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. 2017 Oct;15(5):609-622.
doi: 10.1017/S1478951516001061.

A systematic review of religious beliefs about major end-of-life issues in the five major world religions

Rajshekhar Chakraborty  1 , Areej R El-Jawahri  2 , Mark R Litzow  3 , Karen L Syrjala  4 , Aric D Parnes  5 , Shahrukh K Hashmi  3
Affiliations

A systematic review of religious beliefs about major end-of-life issues in the five major world religions

Rajshekhar Chakraborty et al. Palliat Support Care. 2017 Oct.

Abstract

Objective: The objective of this study was to examine the religious/spiritual beliefs of followers of the five major world religions about frequently encountered medical situations at the end of life (EoL).

Method: This was a systematic review of observational studies on the religious aspects of commonly encountered EoL situations. The databases used for retrieving studies were: Ovid MEDLINE In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid EMBASE, Ovid PsycINFO, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and Scopus. Observational studies, including surveys from healthcare providers or the general population, and case studies were included for review. Articles written from a purely theoretical or philosophical perspective were excluded.

Results: Our search strategy generated 968 references, 40 of which were included for review, while 5 studies were added from reference lists. Whenever possible, we organized the results into five categories that would be clinically meaningful for palliative care practices at the EoL: advanced directives, euthanasia and physician-assisted suicide, physical requirements (artificial nutrition, hydration, and pain management), autopsy practices, and other EoL religious considerations. A wide degree of heterogeneity was observed within religions, depending on the country of origin, level of education, and degree of intrinsic religiosity.

Significance of results: Our review describes the religious practices pertaining to major EoL issues and explains the variations in EoL decision making by clinicians and patients based on their religious teachings and beliefs. Prospective studies with validated tools for religiosity should be performed in the future to assess the impact of religion on EoL care.

Keywords: Advance directives; Artificial nutrition and hydration; Autopsy; End of life; Euthanasia; Pain management; Religion.

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Conflict of interest statement

DISCLOSURES

All the authors have completed the unified competing interest form (see www.icmje.org/coi_disclosure.pdf; available on request from the corresponding author) and declare the following: (1) none of the authors have any financial interests related to the submitted work in the previous three years; and (2) their spouses, partners, and children have no financial relationships that may be relevant to the submitted work. All the authors had full access to all of the study data and can take responsibility for the integrity of our study and the accuracy of its analysis.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram. Adapted from Moher et al. (2009).
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