ABSTRACT
This chapter describes the world's major religions’ point of view on withholding and withdrawing futile therapy, feeding of patients in a vegetative state, the risk of speeding up the dying process while treating pain (double effect) and euthanasia. There are only few universally accepted religious rules – except that euthanasia usually is prohibited. In the Western world much emphasis is set on patient autonomy, with an obligation to inform extensively and correctly about diagnosis, treatment and prognosis. That is not necessarily an obligation when patients from the Far East are treated. Religion and culture are often intermingled matters. Apparently, religious persons will not always act according to the rules set by their church, because of their cultural/personal values and to complicate things further, first-generation immigrants may act and think very differently from second- or third-generation immigrants because of acculturation – they may have adopted the values of their new country. Probably, the only way to cope with these questions in a globalized world is to explore each patient's personal values and explore the role his or her family plays, because in some cultures it is the families, who have the final say in matters of treatment and level of information. In order to achieve a successful palliative process it is vital to try reaching consensus. Not only with the patient and with the family but perhaps most important, among the staff treating the patient, because also doctors and nurses will act, according to their religious beliefs and cultural values. The legislation of the society must of course always be adhered to, but on other issues where consensus is not accomplished, it is recommendable that the local rules and ethics of the workplace are followed. Information from the clergy of the patient's religion may be of help, but to follow advice/directions from the clergy will not always be advisable, as these may contradict legislation or ethics of your society.
