Honoring Long-Lived Cultural Beliefs for End-of-Life Care: Are We Prepared in the Modern Western Society?

The Hippocratic Oath establishes the principle of primum non nocere or "first do no harm" in Western medicine. This not only includes physical health but also encompasses emotional and spiritual health. Various end-of-life care (EOLC) practices exist in different societies, and it is hard but vital for the healthcare community to be aware of these practices to allow wholesome care for their patients, which is emotionally and spiritually fulfilling. A 57-year-old male with a history of metastatic squamous cell carcinoma of the head and neck region presented to the emergency department after an out-of-hospital cardiac arrest. After appropriate post-cardiac arrest care, the patient remained unresponsive, and the family decided to transition to comfort-focused care. Based on their religious and cultural preferences, they preferred palliative extubation at a place where the patient would not have a roof over his head at the time of death, as well as sought help to facilitate a same-day funeral. After coordinating with various departments in the hospital, the patient was taken to the hospital helipad and extubated there in the family's presence. The patient's remains were released to the family within an hour of death for a timely funeral. This case is an example of cultural and religious diversity that exists within our community. Healthcare is a complex field and EOLC is a crucial part of patient care. With a multi-disciplinary approach towards EOLC, the distress related to death can be reduced among families as well as healthcare teams.