Christian Ethical Response to End-of-Life Care: An Indigenous Communitarian Health Care Approach
O James Kithan
  • ISBN : 9789351486381
  • year : 2022
  • language : English
  • binding : Hardbound
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This book is a welcome contribution to the research area of the ethics of health care in general and indigenous health care practices in particular. It certainly raises critical questions on the prevailing health care conditions as regards End of Life issues in India and part of Northeast, especially in the Lotha Naga community. It exposes the poor health care infrastructure in the country, on the one hand, and formulates an indigenous response to the failure of health care practices, on the other. The book engages in conversations with dominant Christian Ethics and provides critique from an indigenous perspective, as it systematically unearths moral gaps in dominant Christian/Secular health care ethics. The book further explicates appropriation of Lotha Naga Indigenous theology and ethics from a senior people’s perspective. Contents Foreword Acknowledgement Preface List of Abbreviation Glossary Introduction 1. Rationale of the Ethics of End-of-Life Care 1.1. Moral Gaps in Health Care Ethics 1.2. Challenges of End-of-Life Care among the Senior People in India 1.3. Issues and Challenges of End-of-Life Care for Senior People among Lotha Naga 2. Methodology 3. Previous Research 3.1. Elisabeth Kubler-Ross (1926-2004) 3.2. Malhia Joshua (2004) 3.3. Medowelu Wezah (2018) 4. Purpose of the Study 5. Limitation/Scope 6. Research Question Chapter 1: Issue of the End-of-Life Care in India with Special Reference to North East India Introduction 1. Concept of End-of-Life Care 2. Historical Development of Concept of End-of-Life 2.1. Changing Understanding of Death and Dying 2.2. Medicalization of End-of-Life 2.3. Hospice Movement 3. Overview of Health Care System in India 3.1. History of Western Healthcare System in India 3.2. The Traditional Systems of Medicine in India: Ayurveda, Yoga and Naturopathy, Unani, Sidha, and Homeopathy (AYUSH) 3.3. Public Healthcare System in India 3.4. Public Health Care Policy 3.5. Critique of the Public Healthcare System in India 3.6. Private Healthcare System in India 3.7. Critique of Private Healthcare System 4. The End-of-Life Care among Senior People in India 4.1. Palliative Care: Indian Perspective 4.2. Hospice Care 5. Issues of End-of-Life Care of the Senior People in India 5.1. Public Health Care and End-of-Life Care for Senior People 5.2. Common Disease-related Death of Senior People in India 5.3. Government Expenditure Towards Senior End-of-Life Care 5.4. Information Deficit in Primary Healthcare 5.5. Hospitalization: Clinical and Disease-specific Rather than Patient-Centric 5.6. Lack of End-of-Life Care Facilities for Senior People 5.7. Challenges of End-of-Life Care of Senior People in India 6. Public Health Care and Infectious Disease with Special Reference to COVID-19 in India: The Challenges of Senior People’s Care 6.1. Lack of Preparedness of Public Health Care 6.2. COVID-19 Pandemic: Impact on the Senior People 6.3. Challenges Faced by Public Health Care During COVID-19 Pandemic in Nagaland 7. Challenges Faced by Rural Health Care Sectors in North-East India 7.1. Shortfall in Health Centers and Human Power 7.2. Low Quality of Rural Health Care Services 7.3. Medical Tourism 7.4. Urban-Rural Gap in Health Care Infrastructures and Services 7.5. Special National Policy and Programme for Northeast 8. Overall Public