Hindu End of Life: Death, Dying, Suffering, and Karma

Susan Thrane, MSN, RN, OCN


Journal of Hospice and Palliative Nursing. 2010;12(6):337-342. 

In This Article

Case Study 1

Mrs S. is an 85-year-old Hindu woman brought to the emergency room by ambulance. She has a history of congestive heart failure and hypertension. She has been in the hospital three times this year. She is having trouble breathing and "lightheaded," and her family is concerned. After diagnostic tests and physical examination, it is found that Mrs S. has symptoms of fluid overload, and her ejection fraction is 12%. A urinary catheter is inserted, and she is given a diuretic. Mrs S. goes into shock, develops respiratory failure, and is put on a ventilator. The physician has a discussion with the family about the seriousness of Mrs S.'s condition. Mrs S. does not have an advance directive. Hindus rarely have advance directives because of their belief in karma and reincarnation. After a discussion with Mrs S.'s husband and children, the decision was made to extubate and give comfort measures only. This decision to shift the goals of care to palliation is in line with Hindu beliefs relating to karma. Being kept alive by machine is often viewed as interfering with karma and inhibiting the natural course of death. Hindu people view death as a part of the natural cycle of life. Death is a transition to a new life. This case illustrates the importance of assessing cultural factors in palliative care and good communication to ensure optimum care.


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