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A systematic review of religious beliefs about major end-of-life issues in the five major world religions

Published online by Cambridge University Press:  19 January 2017

Rajshekhar Chakraborty ,
Areej R. El-Jawahri ,
Mark R. Litzow ,
Karen L Syrjala ,
Aric D. Parnes  and
Shahrukh K. Hashmi
Rajshekhar Chakraborty*
Affiliation:
Hospitalist Services, Essentia Health–St. Joseph's Medical Center, Brainerd, Minnesota Division of Hematology, Mayo Clinic, Rochester, Minnesota
Areej R. El-Jawahri
Affiliation:
Division of Hematology/Oncology, Massachusetts General Hospital, Boston, Massachusetts
Mark R. Litzow
Affiliation:
Division of Hematology, Mayo Clinic, Rochester, Minnesota
Karen L Syrjala
Affiliation:
Department of Psychiatry and Behavioral Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
Aric D. Parnes
Affiliation:
Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
Shahrukh K. Hashmi
Affiliation:
Division of Hematology, Mayo Clinic, Rochester, Minnesota
*
Address correspondence and reprint requests to: Rajshekhar Chakraborty, Hospitalist Services, Essentia Health-St. Joseph's Medical Center, Brainerd, Minnesota. E-mail: rajshekhar.ucms@gmail.com.
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Abstract

Objective:

The objective of this study was to examine the religious/spiritual beliefs of followers of the five major world religions about frequently encountered medical situations at the end of life (EoL).

Method:

This was a systematic review of observational studies on the religious aspects of commonly encountered EoL situations. The databases used for retrieving studies were: Ovid MEDLINE In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid EMBASE, Ovid PsycINFO, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and Scopus. Observational studies, including surveys from healthcare providers or the general population, and case studies were included for review. Articles written from a purely theoretical or philosophical perspective were excluded.

Results:

Our search strategy generated 968 references, 40 of which were included for review, while 5 studies were added from reference lists. Whenever possible, we organized the results into five categories that would be clinically meaningful for palliative care practices at the EoL: advanced directives, euthanasia and physician-assisted suicide, physical requirements (artificial nutrition, hydration, and pain management), autopsy practices, and other EoL religious considerations. A wide degree of heterogeneity was observed within religions, depending on the country of origin, level of education, and degree of intrinsic religiosity.

Significance of results:

Our review describes the religious practices pertaining to major EoL issues and explains the variations in EoL decision making by clinicians and patients based on their religious teachings and beliefs. Prospective studies with validated tools for religiosity should be performed in the future to assess the impact of religion on EoL care.

Keywords

End of lifeReligionAdvance directivesEuthanasiaArtificial nutrition and hydrationAutopsyPain management
Type
Review Article
Information
Palliative & Supportive Care , Volume 15 , Issue 5 , October 2017 , pp. 609 - 622
Copyright
Copyright © Cambridge University Press 2017 

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