Purpose The best end-of-life care addresses patients' and families' spiritual concerns. Cultural beliefs frame such concerns, but little research exists. We sought to characterize, by ethnic group and gender, one important spiritual concern, what happens to the soul after bodily death.
Methods We conducted open-ended interviews with 26 Mexican American (MA), 18 European American (EA), and 14 African American (AA) men and women. A consensus-based content analysis identified themes. Because some subjects responded several ways about a theme, percentages may add to over 100%.
Results Majorities of all groups believed the soul lives on after bodily death (see the Table). Majorities or near-majorities also expressed seemingly inconsistent beliefs that the soul both remains in the body and leaves it at bodily death. Yet clear differences arose over when, if ever, the soul leaves the body and where the soul is after bodily death. For example, subjects timed the soul's departure from before life support stops to 15 minutes to a month after bodily death.
Conclusion The ethnic-gender groups share one belief, that the soul lives on after bodily death, but differ on others. Sensitive end-of-life care requires health professionals to anticipate varying beliefs about the soul at bodily death and to adjust care accordingly. For example, professionals should time organ donation requests or invite discussions about encounters with the dead according to survivors' beliefs.
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