Faith & Medical Decisions · Bedside Reference

Values in Care · valuesincare.com · Content last updated 2026-10-13 · Educational conversation aid · not medical, legal, or religious advice. Beliefs vary. The patient's voiced wishes and advance directives come first. Ask the patient directly.

Ask, don't assume

Communication prompts · not tradition claims

What matters most to you right now?
How do you prefer to receive information, and who else should be part of decisions?
Are there beliefs or practices we should know about to care for you well?
Would a professional interpreter help this conversation?

Grounded in the evidence at valuesincare.com/care-frameworks. The cards below describe documented patterns, never any individual.

Roman Catholicism

Authority: USCCB Ethical and Religious Directives for Catholic Health Care Services, 7th Edition (approved November 2025)

View of death: Transition to eternal life. Euthanasia and assisted suicide morally prohibited.

DNR	Permissible Permissible when treatment offers no reasonable hope of benefit without excessive burden. The "ordinary vs. extraordinary" care framework applies: disproportionately burdensome or futile treatments may be refused. Primary source · USCCB ERDs, 7th ed., 2025
ANH	Generally obligatory with exceptions Generally considered basic care (obligatory) unless the body can no longer assimilate it, it causes severe discomfort, or death is imminent. Withdrawal permissible only when ANH itself becomes disproportionately burdensome. Primary source · USCCB ERDs, 7th ed., 2025
Palliative Sedation	Accepted under double effect Accepted under the "principle of double effect": intent must be relief of suffering, not hastening death. Doses must be proportionate to symptoms; escalation only when lesser measures are ineffective. Primary source · USCCB ERDs, 7th ed., 2025
Hospice	Embraced Catholic health systems widely operate hospice and palliative care programs consistent with ERDs. Hospice is viewed as an expression of solidarity and care for the whole person. Primary source · USCCB ERDs, 7th ed., 2025

Documented guidance from Roman Catholicism's authoritative sources. Beliefs vary. Ask the person, and their own faith leader.

Protestant Christianity

Authority: ELCA, UMC, LCMS, and NAE denominational statements

View of death: Transition to eternal life through faith in Christ. No obligation to endure futile treatment.

DNR	Generally supported ELCA/UMC: Support advance care planning and withdrawal of burdensome treatments. "Life is a gift from God; we are not obligated to endure treatments when pain makes life indistinguishable from torture." (ELCA) Southern Baptist/Evangelical: Generally oppose euthanasia but widely recognize an appropriate time to stop prolonging the dying process. Expert consensus · ELCA, UMC, LCMS, NAE denominational statements
ANH	Withdrawal generally permissible Most Protestant ethicists consider ANH a medical intervention that may be withdrawn when burdensome or futile. UMC resolution explicitly recognizes that dying persons are free to discontinue burdensome treatments. Expert consensus · ELCA, UMC denominational statements
Palliative Sedation	Supported for symptom relief Most Protestant ethicists support palliative sedation when intent is symptom relief. No major denomination prohibits proportionate sedation for refractory symptoms. Expert consensus · Cross-denominational consensus
Hospice	Broadly supported Hospice is broadly supported across Protestant denominations. Resistance may occur when framed as "giving up"; messaging should connect hospice to Christian accompaniment and stewardship of life. Expert consensus · ELCA, UMC, LCMS, NAE

Documented guidance from major Protestant denominational sources. Beliefs vary. Ask the person, and their own faith leader.

Islam (Sunni & Shia)

Authority: International Islamic Fiqh Academy rulings; Yaqeen Institute analysis

View of death: Divine decree. Life is a trust from God (amanah). Euthanasia strictly prohibited (haram).

