This qualitative study of eight First Nation participants and five First Nation Elders is to help understand how First Nation people view spirituality and how it is practiced when one has a terminal illness. Spirituality is often so abstract and practiced in various ways that it requires clarity and understanding from the people around them. Health care professionals could improve health care by understanding some of the spiritual aspects practiced when people are within their health care system. The First Nation people's perspectives aim to banish some of the mystery or unawareness that looms around spirituality in order to improve health services. Social workers have little or no information about First Nation beliefs and practices around spirituality when they have a terminal illness. The study is to help health care professionals and people with a terminal illness understand spiritual practices through specific beliefs and examples of how spirituality is practiced.

This qualitative study of eight First Nation participants and five First Nation Elders is to help understand how First Nation people view spirituality and how it is practiced when one has a terminal illness. Spirituality is often so abstract and practiced in various ways that it requires clarity and understanding from the people around them. Health care professionals could improve health care by understanding some of the spiritual aspects practiced when people are within their health care system. The First Nation people's perspectives aim to banish some of the mystery or unawareness that looms around spirituality in order to improve health services. Social workers have little or no information about First Nation beliefs and practices around spirituality when they have a terminal illness. The study is to help health care professionals and people with a terminal illness understand spiritual practices through specific beliefs and examples of how spirituality is practiced. / Arts, Faculty of / Social Work, School of / Graduate

Law, Wai Yan. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references (leaves 83-92). / Abstracts in English and Chinese. / ABSTRACT --- p.I / 論文摘要 --- p.II / TABLE OF CONTENTS --- p.III / Chapter CHAPTER 1 --- INTRODUCTION --- p.1 / Chapter CHAPTER 2 --- LISA SOWLE CAHILL´ةS THEOLOGICAL BACKGROUND --- p.5 / Chapter 2.1 --- Introduction --- p.5 / Chapter 2.2 --- Cahill´ةs theological approach to Christian Ethics --- p.5 / Chapter 2.2.1 --- Catholicism --- p.6 / Chapter 2.2.2 --- Feminism --- p.9 / Chapter 2.2.3 --- Theological Anthropology --- p.16 / Chapter 2.3 --- Moral Methodology --- p.21 / Chapter 2.3.1 --- The Bible --- p.21 / Chapter 2.3.2 --- Tradition --- p.22 / Chapter 2.3.3 --- Normative Accounts of the Human --- p.24 / Chapter 2.3.4 --- Descriptive Accounts of the Human --- p.25 / Chapter 2.4 --- Conclusion --- p.26 / Chapter CHAPTER 3 --- LISA SOWLE CAHILL´ةS PARTICIPATORY THEOLOGICAL BIOETHICS --- p.28 / Chapter 3.1 --- Introduction --- p.28 / Chapter 3.2 --- Cahill´ةs Participatory Theological Bioethics --- p.28 / Chapter 3.2.1 --- Principle of Analysis --- p.29 / Chapter 3.2.1.1 --- Ordinary and Extraordinary means of life support --- p.30 / Chapter 3.2.1.2 --- Principle of double effect --- p.31 / Chapter 3.2.2 --- The common good and bioethics --- p.34 / Chapter 3.2.3 --- Theological bioethics and Social Transformation --- p.38 / Chapter 3.2.4 --- Summary --- p.40 / Chapter 3.3 --- Evaluation and Dialogue with Cahill´ةs Participatory Theological Bioethics --- p.41 / Chapter 3.3.1 --- Catholicism --- p.41 / Chapter 3.3.2 --- Feminism --- p.42 / Chapter 3.3.3 --- Common Good --- p.44 / Chapter 3.4 --- Conclusion --- p.46 / Chapter CHAPTER 4 --- END-OF-LIFE CARE IN HONG KONG --- p.47 / Chapter 4.1 --- Introduction --- p.47 / Chapter 4.2 --- End-of-life care in Hong Kong --- p.48 / Chapter 4.2.1 --- Decline and dying in Hong Kong --- p.48 / Chapter 4.2.2 --- Ethical judgments by the health care professions --- p.50 / Chapter 4.2.3 --- Advance directive --- p.54 / Chapter 4.2.4 --- Patients or family´ةs participation --- p.54 / Chapter 4.2.5 --- Chinese culture and Bioethics --- p.56 / Chapter 4.3 --- Christianity engagement in the end-of-life care in Hong Kong --- p.59 / Chapter 4.3.1 --- Christian communities --- p.59 / Chapter 4.3.2 --- Theology bioethics --- p.60 / Chapter 4.4 --- Conclusion --- p.61 / Chapter CHAPTER 5 --- PARTICIPATORY THEOLOGICAL BIOETHICS IN HONG KONG --- p.63 / Chapter 5.1 --- Introduction --- p.63 / Chapter 5.2 --- The significance and relevance of Participatory Theological Bioethics --- p.63 / Chapter 5.2.1 --- Both individual and social ethics --- p.64 / Chapter 5.2.1.1 --- Who is/are the poor? --- p.64 / Chapter 5.2.1.2 --- Inequalities in access to end-of-life care --- p.66 / Chapter 5.2.1.3 --- Medical paternalism --- p.71 / Chapter 5.2.2 --- Transcendent meanings of life --- p.73 / Chapter 5.3 --- INTERCULTURAL DIALOGUE OF PARTICIPATORY THEOLOGICAL BIOETHICS --- p.74 / Chapter 5.3.1 --- Familial relationship as a starting point --- p.75 / Chapter 5.3.2 --- Interpretation of ´بParticipatory´ة --- p.76 / Chapter 5.4 --- Conclusion --- p.80 / Chapter CHAPTER 6 --- CONCLUSION --- p.81 / BIBLIOGRAPHY --- p.83

