World Religions for Healthcare Professionals

Mark F Carr, Siroj Sorajjakool, Ernest Bursey, Siroj SSorajjakool, Mark F Carr, Julius J Nam, Siroj SSorajjakool, Mark F Carr, Julius J Nam, Siroj Sorajjakool, Mark F Carr, Ernest Bursey

• Publisher: Routledge
• Year: 2017
• ISBN:
  9781317281016
• Edition: 2
• Topic: Medizin
• Subtopic: Gesundheitsversorgung

Religious beliefs and customs can significantly shape patients' and professionals' attitudes toward, and expectations of, healthcare, as well as their wishes and personal boundaries regarding such daily matters as dress, diet, prayer and touch. Undoubtedly, the sensitivity with which clinicians communicate with patients and make decisions regarding appropriate medical intervention can be greatly increased by an understanding of religious as well as other forms of cultural diversity.

This second edition of a popular and established text offers healthcare students and professionals a clear and concise overview of health beliefs and practices in world religions, including Hinduism, Buddhism, Jainism, Confucianism, Taoism, Sikhism, Islam, Judaism, and Christianity. Adopting a consistent structure, each chapter considers the demographic profile of the community, the religion's historical development, and key beliefs and practices, including views regarding health and sickness, death, and dying. Each chapter also ends with a useful checklist of advice on what to do and what to avoid, along with recommendations for further reading, both online and in print form.

The book's clear and consistent style ensures that readers with little background knowledge can find the information they need and assimilate it easily. A brand new chapter on applications and a set of new case studies illustrating issues in clinical practice enhance this wide-ranging book's value to students and practitioners alike.

1
Introduction

Ernest J. Bursey

Welcome to world religions from a healthcare perspective! The study of world religions offers you the opportunity to more adequately meet the needs of your patients and clients, because you will possess a more accurate knowledge of their religious beliefs and practices.

Extensive research supports the claim that patients who actively participate in a religion enjoy a longer life span and shorter stays in hospital than their counterparts. In a seminal, critical review, J. Levin (1994) concluded that the available published research at that time supported an association between religion and health, that the association is valid, and that it is probably causal. Subsequent research generally supports Levin’s conclusion of a valid association between health and religion or spirituality. The Handbook of Religion and Health, a massive standard reference now in its second edition, estimates more than 2100 qualitative studies have been published, most indicating a positive correlation between religion and health (Koenig et al. 2012). A particularly important finding for our purposes is that the health benefits from religious affiliation are not restricted to one specific religion.

Evidence that the financial interests of a hospital are better served when the religious needs of patients are addressed while in the hospital has led to a growing use of spiritual assessment tools by both physicians and nurses, and the introduction of spirituality and medicine into the curricula of medical schools. In 1994, only 16 out of 126 medical schools offered courses in medicine and spirituality. By 2010, more than 90 percent of medical schools in America addressed spirituality and medicine in their curricula (Koenig et al. 2010).

The number of patients with religious affiliations other than Christianity has significantly increased because the general population of the United States has become more religiously diverse since 1965. That year, President Lyndon Johnson signed the Immigration and Nationality Act, which ended the national quota system that had discriminated against persons from Asia and the Middle East.

In the years since 1965, preferential access in immigration has been given to applicants with scientific and medical expertise needed in the United States. For example, a study by Cornell University in 2002 disclosed that one in ten Muslim households in the United States includes a physician (Allied Media Corporation 2007). One positive benefit from the study of world religions could be a better understanding of the growing number of immigrant healthcare professionals who actively embrace a faith tradition other than Christianity. Nearly all of my graduate nursing students report working alongside nurses or physicians who openly hold to a faith other than their own and who believe their faith makes them better healthcare professionals.

