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Nursing with Dignity Part 4: Christianity II

VOL: 98, ISSUE: 12, PAGE NO: 36

Irena Papadopoulos, PhD, MA, DipNEd, DipN, RGN, RM, NDNCert, RNT, ILTM, is head of the Research Centre for Transcultural Studies in Health, Middlesex University

A number of countries practise Christian orthodoxy, including Ethiopia, Serbia and Russia. Practices differ slightly from country to country, depending on culture, but all orthodox Christian religions share most of the fundamental elements of the Greek Orthodox Church, on which their religions were originally based.

A number of countries practise Christian orthodoxy, including Ethiopia, Serbia and Russia. Practices differ slightly from country to country, depending on culture, but all orthodox Christian religions share most of the fundamental elements of the Greek Orthodox Church, on which their religions were originally based.

In 1996 the Greek Orthodox Archdiocese estimated that there were more than 250,000 Greeks and Greek Cypriots living in the UK, two-thirds of them in London. These figures were based on records of church attendance, marriages, baptisms and deaths, plus the number of children attending Greek schools.

According to a study that explored the views of second and subsequent generations of Greeks and Greek Cypriots, most said the Greek orthodox religion was the most significant marker of their identity (Papadopoulos and Papadopoulos, 1999).

Religion is central to Greek culture. But unlike Islam, which is seen as both a religion and a way of life, the Christian orthodoxy occasionally conflicts with the Greek culture and way of life. This article explains the teachings of the Greek Orthodox Church, although some people who consider themselves orthodox Christians do not adhere strictly to these principles. These teachings are offered as knowledge tools, which should be useful when patients are too ill or unable to express their religious preferences and/or when there is no family member to act as an advocate.

Dignity
According to orthodox Christian religions, all people should be treated with dignity and respect because they have been created in the image of God. This 'divine' dignity gives them fundamental human rights.

Preserving the dignity of a patient does not have to mean being cared for by staff of the same gender. Although some older women would prefer to be examined by a woman doctor and to be cared for by a female nurse in a single-sex ward, preserving dignity depends on respect for 'divine' dignity and the human rights that are derived from it.

Practitioners who are knowledgeable about Greek culture and religion can offer care that is sensitive and maintains patient dignity.

Marriage and sexual issues
Home and family life is central to the orthodox lifestyle. Marriage is one of the seven sacraments. The others are: baptism; chrismation (anointing with sacred oil after baptism, similar to confirmation); confession; holy communion; holy ordination and anointment of the sick.

Marriage is regarded as the only appropriate and morally-fitting place for a sexual relationship. Premarital and extramarital sex, homosexuality and sexual behaviours that are considered abusive are seen as immoral and as attacks on the institution of marriage.

Homosexuality
Nurses need to know that the view of the Greek Orthodox Church is that people with homosexual preferences should receive medical and psychiatric help to restore them to the heterosexual lifestyle intended by God. In practice, the church treats them as sinners but provides pastoral support.

Despite the legal position in the UK, Greece and Cyprus, which accord homosexual people equal rights (with a few exceptions), the attitudes of many orthodox Christians are closer to the church than the state. For this reason it is difficult to be openly homosexual, which can put enormous strain on homosexuals and their families and leads to many negative social and health-related consequences.

Birth control
All forms of birth control are condemned by the church, but in reality most orthodox Christians plan their families and use a wide range of contraception.

Termination of pregnancy
Abortion is condemned as an act of murder, except in certain specific circumstances such as when a woman's life is in grave danger or she became pregnant after being raped. But some women, particularly those who are not married, have terminations as they feel the negative consequences of having a child out of wedlock are more severe than the consequences of having a termination.

Baptism
Babies are baptised soon after birth, and in doing so become members of the orthodox church. For this reason it is important that nurses who care for sick babies who have not been baptised do all they can to help parents who wish to have them baptised on the ward.

