by Amber Sukumaran
Hinduism is a very complex belief system. It is more than a religion--it is a way of life. Much confusion in the West lies in the fact that core Hindu beliefs are often undermined by social pressures. For example, abortion is considered a sin in Hinduism and is addressed in the scriptures many times over. However, many Hindu women in rural India feel pressured by society to abort female babies and have only male ones. This is in direct contrast to Hinduism's teachings of non-violence and the sacredness of life. It is also illegal in India to selectively abort babies.
Hinduism's steadfastness in its core principles and its abiltiy to adapt to modern changes have allowed it to last for many thousands of years. For that reason, there are many personal interpretations of specifics, but the core beliefs remain the same. Vegetarianism is taught throughout Hinduism as part of respecting the sacredness of life, but many who live near the sea eat fish, considering it "a flower of the sea."
First, let me explain a few basic concepts that pervade all sects of Hinduism and are relevant to medicine:
Ahimsa (non-violence): Cause no harm to other living beings either by action, word, or thought. This is why Hindus are tradionally vegetarian. By eating meat, a person takes the life of another living creature. Hindus believe that all creatures contain the life of God, the divine. By causing harm to another creature, a person causes harm to God's soul. Since all living creatures are part of God, by harming another person, you are ultimately harming yourself.
Karma: The universal law that what you put out into the world, either bad or good, comes back to you. It also is a way to describe the experiences that one has that helps to balance the person's soul. For example, if a person loses a leg in an accident, it could mean that he caused someone to lose a leg in the last life, or it could mean that he is need of learning compassion for the handicapped in order to further the development of the soul. Religious services, prayers, and acts of devotion soften karmas. They helps to reduce the intensity of the karma. Instead of losing a leg, the person might just break it, or stub his toe, for example. They also help a person to realize why they are experiencing things ("Perhaps I need to learn compassion for the handicapped"). When a Hindu realizes why the experience is happening and uses the experience to make him or her a better person, that karma is resolved and the person is freed from it. The end result of karma is that a soul gains a variety of experiences and wisdom over a series of lives, and eventually sees the world as God does. Karma can also be good and positive, and rewards in this life are considered the result of gains made in the last.
How do Hindus view medicine and medical treatment?
Hindus have a great respect for medical professionals, but many are quite wary of drugs and pills. If drugs are given, try to explain what it is for and what the effects are. Natural and homeopathic medicine is preferred over drugs and surgery in most cases.
Many Hindu diabetics do not take insulin made from animals, so explain what insulin contains before administering it.
What is the family structure?
The family structure is complex and extended. Traditionally, everyone lives under one roof--grandmother, mom, dad, children, and their spouses and children. In the West we see more nuclear families as young people settle here and start families. Normally, you would get a large extended family visiting at the hospital, but nowadays, most of the family is back in India or Malaysia. Traditionally, the man is in charge of taking care of the family outside the home. He makes all decisions on external family matters such as investments, education, and such. The woman is in charge of the home and family, and is very much respected within her family. She holds the home together, makes sure the children get religious instruction, and takes care of all other family matters. In the West, many families have both man and woman working outside the home, and therefore much of the social convention is lost. However, other Western families are still very traditional.
Are men are superior in the family? Do they make most of the medical decisions?
Depends on who you ask. Traditionally, men are not "superior." Men and women have different roles. Men are very protective of the women in their family. Mothers are sacred and treated with respect. The mother is the first guru to her child. Whether or not the husband makes the medical decisions depends on the family. In many cases, it is a family decision. If it concerns reproduction issues, the husband may play a greater part in the decision. Most Hindus are either very open to medical treatments, or very closed to them. I have not seen much in-between. When discussing medical information, try to include both husband and wife in the conversation. Then leave them alone to make a decision.
Male superiority in Hinduism has only come about in the last two-thousand years, stemming from foreign invasions and foreign cultures. It is traditionally a very matriarchial society.
What are nutritional considerations?
There are two answers to this.
How do Hindus treat death? How should a medical professional handle the body after death?
The time of death is determined by one's karma. Death and illness are generally accepted as being part of life, and most Hindus face this gracefully and quietly. A priest may be called in to do puja. Pujas may involve adorning the person's head with sandalwood paste, holy ash, and red kum kum powder. A red or yellow string may be tied around the person's wrist. Please allow this if possible, as it's very important in the dying process. When the person has passed away, it is important to allow the family members to wash and adorn the body if they wish. Autopsy, organ donation, and embalming are usually not preferred, but it depends on the family. Do not remove the sacred thread that men often wear draped over one shoulder. Also, do not remove womens' wedding pendants without prior consent of the family. Cremation is required.
How do Hindus view artifical life support?
Because artificial life support prolongs life after the brain is dead, it is not viewed favorably. Most Hindus believe that prolongling life after a person's time for death has come interferes in the karma of that person and does not allow the soul to move back into the cycle of reincarnation. When the choice is made to discontinue life-support, the timing is very important, down to the mintute. Priests may be consulted to determine the best time to release the soul. Heroic measures should be tried unless otherwise specified by the family, but most likely the family will allow death to come peacefull and without interference.
