The following has been adapted from Norfolk NHS Guidance on Multicultural issues around death and dying and South Devon Healthcare, Handbook on cultural, spiritual and religious beliefs.
Norfolk NHS guidance on Multicultural issues
South Devon NHS Cultural Handbook
Working with cultural diversity requires knowledge and sensitivity. Family members will often prefer to be asked about their customs and religious requirements around death and dying.
It is vital to establish what is important to the person receiving care regardless of culture or creed in order for their needs to be met.
Do not assume that because a person has declared that they are of a specific faith that they will necessarily adhere to all the associated customs. There will be many variations and interpretations.
Some religious practices and customs are not detailed here, for example the Zoroastrian/Parsi or Merina cultures. Where traditional funeral customs cannot be observed in this country the family of the deceased will be asked for guidance.
Guidelines
These guidelines are intended to help health and social care staff, particularly if no immediate family members are available.
If at all possible the views of the individual or family concerned should be sought. Undertakers can often provide contact details for representatives of different faiths in each locality.
Atheist/Humanist or Agnostic
Atheists do not believe in God or in life after death, while an agnostic neither believes nor disbelieves. The families may or may not object to an organ donation.
The funeral could be held at a crematorium, cemetery chapel or green burial ground and the service may be taken by a member of the family or a humanist minister. The minister would spend some time talking to the congregation about the deceased and would probably read some poetry and then listen to some music. It is very unlikely that an incumbent of a church would allow an atheist/humanist burial in a churchyard.
Baha’i Faith (mainly Iranian)
Baha’is believe that the deceased should be treated with the greatest respect at all times. Prayers may be said by family members at the bedside shortly after the death has occurred. They do not object to post-mortems or organ donation although embalming is not permitted.
Baha’is must be buried and this must be arranged as soon as possible and preferably not more than one hour’s journey from the place of death.
Buddhism
Care of the dying: Consideration for the dying will vary among the different Buddhist groups. The most important considerations relate to the state of mind at the time of death, as Buddhists believe that this will influence the character of rebirth. The dying patient may seek the help in arranging for a time of peace and quiet to allow for meditation, or may seek counselling from a fellow Buddhist. Some form of chanting may be used to influence the state of mind at death so that it may be peaceful.
Once the death has occurred a Buddhist priest needs to be contacted as soon as possible. Ideally the deceased should not be removed until the priest has arrived.
Organ donation is acceptable but sometimes it may be seen as unwise as the moment of clinical death is not seen as the end of the death process.
Most Buddhists prefer cremation rather than burial. Where the rites cannot be observed any burial service may be used, but there should be no reference to Christian doctrine or deity.
Chinese Culture
The position, wealth or poverty of the family are key factors to be considered in the performance of rites. Organ donation is usually acceptable. When an adult dies the body is washed. The family may want to clothe the deceased in white or old fashioned clothing. Relatives and friends may want to see the body before the coffin is closed.
Christian
Although the doctrines of Christian churches vary greatly both within and between countries, there are four features of Christianity that are nearly universal: initiation (baptism), worship, ministry and "good works". The sacred writings of Christian religion are in the Bible. A Christian’s individual faith and religious practice will be influenced by the tradition of the church to which they belong as well as their own personal relationship with God. Please record the individual’s specific denomination in their notes.
Routine Last Rites are appropriate for all Christians.
Most Christians will not object to post-mortems. Organ donation is an individual decision and there are no doctrinal reasons for it to be refused.
Church of England (Anglican)
Always ask the individual and/or family/friends if they would like to see a Chaplain or their local minister.
Prayers may be said at the bedside of a dying patient. Sometimes the family or the patient will ask to receive the “Sacrament of the Sick”. This involves anointing with holy oil.
After death some families may like to offer prayers of thanksgiving for the person’s life.
Roman Catholic
The patient will probably wish to be visited by a Catholic Priest and to receive Holy Communion and the “Sacrament of the Sick”. This is not only for the dying, but also for the sick, especially before an operation. The Sacraments are very important. The Catholic Priest must be called to the dying patient and if the death is sudden, immediately afterwards.
Roman Catholics prefer burial rather than cremation, however some practising and non-practising Catholics are now cremated.
Free Churches
Free churches can include the following:
Baptist
Independent churches and missions
Methodist
Moravian Brethren
Pentecostal
Plymouth Brethren
Presbyterian
Salvation Army
The Religious Society of Friends (Quakers)
United Reformed Church
Free Church patients may like to receive a visit from a Minister, a member of their own church or the Free Church Chaplain. Ceremony/sacraments, may not be observed as strictly as the Anglican and Catholic religions; however, they may welcome prayers being said with them.
