Caring for Hindu patients at the end-of-life: A narrative review.

OBJECTIVES: This paper reviews the existing literature to identify specific challenges that may arise in the context of providing palliative and end-of-life (EOL) care for Hindu patients in the physical, psychological, and spiritual domains. We offer practical strategies where appropriate to mitigate some of these challenges. We review how the Hindu faith impacts EOL decision-making, including the role of the family in decision-making, completion of advance directives, pain management, and decisions around artificial nutrition and hydration (ANH) and cardiopulmonary resuscitation (CPR). METHODS: The PubMed, MEDLINE Complete, Cochrane, and Embase databases were searched for articles using the search strings combinations of keywords such as Palliative care, Hindu, Hinduism, End of Life Care, India, Spirituality, and South Asian. Once inclusion criteria were applied, 40 manuscripts were eligible for review. RESULTS: Our results are organized into the following 4 sections - how Hindu religious or spiritual beliefs intersect with the physical, psychological, and spiritual domains: and decision-making at the EOL. SIGNIFICANCE OF RESULTS: Hindu beliefs, in particular the role of karma, were shown to impact decision-making regarding pain management, ANH and CPR, and advance directive completion. The complexity of Hindu thought leaves a significant role for interpretation and flexibility for individual factors in decision-making at the EOL.

'You don't just do it because someone else said so': Menstrual practices and women's agency in the Hindu diaspora of Trinidad.

Meanings of menstruation are deeply embedded in culture and religion. The current dominant narrative presents menstrual practices as restrictions and often describes Hindu women as 'subjected to' these practices, characterising them as the oppressed victims of their religion. This article seeks to complicate this oversimplified narrative by exploring women's motivations, choices and decisions related to menstrual practices in a small-scale study based on semi-structured interviews and focus groups with women in the Hindu-Trinidadian diaspora. Our findings indicate that the women we interviewed exercise agency in the cognitive, emotional, religious and socio-cultural spheres. Many of them accept the ritual 'impurity' but overwhelmingly restrict this label to the spiritual sphere and separate it from their menstruating bodies. Many reject the idea that the practices are restrictive or stigmatising. They do not understand religion as the source of menstrual stigma but instead value or accept menstrual practices as part of what it means to be a Hindu woman-motivated by religious observance and/or the desire to be part of a community that upholds tradition. These varied manifestations of women's agency challenge the understanding of menstrual practices as necessarily-and-always oppressive and call for acknowledging the nuance and complexity of women's lives.

"Females are always dominated and disregarded by males, just because they are female": the continuation of patriarchal norms for young trafficked women in Nepal.

This article provides insights into the cultural aspects of sexual violence against young women trafficked into the sex industry in Nepal. Participant observation, participatory clay body mapping workshops and group interviews using photography were used to explore the reproductive body of six formerly trafficked women aged 14-22 years. Intimate partner violence against women, domestic violence and violence against women were important issues raised during the research process. Societal and familial patriarchal norms are the root causes of violence against women in Nepal and can be traced back to the Hindu legal code, the Muluki Ain of 1854, which was enforced for over 100 hundred years. Our findings indicate that tackling violence against women is complex for Nepali trafficked women because of its multiple forms and sources.

Playing God? Religious Perspectives on Manipulating the Genome.

The Human Genome Project (HGP) is a remarkable medical science breakthrough that enables the understanding of genetics and the intervention of human health. An individual's health is influenced by physical, emotional, social, intellectual, and religious factors. Among these, religious beliefs shape our thinking on cloning, stem cells, and gene editing, affecting healthcare decisions and the motivation for seeking treatment. Is the human genome sacred? Does editing it violate the idea that we're made in God's image or allow us to "play God"? Understanding the perspectives behind the fundamental religious doctrines of Islam, Christian, Hindu, and Buddhist on gene editing/therapy in somatic and germline cells would ensure a right balance between geneticists and theologians in providing the best healthcare while catering to individual beliefs.

Hinduism and reproductive decision-making: Karma, Samsara, and the in-between.