What do Hindus believe about the use of narcotics?
Highly discouraged. Many do not even take alcohol or caffeine, depending on their personal beliefs. All elevated states are achieved through meditation and increased awarness.
What are the social conventions I should be aware of during examinations?
Traditional protocol is not to point at someone ever (it's considered rude), and don't hand something to someone with your left hand, especially food or medicine. It becomes impure. Woman and men do not shake hands usually. During examinations, try to maintain modesty of women if at all possible. For example, close the curtain around the bed before examination, try to drape a cloth over every part of the body except what is being examined, try to have the husband or female family member present.
What do Hindus believe about birth control?
Rural indians do not widely use birth control, although it is catching on. I am not aware of any scriptures prohibiting birth control, but that does not mean that it does not exhist. The ideal form of birth control to use is abstinance, coming together only for the creation of another life. Most modern Hindus use some form of birth control. The most common form used is condoms. Anything that is taken orally or alters the body's chemistry or function is generally not accepted. Anything that harms a fertilized egg is generally not used for religious reasons. The modern trend in Hindu families is for only one or two children. More rural and less educated families may have more children.
What do Hindus believe about abortion?
Abortion is prohibited in the scriptures, as all life is sacred from conception. Social pressures often cause the mother to abort the child because of poverty or because the child is a girl. This kind of abortion is illegal in India but not well-enforced. Ultrasounds are only used in extreme medical cases, and the sex of the baby is not revealed in India. Below is more information on abortion.
Abortion: The deliberate termination of pregnancy. From the earliest times, Hindu tradition and scriptures condemn the practice, except when the mother's life is in danger. It is considered an act against rita and ahimsa. Hindu mysticism teaches that the fetus is a living, conscious person, needing and deserving protection (a Rig Vedic hymn [7.36.9, RvP, 2469] begs for protection of fetuses). The Kaushitaki Upanishad (3.1 UpR, 774) describes abortion as equivalent to killing one's parents. The Atharva Veda (6.113.2 HE, 43) lists the fetus slayer, brunaghni, among the greatest of sinners (6.113.2). The Gautama Dharma Shastra (3.3.9 HD, 214) considers such participants to have lost caste. The Sushruta Samhita, a medical treatise (ca 100), stipulates what is to be done in case of serious problems during delivery (Chikitsasthana Chapter, Mudhagarbha), describing first the various steps to be taken to attempt to save both mother and child. "If the fetus is alive, one should attempt to remove it from the womb of the mother alive..." (sutra 5). If it is dead, it may be removed. In case the fetus is alive but cannot be safely delivered, surgical removal is forbidden for "one would harm both mother and offspring. In an irredeemable situation, it is best to cause the miscarriage of the fetus, for no means must be neglected which can prevent the loss of the mother" (sutras 10-11). --From "Dancing With Siva"
How are newborns to be treated? Babies are not always named right away. Oftentimes, their name is determined by their astrology at the time of their birth. If the family is traditional, they will consult an astrologer to suggest the first syllable of the child's name, then take it to the temple and have a naming ceremony. The birth star and birth name are calculated from the time of birth and location in relation to the moon. A line is formed from the child, through the moon, and pointing to a star. The parents may hesitate to declare a name for the birth certificate in the hospital. Hindu babies are often adorned with a black mark on their forehead. This is a form of protection and is not toxic or harmful to the baby. If at all possible, allow the mother to adorn her baby as she desires.
Circumcision is NOT practiced in Hinduism. Do not circumcise babies unless the mother specifically requests it. Make sure the mother understands English well enough to make a decision.
Breastfeeding is preferred to formula. Many women choose to breastfeed their babies until age 2 or 3. This is not abnormal. I have heard of cases where social workers in the U.S. have taken babies away from the home because of late breastfeeding! Many Hindu women feel that Western babies are weaned too early and fed solid food at too early an age. If formula must be administered in the hospital, take care that it does not contain any animal byproducts except milk.
How should I treat the adornments that men and women often wear? Women tradionally wear a long gold wedding pendant around the neck under the clothes. It is not to be removed unless absolutely necessary. Even for x-rays, try to drape it up around the neck or head without removing it. If removal is necessary, do not handle it. Try to find a family member who will hold it. If the woman dies, allow a family member to remove it. Married women often wear a "bindi" red dot on the forehead. Please allow them to wear it, as they feel naked without it. The bindi protects them from the evil eye and wards off sickness.
Many men wear a sacred thread draped over the shoulder. Again, try not to remove it. Never cut it off. If it has to be removed, take it off without cutting and save it for a family member.
What do Hindus believe about organ donation?
Organ donation (either giving or accepting) is not accepted in principle, as it does not allow for complete release of the soul of the donor. Many may opt for transplants if they are more modern in thinking. Others may just choose to die peacefully. Blood transfusions are a little more acceptable, but not desirable. Transfusions and organ donations do not harm the reciever and are not subject to the same laws on non-violence, since the donors chose to give their bodies of their own free will (unlike animals). However, some believe that having the tissue of another person mingles the souls of the donor with the recipient. Not a common belief.