Hopefully, as a result of reading this volume, you will become more aware of the religious minorities in your own community and perhaps more sensitive to the challenges they face in maintaining their religious practices and culture. The majority of legal immigrants, particularly from Central and South America, continue to be Christian since the largest percentage of immigrants to the United States are from Central and South America. But significant numbers of Hindus and Muslims, particularly from South Asia, have immigrated and become naturalized citizens. Mosques and temples sprout up in suburban American neighborhoods to meet the religious needs of the growing population of immigrants and their children. Funding for these projects is underwritten in part by affluent immigrant professionals, including those in healthcare and engineering. At the dedication of a new temple in Florida on June 15–19, 2005, a souvenir booklet itemized the names of donors; out of a total of 77 named devotees contributing $10,000 or more each, 42 were listed as “Dr.,” with ten of these double listed as “Drs.,” indicating both marriage partners held doctorates (Hindu Society of Central Florida 2005).

On a wider front, your knowledge about the religions of the world here in North America will give you one more window into understanding current events. Predictions of futurists a generation ago that organized religions would just wither away under the advance of secularism have turned out to be wrong. In the wider world, people are as prone as ever to identify with ancient religious traditions. Religious fundamentalism is alive and even growing within most of the major religions of the world, including Buddhism, Christianity, Hinduism, Islam, and Judaism. While religious difference is usually only one of several causes of armed conflicts, it often functions to give a justification for continuing conflicts between tribes or nations. The universally recognized Dalai Lama from Tibet has brought new luster to Buddhism while being castigated by the Chinese government for fomenting a separatist movement. Muslims around the world have been judged by the actions of the terrorists who flew the two airliners loaded with jet fuel into the Twin Towers on September 11, 2001. The declaration of a worldwide caliphate in 2014 by the Islamic State of Iraq and Syria (ISIS), a jihadist military group, and the response of disaffected young Muslims around the world to join the fighting has increased the fears that Islam is inherently bent on the overthrow of all governments, in spite of the denunciation against ISIS by virtually all Muslim scholars and religious leaders.

Personal benefits and challenges

We are more than healthcare professionals. We are, first of all, human beings who share with all human beings, including our patients, the mysteries of existence and the common experience of suffering and the certainty of death. As creatures with a bent to find meaning in our lives, we seek to cope with events that seem to defy any rational explanation. The medical explanation of an immediate cause for the death of a child falls short of explaining why we are living in a universe where this can happen. Religious people, like other humans, seek to find a conceptual framework that accounts for and even counters the apparent randomness of events. Religions attempt to answer the fundamental questions of why we have been born, the purpose of our existence, and what, if anything, lies beyond this life. It is true that when we begin to study another religion we are confronted with strange terms and even stranger practices that may give us the feeling that we are studying the beliefs of aliens quite different from ourselves. But at a deeper level, studying the religious beliefs of faiths other than your own may give you a sense of the deep bond you share with all other persons. Any medical care that fails to give homage to this common humanity dishonors the dignity of those it seeks to heal.

If you consider yourself an adherent of a particular religion, you may sense the inherent challenges, and even risks, in studying other religions. Students often discover they were misinformed about what a particular religion actually teaches, as a result of taking a course on world religions. Occasionally an introductory course in world religions leads to further study into a new religion and even the change of religious affiliation. A former student described being required as a child to attend her parents’ church where she never felt at home with the ritual and loud preaching: “I often wanted to run out screaming.” When she was an adult student in a world religions course, she chose to visit a Buddhist retreat center where she felt embraced within the serene setting and calmed by the instruction in meditation that reduced her inner stress. She called me from 2500 miles away to announce that she had found her true spiritual home. Her case is an exception. Much more often students challenged in a course in world religions decide to look more closely at their own religious tradition and acquire a more accurate knowledge of its basic beliefs. As any teacher of world religions can attest, most Americans, regardless of the religious tradition to which they belong, have a limited understanding of the resources of their own religious tradition. It has often been observed that by learning a second language a person develops a more acute understanding of one’s native language. Likewise, a course in world religions often serves as a catalyst for a more mature grasp of a childhood faith.

