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Patients who refuse a specific medical treatment for religious reasons must often overcome strongly entrenched presumptions held by physicians and judges, presumptions frequently based on personal values. A case in point is the refusal of blood transfusion therapy by Jehovah's Witnesses. / This paper rests on the following theory: The sanctity of life principle is not necessarily violated by respecting the autonomous decision of a patient who, for religious or moral reasons, chooses one therapy over another that may be favored by the treating physician. Where a patient has decided for conscientious reasons against a certain treatment in any given medical situation, the need to be informed will shift from the patient to the physician. The physician must understand the nature of the religious or moral conviction, as well as his own moral and legal obligation to respect the patient's wishes by providing the best medical care under the circumstances.

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Academic and medical institutions are responding to rising critiques of mainstream, scientific medicine (biomedicine). One response is the establishment of centers and programs devoted to whole person care. I assess the response of the McGill Programs in Whole Person Care (WPC) to these critiques, particularly its incorporation of spirituality into medicine. Through textual hermeneutics, participant observation, and semi-structured interviews with faculty members, I argue that WPC is constructing its own worldview and normative framework. It does this by selectively drawing from the religious traditions of ancient Greece, Buddhism, and Christianity, interpreting these selections in terms of Jungian psychology, and sometimes secularizing them. My aim is to better understand the theory and praxis of whole person care in McGill University's Faculty of Medicine as a case study but also the ethical issues it raises. I conclude by providing points of reflection for institutions wishing to incorporate these health ideas and practices into conventional medicine.

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Aim: The aim of the study was to explore the lived experiences of critical care nurses with Muslim traditional practices. Methodology: A phenomenological approach was used in the study to gain the critical care nurses' perspectives of Muslim traditional illness practices. The realised sample was six participants, from intensive care units within one provincial and one private hospital. The researcher applied the principle of theoretical saturation, which was achieved at the verifying interviews of the participants. Two semi- structured interviews were conducted with each participant an initial and a verifying interview, each of which lasted 20 - 30 minutes. All interviews were recorded and transcribed. Manual data analysis was used to identify categories and themes. Findings: The participants were open-minded to the Muslim clients' belief system on healing and agreed that the clients' cultural beliefs took precedence over their own beliefs. The participants believed that Muslims relied on traditional illness practices as these provided them with hope and faith in times of despair as well as provided them with emotional and spiritual contentment. A number of methods were used by the participants to acquire knowledge about Muslim traditional illness practices. There was great support for the delivery of culturally sensitive care amongst the critical care nurses. Recommendations were suggested for nursing education, nursing practice and further research to facilitate the creation of a culturally sensitive climate in health care delivery. / Thesis (M.N.)-University of Natal, Durban, 2003.

The central theme or 'red-thread' that I consider in this thesis is the concept of risk as it is perceived by and affects the two sides of the medical encounter -in this instance ethnic Pakistanis and Health Professionals- in Britain. Each side very often perceives risk quite distinctively, relating to the balance between the spiritual and temporal realms. This is particularly germane in matters to do with possible congenital defects within the prenatal realm for the ethnic Pakistani, and predominantly Muslim, side of this encounter. Thus one of the factors considered in this thesis is how senses of Islam impact upon the two sides. By ethnic Pakistanis Islam is seen as central to all life decisions, whilst Health Professionals view Islam with some considerable trepidation, little understanding it or its centrality to the former's decision-making processes. This is particularly significant with regard to attitudes to health and health care. In the initial stages of the project I had thought first cousin marriage (FCM), seen by ethnic Pakistanis as desirable and by Health Professionals as putting ethnic Pakistanis at-risk to be central to the argument, but concluded that concerns around FCM were a 'red herring', merely a trope for the tensions between the two sides -at once both British and at-risk from audit culture. Although no longer central, FCM remains a viable touchstone in consideration of the two sides' perceptions of genetic risk. In this thesis the medical encounter between ethnic Pakistanis and Health Professionals is performed within the realm of the so called New Genetics. Here the respective understandings of the New Genetics are informed by the enculturation processes that shape the two sides' world view. Furthermore, I will agree with Lord Robert Winston's and others' concern that any attempt to eradicate an adaptive genetic mutation, in this instance, thalassaemia, from the gene pool is not only undesirable in the short term, but also that such eradications may have an adverse, and far reaching, effect on whole population groups in the future. The main thrust of my argument is that audit culture not only compounds risk for both sides, but also perpetuates institutional racism within the National Health Service (NHS), by promulgating what I have called the language myth. That is to say that much institutional racism is the unwanted by-product of the NHS's attempts to become more patient centred and its continuing efforts to develop systems of best practice. This professionalisation process within the NHS can be seen to impact most strongly in relation to communication -particularly the claimed language barrier between the two sides. This 'barrier' has worrying policy implications for any meaningful communication between the two sides, notably relating to obtaining informed consent from ethnic Pakistani patients -with a resultant increase in risk for the two sides and clear economic consequences for the NHS.