Healthcare Situation in Nagaland 8.1. Lack of Proper Infrastructures and Modern Facilities 8.2. Shortage of Medical Professionals 8.3. Neglecting Rural Healthcare 9. Healthcare Scenario among the Lotha Naga 9.1. Irregularities of Healthcare Workers in their Designated Areas 9.2. Overdependence on Private Clinic and Nursing Homes 9.3. Referral to Urban Hospitals Even in Minor Case (Kohima, Dimapur and Guwahati) 9.4. Negligence of Rural Health Care Services 9.5. Lack of Proper Infrastructures and Services 9.6. Lack of Geriatric Care Services in Wokha District Conclusion Chapter 2: The Indigenous Family and Communitarian Care Among Lotha Naga in Nagaland Introduction 1. Overview of Family Care towards Senior People in India 2. The Changing Pattern of Family Structure in India 2.1. Education 2.2. Occupation and Migration 3. The Family Care among Lotha Naga 3.1. The Traditional Lotha Naga Family Care System 3.2. Indigenous Lotha Naga Women as Care Givers 3.3. Khümoshumo Nzan (Friendship Care) 4. The Lotha Naga Indigenous Communitarian Care and Values 4.1. Eyanta (Lotha Traditional Practices of Sharing) 4.2. Thenhyarünhyata (Inclusivity) 4.3. Kyotarungto (Extending Help to Individual and Community) 4.4. Yingaden (Same Age Group Working Company) 5. Indigenous Lotha Naga Communitarian Values and Ethos as Alternative Resources to Address the End-of-Life Care among Senior People 5.1. Janthechita osi Sochopenchota: An Ethical Space for Visitation and Sharing of Hearts 5.2. Nijüpsüjüp osi Tanüngta: An Ethical Space for Caring and Nurturing of Senior People 5.3. Eyanta Tona Pitalonta: An Ethical Space for Sharing 5.4. Khyotarungta osi Nzanchita: A Space for Supportive Attitude towards Senior People 6. Discontinuity and Continuity of Lotha Indigenous Family Care 7. Indigenous Lotha Naga Understanding and Practices of Health Care 7.1. Ethno-Medicine 7.2. Magico-Religious 7.3. Spirit-Based Health Care Practices 7.4. Ratssen (Medicine Person) 7.5. Montsai (Spirit Invokers) 7.6. Eloe Eopk-mmi lo nzanchi (Women Midwifery) 7.7. Lotha Folklore: The Story of Ranphan and Müntsülo: With Special Focus on the Healing of Montsulo Leprosy 8. Ethical Values Present in the Indigenous Lotha Communiterian Care System 8.1. Ethics of Sharing 8.2. Ethics of Respect 8.3. Friendship Ethics 8.4. Ethics of Communitarian Care 8.5. Ethics of Humility 8.6. Ethics of Integrity 9. Erosion of Lotha Indigenous Communitarin Value and Care for Senior People 9.1. Erosion of Care for Senior People 9.2. Socio-Economic Erosion 9.3. Political Erosion 9.4. Religious Erosion 10. Issues and Challenges of End-of-Life Care among Senior People in Lotha Naga 10.1. Issues End-of-Life Care among Senior People in Lotha Naga 10.2. Challenges of End-of-Life Care among Senior People in Lotha Naga Conclusion Chapter 3: Health Care Ethics and Moral-Gaps with Special Reference to End-of-Life Care Introduction 1. Modes of Ethical Discourse in End-of-Life Care Ethics 1.1. Virtue Ethics in End-of-Life Care 1.2. Deontological Ethics in End-of-life Care 1.3. Teleological Ethics in End-of-Life Care 2. Principles in End-of-Life Care 2.1. Principle of Nonmaleficence 2.2. The Principle of Beneficence 2.3. The Principle of Autonomy 2.4. Principle of Justice 2.5. Critique of Principles 3. Medico-Ethical Challenges of End-of-Life Care in India 3.1. Withdrawing and Withholding Interventions 3.2. Physician-Assisted Suicide 3.3. Challenges in Legalization of Passive Euthanasia 3.4. Lack of Cultural and Spiritual Sensitivity 4. Moral Gaps in Health Care Ethics 4.1. Concept of Moral