Investigations of the role of religious philosophy in reproductive decision-making has exclusively focused on Abrahamic traditions. However, those who practice Eastern religions, such as Hinduism, represent an increasing proportion of the population in the United States and may present for prenatal care. Here, we consider tenets of Hindu philosophy as they may pertain to decision-making surrounding women's pregnancy termination. Such tenets include the cycle of rebirth (samsara), karma, dharma, Hindu writing, and the multivalent nature of Hindu philosophy. Through this brief communication we hope to present a starting point for further exploration which will increase cultural competency of genetic counselors while enhancing awareness of variations of religious beliefs patients may hold.

Religion and Caregiving for Orphans and Vulnerable Children: A Qualitative Study of Caregivers Across Four Religious Traditions and Five Global Contexts.

Studies of caregivers of orphans and vulnerable children (OVC) rarely examine the role religion plays in their lives. We conducted qualitative interviews of 69 caregivers in four countries: Ethiopia, Kenya, Cambodia, and India (Hyderabad and Nagaland), and across four religious traditions: Christian (Orthodox, Roman Catholic, and Protestant), Muslim, Buddhist, and Hindu. We asked respondents to describe the importance of religion for their becoming a caregiver, the way in which religion has helped them make sense of why children are orphans, and how religion helps them face the challenges of their occupation. Using qualitative descriptive analysis, three major themes emerged. Respondents discussed how religion provided a strong motivation for their work, reported that religious institutions were often the way in which they were introduced to caregiving as an occupation, and spoke of the ways religious practices sustain them in their work. They rarely advanced religion as an explanation for why OVC exist-only when pressed did they offer explicitly religious accounts. This study has implications for OVC care, including the importance of engaging religious institutions to support caregivers, the significance of attending to local religious context, and the vital need for research outside of Christian contexts.

A Comparative Analysis on the Perspective of Sunni Theology and Hindu Tradition Regarding Euthanasia: The Impact of Belief in Resurrection and Reincarnation.

The aim of this paper was to study the viewpoints of Sunni Islam and Hinduism on euthanasia to explore whether the Sunni tradition's belief in the hereafter and the Hindu culture's faith in reincarnation have any impact on these two religions' positions on the rejection or justification of euthanasia. Examining these two theologies' approaches demonstrated that Sunni Islam considers euthanasia suicide/homicide in light of the belief in the hereafter, whereas Hinduism can justify euthanasia through Gandhi's interpretation of ahimsa, on the condition that all methods to alleviate the patient's pain and suffering have been exhausted.

Dharmic Religions and Health: A Holistic Analysis of Global Health Literature Related to Hinduism, Buddhism, Sikhism and Jainism.

Bibliometrics and scientometrics are popular and novel disciplines providing information in publication trends in a certain academic field. Although there has been an increasing popularity in bibliometric studies, a limited number of reports have been published in religion and health literature. In this study, to the best of our knowledge we aimed to perform a first bibliometric analysis in the health literature related to Dharmic religions, Hinduism, Buddhism, Sikhism and Jainism. We found a total of 655 health articles related to Dharmic religions as we searched Web of Science databases. The United States of America (USA) ranked first in Health and Hinduism literature with 62 documents followed by India, the UK and Bangladesh (n = 40, 33 and 6, respectively). A detailed keyword analysis revealed that the most used keywords in the field of Hinduism and health were "Hinduism," "religion," "spirituality" and "Islam." The USA was also the leading county in the literature of Buddhism and Health with 159 articles (32.78%) and followed by Thailand, the UK and China (10.72, 6.8 and 6.39%, respectively). The Journal of Religion and Health was noted to be the most prolific source in this field. We found that the developing countries such as India, Thailand, Singapore and Taiwan were found to be included in the most productive countries list on the contrary to previous bibliometric studies in health and religion field.

Religion and Suicide: New Findings.