In South Africa faith plays an important role in community-based volunteering related to HIV and AIDS work. Many community-based volunteers make use of their faith to provide healthcare and social services related to HIV and AIDS. This research examines this faith or religious vibrancy and critic two things: (1) to what extent such volunteers can be understood as a Religious Health Asset, and (2) what criteria can be used to consider community-based volunteers as a new form of the church emerging in a time of HIV and AIDS. The research first examines the concept of voluntary work in South Africa, particularly in times of HIV and AIDS. Field research relies on community based volunteers linked to Sinomlando, a research centre at the University of KwaZulu- Natal through participant observation and open ended interview method. I examine faith or religious aspects in volunteers serving the communities. The research notes that in community-based volunteering, the use of prayers, religious choruses and/or quoting of the Bible is a visible faith practice. I learnt that prayers and choruses are spontaneous, and they are volunteers’ expression and release of emotions caused by socio-economic stressors. The use of the Bible is not a common practice among groups of volunteers as it is with praying and singing. Given this, the thesis argues that faith practices in community-based volunteering can be understood as a religious health asset. Using the ecclesiogenesis theory of Leonardo Boff, the thesis then analyses whether these groups signify a new form of the church is emerging. However, the finding is that they do not constitute a new form of the church, but rather a new form of missionary spirituality as the laity is taking on the responsibility of living out their faith in a new context and in the face of new challenges. / Thesis (M.Th.)-University of KwaZulu-Natal, Pietermaritzburg, 2009.

A qualitative design was used to explore the use of spirituality and prayer by older adults who have chronic illness and reside in a rural community. Thirteen individuals responded to a flyer soliciting participation in a study of the use of spirituality as part of health care. Participants were at least 60 years of age, had at least one chronic illness and resided in North Central Florida. Twelve participants then responded to six open-ended questions based on an adaption of an instrument used by Dr. Shevon Harvey in her doctoral dissertation. The data was analyzed to identify themes and answer four research questions. The four research questions were 1) how do older adults living with chronic illness describe spirituality? 2) how do older adults use spirituality while living with chronic illness? 3) how can health care providers assist older individuals with chronic illness to meet their spiritual needs?, and 4) do patients feel that their spiritual needs are being addressed during their outpatient health care? The interview responses demonstrated that several different practices, including prayer and scripture readings as well as adherence to medication, diet, and exercise recommendations were used as coping mechanisms by study participants. The majority of participants want their health care providers to address spirituality and/or refer them to spiritual advisors for counseling. The study showed that some participants stated that their spiritual needs were met, but there were some who did not want spirituality addressed in the outpatient setting. Four themes were identified, which suggest that 1) spiritual practices were frequently used coping measure for these individual with chronic illness, 2) health care providers are supportive iv of their patients’ spirituality, 3) participants with chronic illness consider adherence to medication, diet, and exercise a coping measure, and 4) participants with chronic illness want their health care providers to recognize their spiritual needs. The findings indicated that individuals who self identify as individuals from whom spiritual life is important and who have chronic illnesses and have spiritual needs that can be addressed in the outpatient setting. The findings also demonstrated use of non spiritual coping measures and the importance of health care provider’s acceptance of spirituality in this specific population. Recommendations for further research are made.