While most healthcare professionals welcome the opportunity to better understand the religious perspectives of their clients and colleagues, not all are convinced, at least at the onset, of the need to spend time, effort, and expense to study the history and beliefs of various world religions. First, some are deeply convinced that their own religious faith is the only true one and that other religions teach dangerous ideas that can lead to the embrace of error, perhaps with eternal consequences. Typically persons holding this position also see it as their duty to share their beliefs with others, out of both a sense of responsibility and a concern for the welfare of others. Upon reflection, it becomes clear that any realistic attempt at sharing one’s faith requires a sound knowledge of the beliefs and practices of the other. All persuasion begins on common ground. Given that the social decorum of healthcare professionals demands appropriate restrictions upon sharing one’s faith, healthcare professionals living with a mandate to share their faith may live with an inner tension between the demands of their faith and their profession. Nonetheless, devout souls who await opportunities to speak of their faith are more likely to find receptive hearers if they are knowledgeable about the others’ beliefs.

A second group that may be resistant to investing in the study of world religions are those who describe themselves as non-religious and who are aware of what they consider to be the harmful effects of religious dogmatism and superstition – wars, religious extremists, entrenched opposition to scientific knowledge and even to beneficial health practices. Concern for their patients’ well-being may lead them to learn enough to avoid the pitfalls that would offend a devout patient. But a study of the worldviews and distinctive practices outside of the narrow healthcare arena seems irrelevant to the curriculum of a healthcare profession. It must be admitted that the non-religious or secular population is typically under-represented in courses on world religions. Perhaps you are part of that group. This marginalization masks the evidence that the secular or non-religious segment of American society, while still small, is growing in numbers and voice. Openly acknowledging the presence and the viewpoints of non-religious students is a vital step toward greater dialogue and engagement over the negative and positive influences of religion.

What is a world religion?

Ask ten people on the street for a definition of religion and you may get ten different answers, some focusing on the beliefs, some on practices or rituals. Even when scholars define religion, the results can be quite diverse, depending in part on whether a scholar is a sociologist or a psychologist, an anthropologist or a theologian. If the sociologist stresses the communal nature of religious practice and the social construction of religious beliefs, the psychologist may address religion within the individual’s search for autonomy and personhood. The anthropologist stands outside the circle of religious belief in describing myth and ritual within a specific cultural context, while the theologian presumes the possibility of communication with a supernatural reality. For the purposes of this book, rather than hammering out a definition of religion, our efforts can be better spent in identifying and comparing the features that are common to different religions and then to recognize the functions that religions and religious beliefs have.

Where do I come from? Why am I here? What happens after death? Religion can be understood as a response to these questions of human origin, purpose, and destination, especially in the light of the certainty of death and the uncertainties of life. The mystery of our own existence and the realization that we are transient creatures attracts many to religions that claim access to the unseen beyond the senses. Each day we are immersed in a stream of events that arrive without warning. Religions typically offer the believer some sort of coherent framework of meaning to interpret these apparently random events. Religions also issue directives on how we might impose a semblance of order in our daily lives through the observance of times of worship, prayer, reading of sacred texts, and meditation.

The focus of this volume is the so-called “world religions,” although Native American religions and new religious movements are included. Humans are universally religious. Yet not every religion can be called a world religion. When academics refer to world religions, the list typically includes Hinduism, Buddhism, Islam, Judaism, Taoism, Confucianism, and Christianity. Other religions occasionally included are Sikhism, Jainism, Zoroastrianism, and the Baha’i. Shinto, the national religion of Japan, and nature religions such as Wicca may be included as well. In addition to being widespread, the so-called “world religions” typically possess scriptures or religious texts that serve to anchor religious beliefs and written collections of authoritative teachings that can be transmitted from one generation to the next. Jews revere the Tanakh and study the rulings of rabbis found in the Mishnah and Talmud. Muslims consider the Qur’an to contain the very words of Allah and draw on the preserved rulings of legal scholars familiar with the collections of sayings about and by Muhammad. But humans have been religious long before they learned to transmit knowledge through the medium of writing. Throughout the world and on every inhabited continent, indigenous peoples have feared unseen spiritual forces and sought to control them or seek their favor, often by elaborate ritual and the observance of taboos.