Suicide rates and risk and protective factors vary across religions. There has been a significant increase in research in the area of religion and suicide since the article, "Religion and Suicide," reviewed these issues in 2009. This current article provides an updated review of the research since the original article was published. PsycINFO, MEDLINE, SocINDEX, and CINAHL databases were searched for articles on religion and suicide published between 2008 and 2017. Epidemiological data on suicidality and risk and protective factors across religions are explored. Updated general practice guidelines are provided, and areas for future research are identified.

Nasal Myiasis in Hinduism and Contemporary Otorhinolaryngology.

Various case reports on nasal myiasis written during the 1990s and 2000s state that nasal myiasis, which is known as peenash among South Asian natives, is a form of divine punishment in Hindu mythology, but do not provide citations from Hindu scriptures that would suggest this interpretation. This paper aims to discuss the phenomenon of peenash in a historical context by examining medical literature written during the nineteenth and early twentieth centuries, to identify Hindu texts contributing to the belief of some Hindus that nasal myiasis is a form of divine punishment, and to provide an overview of contemporary treatment for and management of nasal myiasis.

The Suicide Paradigm: Insights from Ancient Hindu Scriptures.

The world religions in general promote peace and happiness. They strongly discourage all sorts of violence in society including suicide. Religious commitments toward life-saving value are known to prevent suicide attempts since all world religions promote unity, reducing interpersonal hostilities. Therefore, understanding the basics on what religious scriptures narrate on life and death including suicide is essential. This paper highlights the seldom discussed topic on the concept and consequences of suicide portrayed in the ancient Hindu religious scriptures.

Religion and family planning.

Religion is embedded in the culture of all societies. It influences matters of morality, ideology and decision making, which concern every human being at some point in their life. Although the different religions often lack a united view on matters such contraception and abortion, there is sometimes some dogmatic overlap when general religious principles are subject to the influence of local customs. Immigration and population flow add further complexities to societal views on reproductive issues. For example, present day Europe has recently faced a dramatic increase in refugee influx, which raises questions about the health care of immigrants and the effects of cultural and religious differences on reproductive health. Religious beliefs on family planning in, for example, Christianity, Judaism, Islam and Hinduism have grown from different backgrounds and perspectives. Understanding these differences may result in more culturally competent delivery of care by health care providers. This paper presents the teachings of the most widespread religions in Europe with regard to contraception and reproduction.

A Positive Psychology Intervention in a Hindu Community: The Pilot Study of the Hero Lab Curriculum.

India has high rates of mental health issues among its youth and low-income communities experience a disproportionate amount of depression and suicide. Positive psychology, the act of promoting well-being, could be used as a tool to promote wellness and help improve the mental health of youth living in slum areas of India. A pilot positively psychology program, "The Hero Lab", was conducted in a migratory slum in Worli, Mumbai, with trained Hindu community leaders implementing the interventions toward at-risk Hindu youth. The curriculum's impact showed statistical improvement (p < 0.001) in happiness (General Happiness Scale from 11.24 ± 1.56 to 19.08 ± 3.32), grit (Grit Survey from 2.23 ± 0.34 to 3.24 ± 0.67), empathy (Toronto Empathy Questionnaire from 24.92 ± 3.27 to 41.96 ± 8.41), and gratitude (Gratitude Survey from 16.88 ± 3.47 to 27.98 ± 6.59). While a pilot study, the Hero Lab curriculum demonstrates that positive psychology interventions may be an important tool in improving mental health in at-risk children.

A Dialogue between Hindu and Catholic Perspectives in Taking Care of Newborns at their End-of-Life.

