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Sikh Perspectives on Health Care, Dying and Death

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Title: Sikh Perspectives on Health Care, Dying and Death


1
Sikh Perspectives on Health Care, Dying and Death
2
What is Sikhism?
  • Sikhism is a monotheistic religion founded in the
    15th century in the region of northern India
    called Punjab.

3
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4
Sikh demographics
  • Sikhism is the 5th largest religion in the world
  • approximately 25 million Sikhs worldwide
  • approximately 500,000 Sikhs in the United States
  • several Gurdwaras (Sikh temples) in the Metro
    Detroit area
  • 2 of Indian population 3 of Canadian

5
Who is a Sikh?
The word Sikh means disciple.
6
Basic Tenets of Sikhism
  • Kirat karna -- To live an honest life, to be fair
    in all personal and professional dealings, to
    earn an honest living
  • Naam japna -- To meditate on the Name of God
  • Vand chakna -- To share wealth and do charitable
    work (seva)

7
Basic Tenets of Sikhism
  • There is one universal God and that God resides
    within God's creation
  • The goal of human life is to lead a life of
    prayer meditation and service so our souls may
    merge with God
  • The path to salvation does not lie in
    renunciation or celibacy, but leading the life of
    a householder

8
Basic Tenets of Sikhism
  • Sikhism condemns rituals and blind faith
  • People of all races and religions are equal in
    the eyes of God, as are men and women

9
Founding of Sikhism
  • Founder of Sikhism, Guru Nanak
  • Born in 1469 C.E.
  • Nine human Gurus followed Guru Nanak

10
Guru Granth Sahib
Compilation completed by 10th Guru, Guru Gobind
Singh in 1705 Written in Gurmukhi 1430
pages Contains the poetry of 6 Gurus and many
Muslim and Hindu saints/ scholars/poets
11
Gurmukhi Script
The Guru Granth Sahib and small prayer books
(gutkas) are written in this script.
12
Gutka
  • If you see this at a patients bedside, please
  • ask before moving
  • wash hands before touching
  • do not remove cloth if gutka is covered
  • do not place on the floor or near patients feet

A gutka is a small book that contains the Nitnem
(the 5 daily prayers recited by Sikhs).
13
What is the Khalsa?
The Khalsa (the Pure Ones) is an order of
baptized Sikhs who pledge to maintain the
distinct identity of the Khalsa and uphold the
Rahit Maryada.
14
Panj Kakkars (5 Ks)
  • Kesh (unshorn hair) -- acceptance of Gods
    will/design

15
Panj Kakkars (5 Ks)
  • Kachhera/kachha (a knee-length garment normally
    worn under clothes) -- modesty, purity and sexual
    restraint

16
Panj Kakkars (5 Ks)
  • Kangha (small comb worn in the hair) --
    cleanliness
  • Kara (steel bracelet) -- unity and protecting
    oneself

Kangha a small comb worn in the hair
Kara steel bracelet
17
Panj Kakkars (5 Ks)
  • Kirpan (sword) -- responsibility to fight
    injustice

Gatra a strap that enables a kirpan to be
suspended near one's waist or tucked inside one's
belt
Kirpan ceremonial sword
18
Types of Sikhs Different Levels of Orthodoxy
  • Amritdhari
  • Keshdhari
  • Sahajdhari

19
Amritdhari Sikhs
Amritdhari Sikhs have been baptized into the
Khalsa order according to the Amrit ceremony of
Guru Gobind Singh. All Amritdharis are required
to wear the 5 Ks, recite the daily prayers, and
live by the Sikh Rehat Maryada.
20
Keshdhari Sikhs
Keshdhari Sikhs keep their hair, but may or may
not wear the other four Ks. You cannot usually
tell whether a Sikh is keshdhari or amritdhari
simply by looking.
21
Turbans go With Hair
22
Some Women Wear Turbans
23
Sahajdhari Sikhs
Sahajdhari Sikhs believe in one God, the 10
Gurus, the Guru Granth Sahib, the importance of
the Khalsa baptism, and do not claim to be any
other religion. They do not necessarily keep
their hair, and may or may not wear any of the
other four Ks.
24
Views on Death
  • Death is not the end, it is an inevitable part of
    life
  • The soul does not die, only the body does
  • Human life is a gift. It is the only opportunity
    we have to meet God

25
Views on Death
  • We want to die while alive.
  • Achieve the highest state of consciousness
  • Eliminate duality between self/God/creation
  • Eliminate Fear of death

