebirth, to reflect on the life that has director of human resources; Gillian
just passed and to prepare (and wait) for the next. Powell, communications officer; Jean Hill,
head of library; Linda Foote, assistant;
Julie Vance, deputy director of nursing;
Simon Chase, deputy manager clinical
governance; and also the staff
Baptists are a group of Christians who may development administration – Jess Perry,
hold the following beliefs as outlined by the Sam Thomas and Sid Hawkins.
january 5/vol19/no17/2005 nursing standard 17
18. Leicester LE67 9RN
CONTACTS Tel: 01530 244944 or 01530 244945
Islamic Universal Foundation
Afro-Caribbean Mental Health Association
35-37 Electric Avenue
20 Penzance Place
London SW9 8JP
London W11 4PG
Tel: 020 7737 3603
Tel: 020 7602 5273
African-Caribbean Mental Health Project
Zion Centre Muslim Women’s Help Line
Zion Crescent Unit 3
Manchester M15 5BY GEC Estate
Tel: 0161 226 9562 East Lane
Wembley HA9 7PX
Asian Tel: 020 8904 8193 or 020 8905 6715
Tel: 020 7713 7867 Jehovah’s Witnesses
Jehovah’s Witness Hospital Information Services
Baha’i ISBA House
Natural Spiritual Assembly of Baha’is The Ridgeway
of United Kingdom London NW7 1RN
27 Rutland Gate Tel: 020 8906 2211
London SW7 1PD
Tel: 020 7584 2566 Judaism
Buddhism The Office of the Chief Rabbi
London Buddhist Centre Adler House
51 Roman Road 735 High Road
London E2 0HU London N12 0US
Tel: 0845 458 4716 Tel: 020 8343 6301
The Buddhist Society (Progressive Jews)
58 Eccleston Square Union of Liberal and Progressive Synagogues
London SW1V 1PH 21 Maple Street
Tel: 020 7834 5858 London W1T 4BE
Tel: 020 7580 1663
Chinese Health Information Centre Board of Deputies of British Jews
First Floor Woburn House
39 George Street Upper Woburn Place
Manchester M1 4HQ London WC1H 0EP
Tel: 0161 228 0138 Tel: 020 7387 3952
Hindu Centre Sikh Missionary Resource Centre
5-7 Cedars Road 346 Green Lane
London E15 4NE Small Heath
020 8361 4484 Birmingham B9 8DB
Tel: 0121 772 5365
Islamic Cultural Centre General
London Central Mosque National Health Service Ethnic Health Unit
146 Park Road 7 Belmont Grove
London NW8 7RG Leeds LS2 9NP
020 7724 3363 Tel: 0113 246 7336
The Islamic Foundation Sickle Cell Society
Markfield Darah Centre 54 Station Road
Ratby Lane London NW10 4UA
Markfield Tel: 020 8961 7795
18 nursing standard january 5/vol19/no17/2005
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