title: Hinduism and death with dignity: historic and contemporary case examples.
abstract: An estimated 1.2 to 2.3 million Hindus live in the United States. End-of-life care choices for a subset of these patients may be driven by religious beliefs. In this article, we present Hindu beliefs that could strongly influence a devout person's decisions about medical care, including end-of-life care. We provide four case examples (one sacred epic, one historical example, and two cases from current practice) that illustrate Hindu notions surrounding pain and suffering at the end of life. Chief among those is the principle of karma, through which one reaps the benefits and penalties for past deeds. Deference to one's spouse or family is another important Hindu value, especially among Hindu women, which can impact the decision-making process and challenge the Western emphasis on autonomy. In addition, the Hindu embrace of astrology can lead to a desire to control the exact time of death. Confounding any generalizations, a Hindu patient may reject or accept treatments based on the individual patient's or family's interpretation of any given tradition. Through an awareness of some of the fundamental practices in Hinduism and the role of individual interpretation within the tradition, clinicians will be better able to support their Hindu patients and families at the end of life.
authors: Department of Pathology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, YA 309, Boston, Massachusetts 02215 USA. rdewar@bidmc.harvard.edu.
authors: Rajan
authors: R
authors: Dewar
authors: Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, Massachusetts 02215 USA.
authors: Nancy
authors: N
authors: Cahners
authors: Harvard Medical School, Center for Bioethics, 641 Huntington Avenue, Boston, Massachusetts 02115 USA. christine_mitchell@hms.harvard.edu.
authors: Christine
authors: C
authors: Mitchell
authors: Palliative Care Program, Department of Medicine, Beth Israel Deaconess Medical Center, YA-109, 330 Brookline Avenue, Boston, Massachusetts 02215 USA.
authors: Lachlan
authors: L
authors: Forrow
mesh_terms: D001255:Astrology; D003142:Communication; D003466:Cultural Characteristics; D003643:Death; D003657:Decision Making / Q000941:ethics; D004522:Educational Status; D005260:Female; D018596:Hinduism / Q000523:psychology; D049673:History, 20th Century; D049690:History, Ancient; D006801:Humans; D007194:India; D008297:Male; D009229:Mythology; D010146:Pain / Q000523:psychology; D059408:Pain Management / Q000941:ethics / Q000266:history / Q000523:psychology / Q000592:standards; D010166:Palliative Care / Q000941:ethics / Q000379:methods / Q000592:standards; D026684:Personal Autonomy; D012068:Religion and Medicine; D012297:Right to Die; D018454:Spouses; D013315:Stress, Psychological / Q000523:psychology; D013727:Terminal Care / Q000941:ethics / Q000266:history / Q000523:psychology / Q000592:standards; D013997:Time Factors; D014481:United States