The marginalisation of palliative and pastoral care practices by conventional approaches to care for terminally ill patients, motivated the research curiosity. The significance of terminal patient's spirituality, their language practices and communities of concern are endorsed as being the major contributing factor to meaningful 'living' with terminal illness. Listening to stories has been the qualitative research practice, revealing meaning-making, quest stories. Feminist theology and post-modern ideas and discourses have assisted me, and the participants, in the deconstruction of power, patriarchy and dualism as the primary contributing factors to marginalisation of people due to illness, race, gender, poverty, culture and education. Pastoral care practices and feminist theology have guided us to emphasise the necessity to recognise the God of Grace as an important part to ensuring holistic patient care. Recognising the 'God-Self, respectful narrative and pastoral care practices paved the way to honour sacred spaces and voice stories of terminal illness. / Practical Theology / M.Th (Specialisation Pastoral Therapy)

The marginalisation of palliative and pastoral care practices by conventional approaches to care for terminally ill patients, motivated the research curiosity. The significance of terminal patient's spirituality, their language practices and communities of concern are endorsed as being the major contributing factor to meaningful 'living' with terminal illness. Listening to stories has been the qualitative research practice, revealing meaning-making, quest stories. Feminist theology and post-modern ideas and discourses have assisted me, and the participants, in the deconstruction of power, patriarchy and dualism as the primary contributing factors to marginalisation of people due to illness, race, gender, poverty, culture and education. Pastoral care practices and feminist theology have guided us to emphasise the necessity to recognise the God of Grace as an important part to ensuring holistic patient care. Recognising the 'God-Self, respectful narrative and pastoral care practices paved the way to honour sacred spaces and voice stories of terminal illness. / Philosophy, Practical and Systematic Theology / M.Th (Specialisation Pastoral Therapy)

Text in German, with German, English and Southern Sotho summaries / Includes bibliographical references (leaves 149-153) / Die praktisch-theologische Studie untersucht spirituelle Bedürfnisse von ambulanten Palliativpatienten. Dazu wurden Fokusgruppendiskussionen mit Teams aus der ambulanten Palliativversorgung in Nordhessen durchgeführt und diese nach ihren Erfahrungen und Beobachtungen gefragt. Theoretische Grundlagen zur Spiritualität im Kontext der Palliativversorgung bilden den Rahmen zur Auswertung der empirischen Masterarbeit mittels qualitativer Inhaltsanalyse. Der Befund zeigt, dass das Erkennen von spirituellen Bedürfnissen bei Patienten die Teammitglieder mehrheitlich vor Herausforderungen stellt und multiple Verunsicherung sowie Probleme im Umgang bestehen. Außerdem prägen persönliche Überzeugungen ihre Wahrnehmung maßgeblich. Die beobachtete Spiritualität ist überwiegend kirchlich geprägt und beruht auf christlichen Elementen wie Gebete, Glauben oder Begleitung durch PfarrerInnen. Teammitglieder sprechen zudem Begegnungen, „Dasein“ und (Kirchen)Musik eine spirituelle Dimension zu. Es gibt auch Patienten, die keine spirituellen Bedürfnisse haben oder derartiges ablehnen. Die Praktische Theologie könnte zukünftig als bedürfnisorientierte Kompetenzgeberin dienen, damit Mitarbeitende aus dem Gesundheitssystem befähigt werden, spirituelle Bedürfnisse ihrer Patienten wahrzunehmen, zu reflektieren und ihnen angemessen zu begegnen. / This practical theological study examined the spiritual needs of outpatient palliative care patients. Focus group discussions were conducted with outpatient palliative care teams. They were asked about their experiences and observations. Theoretical foundations of spirituality and palliative care formed the framework for the evaluation of empirical research by using qualitative content analysis. Findings show that recognition of spiritual needs in patients poses a challenge to the majority of team members, as well as insecurities and problems in dealing with them. The observed spirituality is predominantly ecclesiastical and based on Christian elements such as prayers, faith and accompaniment by pastors. Team members address encounters, "being" and music as spiritual dimensions. There are also patients who have no spiritual needs. In future, practical theology could serve as a needs-based provision of competences, so that employees of health systems can be empowered to perceive, reflect on and adequately respond to the spiritual needs of their patients. / Boithuto jwa thutobomodimo bo tlhatlhobile ditlhokwa tsa semoya tsa balwetse ba tlhokomelo ya malwetse a bofelelo ya kalafo ya balwetse ba kwa ntle. Dipuisano tsa setlhopha tsa tsepamo di ne tsa dirwa ka ditlhopha tsa tlhokomelo ya malwetse a bofelelo a kalafo ya balwetse ba kwa ntle. Ba ne ba bodiwa ka maitemogelo le ditemogo tsa bona. Metheo ya thutobomodimo le tlhokomelo ya malwetse a bofelelo di bopile letlhomeso la tlhotlhwafatso ya patlisiso ya mmatota ka go dirisa tshetshereganyo ya diteng tsa boleng. Dipatlisiso di bontsha fa kamogelo ya ditlhokwa tsa semoya mo balwetseng e tlisa kgwetlho mo bontsing jwa ditokololo tsa setlhopha, ga mmogo le go sa itshepeng go gontsi le mathata a go samagama le tsona. Bosemoya jo bo bonwang bontsi ke jwa sekeresete, mme bo ikaegile ka dielemente tsa Bokeresete jaaka dithapelo, tumelo le tshwaragano le baruti. Ditokololo tsa setlhopha di bua ka ga dikgolagano, "go nna" le mmino jaaka ditekanyo tsa semoya. Gape go na le balwetse ba ba se nang ditlhokwa tsa semoya. / Philosophy, Practical and Systematic Theology / M. Th. (Practical Theology)