Christian and Indian religions on palliative sedation: a scoping study

Though especially in the last decade, much work has been done on various aspects of palliative sedation, little attention has been given to the role played by religious beliefs and traditions. Since the attitudes and decisions of patients, family members, and caregivers can be deeply influenced by religion when faced with severe suffering at the end of life, it is important to know the views of these traditions regarding palliative sedation. This study discusses and compares normative views in Christian denominations (Anglicanism, Catholicism, Eastern Orthodoxy, Protestantism) and Indian religions (Hinduism, Buddhism, Sikhism).

This study used a scoping study method to analyse religious normative perspectives on palliative sedation. Comprehensive database and grey literature searches were conducted to gather relevant sources from Christian denominations and Indian religions, followed by snowballing and expert consultation. The systematic mapping of views and arguments was followed by a grounded theory analysis of the mapped information and a comparative analysis between the Christian and Indian religious traditions. This manuscript is written following the Scoping Reviews PRISMA-ScR checklist.

Christian traditions generally view palliative sedation as a morally acceptable means to relieve suffering, grounded in charity and dignity, but in doing so stress the importance of intent and a clear distinction from euthanasia. Concerns persist regarding the impact of lowered consciousness on the spiritual preparation for death, especially in Eastern Orthodox traditions; Protestant perspectives add the issue of autonomy and personal agency. Indian religions lack robust explicit authoritative statements but commonly value consciousness at the moment of death for spiritual reasons related to rebirth and karma. Palliative sedation could be an option, but Indian religious traditions also emphasize spiritual practices, such as prayer and meditation, to alleviate end-of-life suffering.

Religious traditions significantly influence views and practices concerning palliative sedation, shaping both professional and patient decisions in advanced disease care. The major Christian denominations permit palliative sedation with safeguards, while Indian religions generally recommend spiritual awareness at life's end but accept palliative sedation as an option. Recognizing these beliefs deepens understanding of diverse end-of-life values and enhances culturally and religiously sensitive care in palliative settings.