If someone has not been baptised, he or she cannot marry in the orthodox church. Since only one baptism is allowed, the church recognises the validity of baptisms performed in other Christian churches.

Names
Many children are named after their grandparents out of respect. Most Greek orthodox names come from the Bible or are the names of saints. Popular names for men are Andreas, George and Christos, while popular women's names are Maria, Eleni and Androula. Nurses can call older adults by their first name with the prefix Mr or Mrs, for example, Mr Andreas or Mrs Eleni.

Circumcision
This is not practised unless it is required for medical reasons.

Diet and fasting
There are no dietary restrictions except during periods of fasting, which are seen as a spiritual catharsis. Unlike Muslims, who abstain from food from dawn to dusk during holy periods, for orthodox Christians fasting means abstaining from animal and dairy products.

The church requires healthy adults to fast at least three days before taking communion and during the holy periods of Easter (50 days up to Easter Sunday), the Assumption of the Virgin Mary (August 1-14), and Christmas (40 days up to Christmas Day).

Apart from the older generation, in practice few people observe the rules of extended fasting. Those who wish to take holy communion usually fast for three days during the year, apart from before Easter and Christmas, when they fast for a week. Young children and the sick are excluded from fasting.

Blood transfusions
These are permitted and are seen in the same way as any other treatment designed to maintain life.

Organ transplants
After careful evaluation of the consequences for the donor and recipient, the Greek orthodox religion allows organ transplants. Although some people will not consent to organ donation because of the importance they place on the integrity of the body after death, the church teaches that organ donation is an act of Christian love.

Mental health problems
Mental illness is considered a stigma for those with the condition and their families. Many orthodox Christians see mental health problems, and to some extent illnesses in general, as either a punishment from God or a test of their faith.

However, the church teaches that people with a mental health problem are complete beings, are loved by God and should therefore be loved and helped by their fellows. This conflicting position results in close family protecting and caring for a person with mental health problems while keeping their condition hidden from the wider community.

Suicide
The church teaches that no matter how hopeless a person may feel, with God all things are possible and there is always hope. Although it is acknowledged that there are complex issues surrounding suicide, orthodox Christianity states that life is a sacred gift from God that must be nurtured lovingly and accepted thankfully, regardless of the difficulties encountered. As someone's life is not therefore theirs to take, suicide represents a lack of faith and the families of those who commit it feel ashamed and conceal the fact.

Dying and death rituals
A very sick person or a member of his or her family may ask a priest to perform one or more of the holy sacraments. By anointing the sick with oil in Christ's name, the priest asks Him to alleviate suffering and heal the person, either in this or the eternal life. The dying person may also want to take confession and holy communion. These rituals are important preparations for the journey to the next life.

In areas with large orthodox communities, contacting priests should not be a problem. In areas with a small orthodox community, health care staff should plan ahead.

Euthanasia
The orthodox church is pro-life, seeing death as evil and the opposite to its life-giving God and Christ's victory over death through His resurrection. It opposes euthanasia, which it sees as suicide for the individual and murder by those who assist.

Resuscitation
Despite its views on euthanasia, the church does not support the excessive use of technology to prolong life. It teaches that people have a responsibility to take care of the life given to them by God, but accepts the inevitability of death. Orthodox Christians expect to be resuscitated but may not wish to see life prolonged by the long-term use of artificial support.

Cremation
This is not condemned, but is rare because of the belief in life after death. Traditionally, the body is buried complete to await resurrection.

[TX] USEFUL ADDRESSES AND WEBSITES

[TX] Western Europe (including the UK and Ireland) comes under the jurisdiction of Archbishop Gregorios who is based in London. His address is: Thyateira House, 5 Craven Hill, London W2 3EN

Details on aspects of the Orthodox religion: www.goarch.org/access/orthodoxy

Lists of UK churches and culture-related information: www.greeklegacy.com/religion.htm

[TX] This series has been endorsed by the Transcultural Nursing and Healthcare Association

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