26
Religious and Cultural Considerations in the Care
of Sikh Patients
27
Health-Seeking Beliefs
  • Whoever is born will eventually die
  • Physical body is perishable, but soul is eternal
  • The soul is a part of the One Universal Creative
    Force and yearns for reunion
  • Liberation from the cycle of birth and death,
    from millions of life forms ? Human life is
    valuable

28
Health-Seeking Beliefs
  • Concept of hukam (Gods will)/kismat (fate or
    destiny) -- acceptance of illness
  • Fighting spirit/martial tradition of the Sikhs --
    active role in illness
  • Generally, Sikhs will accept their physical
    state, but will also try to improve it

29
Illness Behaviors
  • Illness may be in the hukam, but ones effort is
    required in recovery
  • Meditation or recitation of Gurbani by patient or
    visitors
  • Shabad Kirtan Singing of poetry from the Guru
    Granth Sahib by patient or visitors, CD, tape,
    DVD, Mp3, phone
  • Cultural practice Family and family friends

30
Illness Behaviors
  • Ardaas Prayer of supplication
  • Done at any time, particularly time of death or
    birth or other difficult times.
  • Meditation

31
Modesty
  • Cultural issue
  • Head coverings
  • Rehat Maryada specifies that Khalsa Sikhs must
    always wear kachhera
  • Most women would prefer to keep themselves as
    covered as possible

32
Diet
  • Meat is not served at langar
  • Rehat Maryada states that Sikhs cannot eat
    ritually slaughtered meat
  • Some Sikhs are vegetarian and some are not
  • Sikhs do not fast for any reason

33
Community on Health Care
  • Sanctity of life is an injunction, therefore
  • Assisted suicide and euthanasia not encouraged
  • Therapeutic genetic engineering accepted

34
Community on Healthcare
  • Pregnancy and birth are celebratory events
    cultural biases against females
  • Reproductive assistance only within marriage
  • Therapeutic abortions accepted (injunction
    against female infanticide in Gurus writings and
    the Rehat Maryada)
  • No postpartum rituals

35
Community on Healthcare
  • Organ transplants and blood transfusions
    accepted Sikh youth encouraged to donate
  • Male infants not circumcised

36
Your Approach
  • Family important in decision making
  • Respect modesty and privacy
  • Vegetarian choices
  • Familiar food is an issue for older Sikh patients
  • We encourage hospitals and long term care
    facilities to have Sikh chaplain on list.

37
Your Approach
  • Avoid interrupting prayer or meditation for
    routine patient care
  • Sensitivity to 5 Ks particularly turban for men
  • Consult patient and family before procedures
    requiring removal of hair

38
Nursing Home/Assisted Living Care
  • Culturally, nursing home are usually considered
    acceptable for temporary or rehabilitation care.
  • Most families will bring elders home if at all
    possible.
  • Providing advice on elder care

39
Advance Directives
  • Advance directives are individual choices
  • Maintaining a terminal patient on artificial life
    support for a prolonged period in a vegetative
    state is not encouraged, so most Sikhs will
    probably specify a period of time during which
    they would prefer to be kept on life support
    because mind is not alive anymore

40
End of Life Care
  • No contraindication to autopsies
  • Consult patient, family and Sikh scholar
  • Have relatives and Sikh granthi nearby to recite
    Shabad Kirtan
  • Death is viewed as a part of life, not to be
    feared

41
Hospice care
  • No contraindication to palliative care
  • Patient might be very comforted bySikh hymns,
    prayers and meditation.
  • Family or Gurdwara granthi can do this
  • Be sensitive to officials of other religions
    doing prayers with patients

42
End of Life Care
  • Allow family and granthi to follow traditions to
    prepare body for cremation
  • Body to be cremated expediently, unless waiting
    for relatives to arrive

43
Traditions at the Time of Death
  • Family and Friends Gather, pay condolence calls
  • Prayer services/reading of the scripture at home
    or at the Gurdwara
  • Prayer service at the funeral home
  • Cremation

44
Philosophy Surrounding Death
  • End of body, not soul
  • Soul is meeting with great soul
  • Ardaas/supplication is that God take the departed
    back to the true home

45
Resources
Sikh Patients Protocol for Health Care
Providers, www.sikhwomen.com/health/care/index.htm
The Sikhism Home Page, www.sikhs.org Shiromani
Gurdwara Parbandhak Committee, www.sgpc.net Gatewa
y to Sikhism, www.allaboutsikhs.com The Sikh
Coalition, www.sikhcoalition.org Sikh-Seek (Sikh
search engine), www.sikhseek.com
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