DNR	Permissible when treatment is futile Withdrawal of life support permissible when treatment is medically futile, death is imminent, and expert physicians concur. The legal maxim "harm must be eliminated" (la darar wa la dirar) supports this position. Brain death accepted as legal death by many (though not all) Islamic scholars when confirmed by multiple expert physicians. Expert consensus · Islamic Fiqh Academy; Yaqeen Institute
ANH	Contested, but generally maintained Hastening death by withdrawing nutrition is generally forbidden. However, many contemporary scholars and the Islamic Fiqh Academy allow ANH withdrawal in cases like terminal dementia or PVS where the digestive system has irreversibly failed and ANH causes active harm (hypervolemia, aspiration). Expert consensus · Synthesized fatwa literature; Islamic Fiqh Academy
Palliative Sedation	Permissible for symptom relief Permissible when intent is symptom relief and less sedating options are ineffective. Islamic ethics discussions of the double-effect principle allow medications that may secondarily shorten life if the primary intent is pain relief. Expert consensus · Islamic Fiqh Academy; IMANA
Hospice	Generally accepted Accepted when framed correctly: "hospice does not abandon the patient; it provides full comfort care while honoring God's timing." Involve local imams and Muslim chaplains early. Sunni/Shia perspectives often converge but local scholarly authority matters. Expert consensus · Islamic Fiqh Academy; Yaqeen Institute

Involve local imams and Muslim chaplains early. Sunni/Shia perspectives often converge on these points but local scholarly authority matters.

Documented guidance from Islam's authoritative sources. Beliefs vary. Ask the person, and their own faith leader.

Judaism

Authority: MJHS Resource; CCAR responsa; Orthodox Union guidelines; Palliative Care Fast Facts

View of death: Every moment of life has infinite value (pikuach nefesh). Active hastening of death prohibited.

DNR	Movement-dependent Orthodox: Discontinuing continuous ventilation may be viewed as an act of commission (killing), versus withholding new interventions (permissible in terminal cases). Rabbinic consultation essential. Conservative: Withdrawal of treatments of doubtful efficacy permissible. Balances tradition with patient autonomy. Reform: Heavy emphasis on individual autonomy. Fully embraces advance directives. Expert consensus · MJHS resource; CCAR responsa; palliative fast facts
ANH	Varies by movement Orthodox: Many authorities do not consider ANH a medical treatment. Its discontinuation is often forbidden. Conservative: ANH withdrawal allowed if it aligns with advance directives and relieves suffering. Reform: Supports patient autonomy in ANH decisions. All movements: Involve the patient's rabbi for decisions. Expert consensus · MJHS resource; CCAR responsa
Palliative Sedation	Generally acceptable for comfort When prognosis is limited, sedation for intractable suffering may be acceptable if the goal is comfort rather than life-shortening. Active euthanasia remains prohibited across all movements. Expert consensus · MJHS resource; palliative fast facts
Hospice	Widely accepted Conservative: Hospice described as "Jewishly preferable" and life-affirming. Reform: Fully embraces hospice and advance directives. Orthodox: Accepted when it does not actively hasten death. Brain death criteria often not accepted. Shabbat and kashrut considerations for hospice care. Expert consensus · MJHS resource; CCAR responsa

All denominations: Involve the patient's rabbi for DNR, ventilator withdrawal, and organ donation decisions.

Documented guidance from Judaism's authoritative sources. Beliefs vary, especially across Orthodox, Conservative, and Reform movements. Ask the person, and their own rabbi.

Hinduism

Authority: Palliative Care Network of Wisconsin Fast Facts; BMJ Supportive & Palliative Care; PMC reviews

View of death: Transition in cycle of rebirth (samsara). Karma influences the next life. A "good death" (śānti) means a peaceful mind focused on the divine.

DNR	Generally acceptable Extreme life-prolonging measures that cause suffering or interfere with a peaceful transition are often viewed unfavorably. No central prohibition against allowing a natural death. Emerging evidence · PMC palliative review; Palliative Care Network fast facts
ANH	No strict prohibition against withdrawal No strict central prohibition against withdrawing ANH if it allows a natural death. Family involvement in decision-making is essential. Emerging evidence · PMC palliative review
Palliative Sedation	Tension between comfort and consciousness Generally accepted for symptom relief. However, sedation that clouds consciousness at the moment of death may be resisted. Consciousness is spiritually important at the time of dying. Shared decision-making about dose, timing, and intent is essential. Emerging evidence · PMC palliative review; Palliative Care Network fast facts
Hospice	Increasing acceptance Increasing acceptance when it supports family caregiving and respects ritual continuity. Home death often preferred for spiritual reasons. Family rituals, chanting, and priest presence are important. Emerging evidence · PMC palliative review

Documented guidance from Hindu scholarly sources. Hinduism has no central doctrinal authority, and practice varies by region, family, and community. Ask the person, and their own spiritual leader.