Religion and culture

This textbook focuses on religions and on the religious beliefs and practices that are characteristic of religions, not on culture and cultural practices. But religion is a part of culture. Culture includes the totality of the customs and practices of a distinct group of people. So separating what is religious from what is simply cultural is not an easy matter. It might seem that the beliefs and rituals of a world religion like Buddhism or Islam or Christianity ought to be the same anywhere in the world. Yet the way a religion is actually practiced may vary considerably from culture to culture, and age to age. Labels like “fundamentalist,” “conservative,” “progressive,” and “liberal” are used to describe the variations within a religion and suggest that the individual variations in religious practices may not be isolated but part of a larger collection of specific practices and beliefs considered as “core” for groups within a given religion.

Deciding what belongs under the umbrella of religion can be complicated and even confusing. Persons living in one country may include rituals or customs as part of their religious obligations that persons belonging to the same religion but living in a different country consider optional or even refuse to practice. For instance, the practice of female genital mutilation or female circumcision is widely practiced in Egypt. According to a recent study, 92 percent of Egyptian women have undergone some form of female circumcision (Ministry of Health and Population et al. 2015: 185). The Egyptian government made the procedure illegal in 2008. Yet the practice persists. A frequently cited reason is the belief that good Muslim women undergo the operation. In contrast to the societal encouragement in Egypt, the conservative Muslim society of nearby Saudi Arabia looks down upon the practice as against the principles of Islam. Saudi Arabia has legally forbidden the procedure as well.

Who then decides whether a belief or practice is to be truly considered a religious obligation or simply a traditional cultural practice? In some religions, a recognized religious authority may make the decision about what is core and non-negotiable. Roman Catholics generally consider the decisions of popes, past and present, to define what they are to believe and practice. In some religions, there may be no comparable, universally recognized figure or authoritative group. More than 50 percent of Egyptian women still consider female circumcision to be a religious requirement (Ministry of Health and Population et al. 2015: 185). High-ranking religious leaders claiming otherwise are dismissed because they are government funded.

The impact of American culture on transplanted faith traditions is often profound. Immigrants who come to the United States from a country where their religion was sponsored by the government discover on arriving that if they want to retain their religious faith they must take more personal initiative in the practice of their religion than they had taken in their country of origin. The openness and even secularization of American culture can have a double-edge effect on religious minorities – on the one hand, leading to a deepening personal understanding of one’s faith, but on the other hand, raising legitimate concerns about the religious commitments of the second and third generation. I recall a Muslim businesswoman from Tanzania telling the students in my classroom that she knew more about her faith and why she was a Muslim than her relatives who remained in Tanzania, where their religion was taken for granted and supported by loudspeakers announcing the times of prayer.

Scholars of religions in America note that transported religions, including even the major world religions, tend to morph into more distinctly American forms. The openness of American culture makes isolation difficult. A continual infusion of new immigrants ensures the retention of traditional practices and views. But over time, something uniquely American or Westernized begins to emerge. Factors that drive this on-going process include the expectation of American women to fully participate and even lead out in religious functions, the constitutional freedom to openly discuss and debate religious matters, the recognized absolute right of personal choice in matters of faith, and the acceptance of inter-faith marriages. Debates over the physical presence of women in public worship continue to percolate in traditional Muslim and Orthodox Jewish communities.

The desire of immigrants to lessen prejudice by blending into the cultural landscape and to demonstrate loyalty to an adopted country leads to changes in the practice of their religion. R. H. Seager observes an indigenous American Buddhism in the making, though the process is far from completed (Seager 2002: ...