Death, Religion and Law

A Guide For Clinicians

Peter Hutton, Ravi Mahajan, Allan Kellehear

• Publisher: Routledge
• Year: 2019
• ISBN:
  9780429952784
• Edition: 1
• Topic: Medicine
• Subtopic: Medical Theory, Practice & Reference

This practical guide summarizes the principles of working with dying patients and their families as influenced by the commoner world religions and secular philosophies. It also outlines the main legal requirements to be followed by those who care for the dying following the death of the patient.

The first part of the book provides a reflective introduction to the general influences of world religions on matters to do with dying, death and grief. It considers the sometimes conflicting relationships between ethics, religion, culture and personal philosophies and how these differences impact on individual cases of dying, death and loss. The second part describes the general customs and beliefs of the major religions that are encountered in hospitals, hospices, care homes and home care settings. It also includes discussion of non-religious spirituality, humanism, agnosticism and atheism. The final part outlines key socio-legal aspects of death across the UK.

Death, Religion and Law provides key knowledge, discussion and reflection for dealing with the diversity of the everyday care of dying and death in different religious, secular and cultural contexts. It is an important reference for practitioners working with dying patients, their families and the bereaved.

Part I

Belief systems in society and human history

Interpretations of the mysteries of life and death

Chapter 1

Introduction to death and religion in society

Doctors, nurses, physiotherapists, social workers and all other health and social care staff follow undergraduate and postgraduate training that is predominantly designed to give them the professional tools to practise safely. This is as it should be because the application of specialized skills to meet agreed standards is the cornerstone of quality care.

During training there will be some teaching on the wider issues of management such as ethics, withdrawal of care and legal issues surrounding death. It is however generally only in advanced practice, several years after professional qualification, that practitioners look at the patient in a truly holistic manner and consider their beliefs and societal context when deciding with them and their relatives the best course of action. Yet when patients are approaching the ends of their lives and when they actually die, at key moments such as breaking bad news or confirmation of death it is often those who are only recently qualified that are the ones present to speak to patients, manage events and have discussions with relatives.

The management of the final days is so important for the patient and their loved ones. Also, after death, how these events evolved and the manner of their happening are crucial factors for relatives or close friends in determining poor or positive bereavement outcomes. This is even more so when death is sudden or tragic. Clinical staff do their best at handling death and its consequences, but good will, although vital, needs to be underpinned with a knowledge and appreciation of how major life events are interpreted, shaped and dealt with by persons who, both socially and in their belief systems, are unlike themselves.

The majority of healthcare staff do think about life and death but it is inevitably against a background of their own social and religious beliefs. These various beliefs (both explicit and implicit) are ingrained into all societies and have been so for millennia. There is normally an appreciation of the variations of the attitudes and beliefs of others in a modern multi-cultural society, but this may simply be formed and bounded by the lottery of life’s experiences. Albert Camus in his novel L’Étranger¹ and Henrik Ibsen in his play An Enemy of the People² focused on the importance of the membership of one’s ‘tribe’ in society and the penalties and alienation that result when an individual declines to conform to social norms. Such tribalism inhibits spontaneous assimilation of other people’s lifestyles. A special effort and an appreciation of ‘where the other person is coming from’ has to be made by a healthcare worker to properly engage and interact at a meaningful level with a member of ‘another tribe’.

As will be seen in Part II of this book, religion and belief systems are another visceral component of a person’s constitution, whether they necessarily appreciate it or not. In approximately 700 BCE Homer declared that:

all men have need of the gods³

and over 2,000 years later Voltaire in one of his epistles wrote:

If God did not exist, it would be necessary to invent him.

Let the wise man announce him and kings fear him.

Kings, if you oppress me, if your eminencies disdain

The tears of the innocent that you cause to flow,

My avenger is in the heavens: learn to tremble.