Buddhism (Theravada, Mahayana, Tibetan)

Authority: Frontiers in Sociology 2025; PMC Spiritual Care Guide in Hospice-Palliative Care

View of death: Transition to next life in cycle of rebirth (samsara). Mental state at time of death critically important for rebirth trajectory.

DNR	No obligation to preserve life at all costs Acceptance of natural death. Withdrawal permissible when treatment merely prolongs dying. Compassion (karuṇā) and non-harming guide decisions. Expert consensus · Frontiers 2025; PMC palliative guide
ANH	Withdrawal generally acceptable No doctrinal requirement to maintain ANH when it prolongs dying without benefit. Emphasis on allowing a peaceful, natural death. Expert consensus · Frontiers 2025; PMC palliative guide
Palliative Sedation	Tension exists Mindfulness and clarity of consciousness at death are highly valued (especially Theravada and Tibetan), which may create resistance to heavy sedation. Compassion principles support pain relief when suffering is severe. Shared decision-making about dose, timing, and intent is essential. Expert consensus · Frontiers 2025; PMC palliative guide
Hospice	Generally accepted Accepted when it enables peaceful, dignified death and accommodates meditation, chanting, or prayer. Post-death handling: some Tibetan traditions request the body not be disturbed for a period after death. Expert consensus · Frontiers 2025; PMC palliative guide

Documented guidance from Buddhist scholarly sources. Beliefs vary across traditions. Ask the person, and their own spiritual teacher.

Sikhism

Authority: BMJ Supportive & Palliative Care: "Sikh religion and palliative care" (2022)

View of death: Death is understood within Hukam (God's will) and the goal of union with Waheguru. Excessive attachment to bodily life is discouraged.

DNR	Individualized: no single Sikh ruling The cited evidence does not establish a universal Sikh position on DNR or on withdrawing treatment. Decisions are made by the patient and family, often framed by acceptance of Hukam. Ask directly. Emerging evidence · BMJ Support Palliat Care 2022;12(2):207-210 (PMID 33139306), tradition context only
ANH	Individualized: no single Sikh ruling No universal doctrinal rule on artificial nutrition and hydration is established by the cited evidence. Explore the patient's and family's own understanding rather than applying a tradition-level default. Emerging evidence · BMJ Support Palliat Care 2022;12(2):207-210 (PMID 33139306), tradition context only
Palliative Sedation	Limited literature. Discuss awareness at death A 2026 scoping study reports that Sikh literature on palliative sedation is very limited. Awareness at the time of death may be spiritually important for some patients, while sedation can still be acceptable for agitation or distress. Name this uncertainty and decide with the patient and family. Emerging evidence · Christian and Indian religions on palliative sedation: a scoping study, Annals of Palliative Medicine (DOI 10.21037/apm-2025-aw-129)
Hospice	Individualized: familiarity varies The cited evidence does not establish a tradition-level position on hospice. Some families may be unfamiliar with hospice; explain what it offers and ask what spiritual support they want. Emerging evidence · BMJ Support Palliat Care 2022;12(2):207-210 (PMID 33139306), tradition context only

There is no single central Sikh authority that issues clinical rulings. The context below is drawn from a peer-reviewed overview; positions on specific decisions are individual. Always ask the patient and family, and involve a granthi or Sikh chaplain if they wish.

Indigenous / Native American Traditions

Authority: University of Toronto CPD; IJPN 2018

View of death: Death as part of a cycle ("circle of life"). The spirit returns to the Creator. Holistic connection between body, mind, spirit, earth, and community.

