By Anne Bruce, RN, PhD

Recently I received an email from a clinical nurse specialist (CNS) seeking assistance with a challenging case review. The nursing staff were concerned that a patient’s Buddhist beliefs were a significant factor in what they saw as inadequate pain management. In their opinion, the patient’s beliefs were responsible for her refusing pain medication until she was in agony. This case raises important questions about the gaps in knowledge concerning faith and cultural perspectives in end-of-life care. A team of researchers at UVic and abroad embarked on a project to begin addressing questions of religion and what ‘good death’ entails.

The result is a recently published text, Religious Understandings of a ‘Good Death’ in Hospice Palliative Care (2012), edited by Harold Coward (founder of the UVic Center for Studies of Religion and Society) and Kelli Stajduhar (School of Nursing) that will serve nurses and care providers in palliative care worldwide. In addition to a chapter entitled, Buddhist Perspectives on Good Death, this research sparked further inquiry into the concerns presented in the case example above. Currently I am exploring understandings of suffering and death from a Vajrayana Buddhist perspective in comparison with Canadian palliative care practices. Contrasting these understandings may shed light on key questions faced by palliative care practitioners: How do taken-for-granted assumptions about a ‘good death’ constrain patients’ and families choices of dying in their own ways? To what degree is the choice to suffer truly a patient’s choice? How do taken-for-granted assumptions of suffering and dying from any perspective hinder health professionals’ capacity to serve? This research contributes to knowledge needs expressed by nurses dedicated to providing culturally and faith-sensitive palliative care.

Anne Bruce is the Acting Director, Nurse Educator Program Coordinator, and an Associate Professor and at the UVic School of Nursing.

From the 2013 Spring Communiqué — Palliative Care