Hinduism is considered one of the most ancient religions in the world. Although the technological innovation of modernization has undermined the reliance on their traditions, Hindus may still rely on Hindu Scripture when making decisions. From their standpoint, contrary to Western medicine, human lives cannot be reduced to statistical and empirical facts. They focus more on preserving the spirit, rather than considering survival as one of the goals of medicine. Consequently, when a preterm infant is born, Hindu parents might struggle to understand the goals of Western neonatologists. This divergence may create misunderstandings when discussing end-of-life decisions. Since they value relational aspects to be of utmost importance, they may accept treatments only in the likelihood of good neurological outcomes. Being able to interact allows Hindus to act virtuously with the aim of purifying their soul toward moksa. When it comes to end-of-life decisions on behalf of newborns, Hindu parents may opt to forgo treatments and let the baby peacefully die, while praying for their soul to have a better rebirth. This paper aims to evaluate quality-of-life assessment in the Hindu tradition in comparison with the Catholic tradition. It draws parallelisms between these two different religions to investigate whether an inter-religious dialogue is possible. This work will help Catholic, and more broadly Western, doctors to have a better understanding of the Hindu end-of-life views.

Is religious affiliation associated with parent disciplinary behavior in Suriname and Guyana.

BACKGROUND: Although limited, there is some evidence that certain physical punishments may vary by household religion. OBJECTIVE: This study aimed to determine whether parent disciplinary behavior varies by religious affiliation in two countries which have large, diverse religious groups. PARTICIPANTS AND SETTING: Data from Multiple Indicator Cluster Surveys for Suriname (2018) and Guyana (2019-20), which contain nationally representative household samples, were used. The study was restricted to the three most prevalent religious groups: Christians, Hindus, and Muslims. METHODS: Adult responses to a standardized survey that included questions about use of disciplinary behaviors in the household towards children (aged 1-14 years) were examined in relation to religious affiliation of the head-of-household and multiple covariates. RESULTS: Of the 3518 Suriname households, 62.4 %, 23.3 % and 14.3 % were Christians, Hindus, and Muslims, respectively. Compared to Christians, children in both Hindu and Muslim households had significantly lower odds of being hit with an object in adjusted logistic regression models. However, only Hindus had lower odds of being spanked and Muslims lower odds of exposure to a combined physical and non-physical practice, compared to Christians. Of the 2535 Guyana households, 69.5 %, 23.5 % and 7.0 % were Christians, Hindus, and Muslims, respectively. Children in Hindu, but not Muslim households, had significantly lower odds of being spanked, hit with an object, and exposed to a combine practice in adjusted models compared to Christians. CONCLUSIONS: Partial support was found for a potential influence of religion on some disciplinary behaviors. Further investigation is warranted to identify possible conditions and mechanisms.

The Missing Voice: Incorporating the Hindu Community in Developing Inclusive Chaplaincy.

This manuscript highlights potential barriers hospitalized Hindu patients and caregivers living in the United States encounter while accessing chaplaincy care. Community-based participatory research is suggested to foster partnerships between chaplains and the Hindu community in developing evidence-based, inclusive models of pastoral care.

End of Life Care Practices for Hindu Patients During COVID-19.

With coronavirus disease 2019, the risk of death has increased in the general population. In these unprecedented times and even otherwise, it is important for the health care professionals caring for Hindu patients to be aware of the end of life practices in Hinduism. There is limited information in the medical literature about traditions and practices followed in Hinduism which is observed by 15% of the world population. Hinduism is currently the third largest religion following Christianity and Islam. Based on Hindu beliefs about life, death, and reincarnation, we propose 10 end of life best practices for Hindu patients.

Hindu Response to Dying and Death in the Time of COVID-19.

We wake each morning to news on the glaring statistics of people infected by COVID-19 and others reportedly dying from complications thereto; the numbers are not receding in at least a number of countries across the world (barring a few that imposed strict lockdowns, testing and quarantining measures, such as Australia, Singapore, New Zealand and Vietnam). It is hard to imagine a moment such as this that most of us have lived through in our life-time; but it is a reality and public challenge that we can neither ignore nor look away from. In what follows I will explore perspectives on death from the Hindu tradition and the kinds of response-and solace or wisdom-afforded by the tradition to the angst and fears evoked by this pandemic situation. In concluding the discussion, I shall offer tentative reflections on how the Hindu perspective may be universalized, such as might invite conversations with therapists and care workers who may be seeking alternative resources to help expand the therapeutic space in more beneficent ways during the Covid-19 pandemic and its after-effects.