DNR	Communal decision-making Decision-making is often communal and family-centered rather than strictly individual. Ask who the person wants involved. Do not assume. Emerging evidence · U of Toronto CPD; IJPN 2018
ANH	Tribe-specific: always ask No universal Indigenous position. Positions vary enormously by tribal tradition. Decisions should involve traditional healers and extended family. Emerging evidence · Limited large-scale quantitative data; qualitative evidence
Palliative Sedation	Varies by tradition Spiritual needs at death (ceremonies, chanting, sacred items) may influence sedation preferences. An interrupted ceremony is viewed as spiritually damaging. Coordinate timing carefully. Emerging evidence · U of Toronto CPD; IJPN 2018
Hospice	Low use reported; ask about preferences Historical trauma and institutional mistrust are among the reasons reported for low hospice use. Ask whether a Native-run or tribally informed program is available and whether the person wants one. Spiritual needs include traditional healers, pipe ceremonies, smudging, sacred items, and continuous bedside vigils. Emerging evidence · U of Toronto CPD; IJPN 2018

IMPORTANT: Indigenous spiritual traditions are highly diverse and tribe-specific. This section provides a general framework only. Never generalize across tribes. Always ask about specific tribal affiliation, preferred spiritual leaders, and required ceremonies.

Secular / Non-Religious

Authority: PMC: "Spiritual Caregiving for America's Religious Nones"; Frontiers in Sociology 2025

View of death: Spiritual needs exist without religious belief: meaning, legacy, relationships, existential peace.

DNR	Individual autonomy emphasized Advance directives heavily emphasized: clear documentation of individual values is especially important. No religious framework to defer to; patient autonomy is paramount. Primary source · Professional chaplaincy standards; Frontiers 2025
ANH	Patient choice VSED (Voluntarily Stopping Eating and Drinking) is recognized in the literature as an option some patients choose. Discuss with your care team. Decisions based on individual values and quality-of-life assessment. Primary source · Professional chaplaincy standards; Frontiers 2025
Palliative Sedation	Full acceptance Total acceptance of palliative sedation to alleviate physical and existential suffering. Humanist chaplains can provide support without religious content. Primary source · Professional chaplaincy standards
Hospice	Full acceptance Total acceptance of hospice. Professional chaplains (secular and humanist) are trained to support atheists and agnostics. FICA Spiritual History Tool (GWish.org) designed to elicit values without presuming theism. Primary source · Professional chaplaincy standards; Frontiers 2025

This represents documented guidance from professional chaplaincy and academic sources. Individual values and preferences vary significantly. Always ask directly about what matters most to the patient.

Jehovah's Witnesses

Authority: Secondary source only: 2019 transplant-surgery review (Figueiredo et al., World J Transplant). Watch Tower texts not re-read for this review.

View of death: No source read.

DNR	No position stated here No source read for this topic. Ask the patient and their clergy. Not sourced · None
ANH	No position stated here No source read for this topic. Ask the patient and their clergy. Not sourced · None
Palliative Sedation	No position stated here No source read for this topic. Ask the patient and their clergy. Not sourced · None
Hospice	No position stated here No source read for this topic. Ask the patient and their clergy. Not sourced · None

A 2019 transplant-surgery review states that Jehovah's Witness patients will not accept red cells, white cells, platelets or plasma, even to save their lives. Decisions on other blood fractions are a matter of personal choice. Ask each patient what they accept.

Summarizes one secondary source. Watch Tower texts not re-read for this review. Not reviewed by a Jehovah's Witness. Ask the patient directly.

Orthodox Christianity

Authority: Secondary sources only: 2023 chapter on Greek Orthodox patients; 2013 review of Romanian Orthodox Church documents. OCA and GOARCH texts not read.

View of death: A 2023 chapter on Greek Orthodox patients states that the church emphasizes a positive outcome in death: "the deceased is alive with God." A 2013 review of Romanian Orthodox Church Holy Synod documents reports that the Synod's euthanasia document rejects the intentional hurrying of the natural process of life.

DNR	One secondary source on life support A 2023 chapter on Greek Orthodox patients states that artificial life support is justifiable only when it offers hope for meaningful recovery, and that just as death should not be hastened, the natural dying process should not be prolonged. Emerging evidence · 2023 chapter on Greek Orthodox patients (abstract read)
ANH	No position stated here No source read for this topic. Ask the patient and their clergy. Not sourced · None
Palliative Sedation	No position stated here No source read for this topic. Ask the patient and their clergy. Not sourced · None
Hospice	No position stated here No source read for this topic. Ask the patient and their clergy. Not sourced · None

Positions can vary by jurisdiction and by individual priest. Confirm the family's own pastoral relationship.