Christian Scientist
There are no last rites or special rituals and routine last offices are acceptable. Female nurses should only handle females. Organ donation is not normally approved of and post-mortem is only allowed if legally required.
Hinduism
Care of the dying: A devout Hindu who is very ill or dying may receive comfort from hymns and readings from the Hindu hold books, especially the Bhagavad Gita. Some may wish to lie on the floor, symbolising closeness to Mother Earth. Hindus very much wish to die at home. This has religious significance and death in hospital can cause great distress. All possible steps should be taken to enable the person to go home to die – if this has been requested.
The deceased needs to be treated with great respect. Sometimes the family may want to perform last offices. Under normal circumstances – where the attending doctor has issued a death certificate – the family should, if available, be consulted before non-Hindus touch the body. The family will usually want to wash the body at home. There is no objection to organ donation. The eldest son usually takes part in arranging the funeral whatever his age. Hindus are always cremated except for children under 5 years of age who are buried. The cremated remains are quite often sent to India to be scattered on the Ganges or alternatively on the waters of a British river or sea, so long as it is flowing. If no family are available, the following procedure should be followed:
- Wearing disposable gloves, close the eyes and straighten the limbs
- Jewellery, sacred threads and other religious objects should not be removed
- Wrap the body in a plain sheet
- In most cases the body should not be washed as this is part of the funeral rites and will usually be carried out by relatives later
- If there is a delay, e.g. because the death has to be reported to the Coroner, this must be carefully explained to the family because it is their practice for the funeral to take place as soon as possible
- If a body is to be left in a room overnight a light or candle should be left burning throughout the night
- If the family wish to view the body, staff should ask the mortician to ensure that the room is free of any other religious “symbols”
Islam
Care of the dying: The dying Muslim may wish to sit or lie with their face towards Mecca. Another Muslim, usually a relative, may whisper the call to prayer in the dying persons‟ ear and family members may recite prayers round the bed. If no relatives are available and the patient has required this service, any practising Muslim can give help and religious comfort.
Muslims believe that the soul remains in the body for some time after death and that the body still feels pain. The deceased should be treated with the greatest respect and gentleness. After death the body should not be touched by non-Muslims, and for this reason social care workers who need to touch the body should wear disposable gloves.
Strict Muslims will not agree to organ transplants, and the subject should not be raised unless the family initiates the discussion.
A Muslim funeral should take place as soon as possible, preferably within 24 hours of death. Muslims are buried not cremated.
The body should be prepared according to the wishes of the family. If family are not available, the following procedure should be followed wearing disposable gloves:
- Turn the head towards the right shoulder before rigor mortis begins. This is so that the body can be buried with the face towards Mecca
- Do not wash the body, nor cut hair or nails
- Wrap the body in a plain white sheet
Jehovah’s Witnesses
Jehovah’s Witnesses give no recommendation for either burial or cremation. There is no formal ritual. The funeral would take place at either the local Kingdom Hall or the chapel or the local cemetery or crematorium.
Although they refuse blood transfusions, they do not object to organ donations and transplants.
Jewish faith
Care of the dying: A dying Jew may wish to hear or recite special psalms, particularly Psalm 23 (The Lord is my Shepherd) and the special prayer (The Shema) and may appreciate being able to hold the page on which it is written.
The family will possibly want to wash and prepare the body once death has occurred. The eyes should be closed, preferably by a member of the family. Relatives would be unhappy to consent to post-mortems unless it is legally required and would not accept organ donation.
Orthodox Jews are against cremation and will insist on a traditional burial. This will ideally take place within twenty-four hours. However in this country it is not always possible. Non-orthodox Jews may accept cremation, although it is not encouraged.
Mormon
The deceased are usually buried, however cremation, though not encouraged, is permitted. Organ donation is allowed, after taking medical advice and this being confirmed through prayer.
Quaker
Quakers attach little importance to the body after death and concentrate more on celebrating the life of the deceased. They do not object to organ donation.
Sikh
Care of the dying: A dying Sikh may receive comfort from reciting hymns from Gur Grant Sahab, the Sikh holy book. If he or she is too ill to recite hymns, then a relative or reader from the Sikh Gurdwara (temple) may do so instead. If no family members are present, any practising Sikh may be asked to give help and religious comfort should it be required by the patient. If they are not present at the death, the family should be consulted immediately because they may want to carry out the last rites themselves. Apart from still births and neonates who may be buried, Sikhs are always cremated with the remains being scattered on a rise or at sea. There are no objections to post-mortems or organ donations.
