The Humanist Society (Singapore) has conducted some research into non-religious perspectives on palliative care for non-religious individuals.
We would like to bring up two articles below, and have provided a summary.
Key points from the two articles
Diversity of belief and non-belief increased dramatically in recent decades. There is diversity not just between religions, but also between religious and non-religious, and within the religious and non-religious populations.
Many life questions are shared by faith and non-faith, for concerns about identity and meaning are universal. Some terminology will be shared by religious and non-religious, such as “spiritual”.
However, there’s potential conflation of ‘spiritual’ and ‘religious’ among patients. While some non-religious individuals identify themselves as “spiritual but not religious”, some others are uncomfortable with the word.
Hospice UK has come across some patients who decline a spiritual care visit because they are not religious. For this group, caregivers can use vernacular, everyday terms that are used to describe everyday experience.
For the non-religious, two broad paths to meaning or purpose in life:
- Meaning through work or action, the external world of achievement.
- Meaning through encounters or relationships; the internal world of experience.
Many people’s lives contain a mixture of the two.
How can we provide comfort to non-religious palliative care patients?
We can spend time listening to particular concerns or to life stories, and identifying the values, strengths, hopes and fears that they reveal.
Patients often find value in being listened to carefully and sympathetically, and gentle probing can help to articulate their concerns.
There may be no direct answers to their questions but sometimes the process of clearly identifying them can provide its own answers.
People in palliative care may want to talk about their fears of dying and their regrets at their lack of time.
They may want to review their lives and take stock of them, perhaps talking about what they have done in the external world of work and action as well as the relationships they have enjoyed in the world of experience.
They may want to settle their affairs and leave as few loose ends as possible, and exercise control over these areas for as long as they can.
In the act of listening the care-giver may be able to offer reassurance, or help the patient to arrive at his or her own self-reassurance, that the life that is coming to an end has meaning, validity and value.
While it is easier and faster to provide ready-made answers from religious texts, facilitating the patient’s journey to find his own closure is the best comfort for the non-religious person.
In one of the two articles, there is a survey of non-religious people in the United States to understand their views on end-of-life care.
In this research paper, the author surveyed participants in closed online social media groups designated as being for “atheist,” “agnostic,” and “secular” social media users.
The author surveyed 263 participants, mostly from the US, comprising:
- 67% atheist
- 23% agnostic.
- 8% humanist
- 6% spiritual
Survey found that support for hospice care is strong: 96% of the total survey respondents indicated that if presented with a situation in which medical interventions were unlikely to improve their quality of life in the wake of a terminal illness, they would choose hospice care.
There is wariness of religious chaplains: 63% reported that they would decline chaplain services.
There is wariness of proselytisation: Of survey participants that were open to chaplain services, many expressed the importance of not being proselytised to.
Religious expressions offered for comfort could cause the non-religious to feel angry. Some non-religious feel that the chaplains praying for them is taking care of their own emotional needs rather than the needs of the dying person.
Empathy is a recurring theme: Empathy for the needs of others and acknowledgement of varying world views. Many non-religious people approaching end-of-life emphasized that they do not hate religious people.
A 39 year old atheist man from South Carolina shared, “I respect my friends’ and family members beliefs and would want them to receive whatever care they need when I die.” A 65 year old atheist from California shared that she would want religious healthcare workers “to know I don’t hate their god.”
One key thing to note is non-religious people are “not obvious” in their non-religiosity.
Non-religious people do not wear any accessories, wear head-gear or take on names that make it obvious that they are non-religious.
Thus, the patient’s identity should be part of the initial healthcare assessment.
Overall, the two articles recommend:
To better care for the non-religious
– Relate to everyday experience, expressed in vernacular, everyday terms
– Listen to their concerns / life stories.
– Identify their values, strengths, hopes and fears.
– Reassure, or help the patient to arrive at his or her own self-reassurance that the life that is coming to an end has meaning, validity and value.
Palliative caregivers need to avoid:
– Assuming the person’s religiosity from name and appearance, even if they have overtly religious names.
– Providing a chaplain, unless the non-religious person requests for it
– Proselytisation during a chaplain’s service.
– Using religious terms that are meaningful only to a particular religious community