Summarizes secondary sources about Greek and Romanian Orthodox practice. Not reviewed by an Orthodox chaplain or ethicist. Confirm with the patient's priest.

Latter-day Saints

Authority: Secondary sources only: 2021 chapter in Mormonism, Medicine, and Bioethics; 2023 chapter by a chaplain. Church texts not re-read for this review.

View of death: No source read.

DNR	One secondary source on treatment cessation A 2021 scholarly chapter states that Latter-day Saint teaching has supported a negative right to die from treatment cessation while consistently opposing legalization of a positive right to die through a lethal drug. Emerging evidence · 2021 chapter, Dying Well (abstract read)
ANH	No position stated here No source read for this topic. Ask the patient and their clergy. Not sourced · None
Palliative Sedation	No position stated here No source read for this topic. Ask the patient and their clergy. Not sourced · None
Hospice	No position stated here No source read for this topic. Ask the patient and their clergy. Not sourced · None

A 2023 chapter by a chaplain states that members of the Church accept modern medical science and believe in receiving medical treatment along with seeking divine guidance. Ask the patient.

Summarizes secondary sources about Latter-day Saint teaching. Not reviewed by a Latter-day Saint chaplain or ethicist. Ask the patient.

Baháʼí Faith

Authority: Secondary source only: 2025 German pilot study (Tekbas et al., Cureus). Baháʼí texts not read.

View of death: No source read.

DNR	One expert opinion on medical advice In a 2025 German pilot study, one interviewed Baháʼí expert described medical treatment as guided by seeking competent medical advice and facing death with hope and expectation. This is an individual expert opinion. Emerging evidence · Tekbas et al. 2025, Cureus (full text read)
ANH	No position stated here No source read for this topic. Ask the patient and their clergy. Not sourced · None
Palliative Sedation	No position stated here No source read for this topic. Ask the patient and their clergy. Not sourced · None
Hospice	No position stated here No source read for this topic. Ask the patient and their clergy. Not sourced · None

Ask the patient and family about burial, cremation and timing early. No source read for these.

Summarizes one secondary source about Baháʼí practice. Not reviewed by a Baháʼí community member. Ask the patient and family.

Multi-faith and Interfaith Perspectives

Authority: HealthCare Chaplaincy Network; APC Standards of Practice; ACPE research

View of death: Varies. Beliefs may blend multiple theological frameworks. Focus on shared values: love, dignity, peace, legacy.

DNR	Negotiate shared values When family members hold different faith positions, focus on shared values (dignity, comfort, love) rather than doctrinal positions. A board-certified chaplain can facilitate interfaith family meetings. Document which family member holds which tradition to avoid assumptions. Expert consensus · HealthCare Chaplaincy Network; APC Standards
ANH	Family-centered decision process Use structured family meetings with chaplaincy support to navigate differing beliefs. Identify the patient's own expressed wishes as the primary guide, regardless of family members' traditions. POLST/MOLST documentation is especially important in interfaith families. Expert consensus · HealthCare Chaplaincy Network; APC Standards
Palliative Sedation	Patient preference guides Patient's own stated preferences take priority over family members' differing religious views. Chaplains trained in interfaith dialogue can mediate competing perspectives. Ethics committee consultation may be helpful when family disagreement is significant. Expert consensus · HealthCare Chaplaincy Network; ACPE research
Hospice	Generally accepted across traditions Most traditions in this matrix document hospice as compatible with their guidance. The Sikh and Indigenous entries describe differences in familiarity or use. Families vary. Chaplains can create blended spiritual care plans honoring multiple traditions. Cultural rituals from different traditions can often coexist at the bedside. Expert consensus · HealthCare Chaplaincy Network; APC Standards

The FICA Spiritual History Tool is especially valuable for interfaith families. It elicits individual values without presuming any single tradition.

Interfaith families may hold multiple, sometimes competing, spiritual frameworks. No single tradition's guidance should be assumed. Always explore the specific blend of beliefs present.