Such, at least, is the fruit of a useful creed.⁴

Today things are just the same, even if the players are different. Religions are living, ever changing mediums into which people are born. Faiths consider the metaphysical nature of being and the hereafter, care for the psyche and provide social structures with their own behavioural norms. They are constantly morphing as time passes. Some grow, others contract and different belief systems cope well or not so well with the modern world.

The possible combinations of social tribes, religious beliefs (or otherwise), metaphysical ideologies, ethnicities and legal structures that surround dying, death and the disposal of bodies are limitless. There is a vast literature available covering all these aspects, but they are dispersed and not always easy to source. In short, it is difficult for a busy healthcare professional to easily access a succinct review of what matters to different people in life and death so as to be able ‘to put themselves in their shoes’. In this book we attempt to provide an overview of this landscape. The drivers for faith, tolerance and intolerance, the characteristics of religions, the possibilities of a soul and an afterlife, what death means to different people, the entanglement of religion, ethics and societal development and the uses and abuses of religion are all discussed.

To demonstrate the breadth of approaches, which those who have tried to tackle these issues of human existence have used, examples are drawn from the past and present, countries across the world, religious and secular texts, poetry, plays, musicals and scientific papers. Our hope is that this text will provide a conveniently accessible, unbiased and readable source for those who want the knowledge but who, in the jargon, ‘are not time rich’. Although they will probably find more questions than answers, knowing what others think and believe is fundamental to compassionate practice.

Notes

1 Camus A (2013 [1942]): The Outsider (L’Étranger), translated by Smith S, Penguin Modern Classics.

2 Ibsen HJ (2018 [1882]): An Enemy of the People, translated by Marx E, CreateSpace Independent Publishing Platform.

3 Homer (2003 [c.700 BCE]): The Odyssey, translated by Rieu EV, Penguin Classics, book 3, lines 45–50.

4 Voltaire (1877–1885 [1768]): Epître à l’auteur du livre des Trois imposteurs (Oeuvres complètes de Voltaire, edited by Louis Moland, Garnier, tome 10, pp. 402–405), available at: www.whitman.edu (search for The Voltaire Society of America).

Chapter 2

Faith, why people believe and the need for tolerance

Although there are anthropological views suggesting that some cultures believed in an afterlife whilst others did not, from the time it was possible to chip thoughts into stone and paint images on walls, generations of humans have conjectured on the purpose of existence and the possibilities of life after death.

These questions are not new, but their resolution and the belief systems created to explain them depend upon a contemporaneous interpretation of society and scientific knowledge. Since these change, so too do perceptions of reality and belief. Proposed paths to understanding commonly, but not always, result in the postulation of one or more great powers or gods, or a Creator, or a single divine being or God who is eternal. As time passes, following the traditional ordained creed can set a group apart as it observes its stipulated rules and tries to maintain them within a wider social or pluralistic national setting.

Fundamentalists adhere to what they assert to be the original beliefs and prescribed behaviours set out when a religion was created, but many others would argue that to do so is illogical because the personal, local and world situation is constantly changing. Each generation gains new insights into their sacred texts through the lens of their current times and culture. This is the sociological meaning of the term ‘revelation’, which should not be confused with the religious meaning of ‘revelation’ that describes a divine or supernatural communication to a man or prophet from a god. Re-interpretation and/or modification to original tenets create branches and divisions within the founding faith: this phenomenon is present throughout all the major world religions. Hence for many, religion is a living paradigm within which there is a need to respond and to modify one’s beliefs and practices as time progresses, knowledge accumulates and society changes.

Consequential links between religious belief and practice and social development were analysed by Weber in his classic The Sociology of Religion where he introduced the term ‘theodicy’. The theodicy of fortune (privilege) and misfortune (disprivilege) is the theory of how different social classes adopt different belief systems to help explain their social situation. These distinctions can be applied not only to class structure within a society but also to denominational and ethnic segregation within religions. In relation to ancient Eastern religions he writes:

Wherever a developing priestly ethic met a theodicy of disprivilege halfway, the theodicy became a component of congregational religion, as happened w...