Gaps 4.2. Moral Gaps in Health Care Ethics 5. Moral Gaps in Health Care Ethics in Conversion with Robin Gill 5.1. Biased Secular Version of Health Care 6. Christian Ethics in Addressing End-of-Life Care 6.1. Ethics of Care 6.2. Compassion Ethics 6.3. Value of Life 6.4. Quality of Life Conclusion Chapter 4: The Concept of Sükhying: Towards the Construction of the Lotha Naga Indigenious Communiterian Health Care Ethics Introduction 1. Re-Visiting the Indigenous Theological Methodologies 1.1. Indigenization and Contextualization 1.2. Method of Synthesis-Praxis 1.3. Land-Centered Method 1.4. Indigenous Postcolonial Theory 1.5. Indigenous Feminist/Womanist Methodology: A Critique of the Male-Centered Indigenous Theology 2. Indigenous Communitarian Concepts that Inform End-of-Life Care in the Context of North East India 2.1. Mizo Concept of Tlawngaihna 2.2. Ao Naga Concept of Sobaliba 2.3. Kuki Concept of Khankho 2.4. Khasi Concept of Ka Hok 3. Critique of Indigenous Communitarian Ethics 3.1. Critique of Patriarchy 4. Liberative Communitarian Method 5. The Understanding of the Concept of Sükhying among Lotha Naga 5.1. From Sükhyingo to Omon Sükhying 6. The Conceptual Framework for the Understanding of Sükhying 6.1. Sükhying: Potsow (Supreme Being) 6.2. Sükhying: Sütsungrham (Evil Spirit or Demons) 150 6.3. Sükhying: Tathi na Sekacho osi thenhyacho (Destiny) 151 6.4. Sükhying: Rothakcho enhunga ete Sükhying (Past and Lived Experience) 6.5. Sükhying: Osen (Heredity) 6.6. Sükhying: Mmhalatero (Blessings) 152 6.7. Sükhying: Orensükhying (Circumstances and Situation) 152 6.8. Sükhying: Sari-Sapvü osi sari-nmvü (Taboo and Profanation) 153 6.9. Sükhying: Sukhying Ehan Eramoe (Special Possession by the Senior People) 6.10. Sükhying: Monkhum Yikrachi (Respecting Self and Fellow being) 6.11. Sükhying: Nkhyontoe osi Nochonori Nzanchi (Care for Needy and Sick) 7. Appropriating Sükhying: An Ethical Space for Communitarian Caring 7.1. Sükhying: Spirit-Based Care Ethics 7.2. Sükhying: Ethical Space for Respect for Senior People 7.3. Sükhying: Ethical Space for Compassion 7.4. Sükhying: An Ethical Space for Hospitality 8. Feminization of Care: Critique of Patriarchal Notion of Care 8.1. Sükhying as a Critique of Patriarchal Notion of Care 9. Juxtaposition or Bland of Lotha Naga Cultural Values with Christian Values 9.1. Sükhying as the Holy Spirit Conclusion Chapter 5: Towards an Indigenous Lotha Naga Communitarian Health Care Ethics in Addressing End-of-Life Care Among Lotha Naga Senior People Introduction 1. Critique of Euro-American Health Care Ethics and the Rationale for an Indigenous Lotha Naga Communitarian Health Care Ethics 2. Theology of Seniority from the Perspective of Disability 3. Enumerating Discourses of Senior People Ethics in the Postmodern World 3.1. Senior People as Multitude: Quest for Liberative Space 3.2. Reclaiming Seniority as Counter Public Spheres 3.3. Planetary Ethics: A Space for Alterity of Senior People 4. Christian Theological and Ethical Re-Imagining of Senior Peoples 4.1. Reclaiming Eucharist: The Broken Body of Christ for Senior People 4.2. The Cross and End-of-life Care 4.3. Resurrected Bodies and End-of-life Care 5. Towards Appropriating the Lotha Naga Indigenous Theology and Ethics from Senior People Perspective 5.1. Encountering the Omon Sükhyingo: The Lotha Naga Deity with Disability 5.2. Lotha Naga Understanding of the Divine Being (Sükhying) 5.3. Appropriating the Understanding of the Divine Being (Omon Sükhyingo): Claiming the Space of the Vulnerable 5.4. Re-Visiting Mijen: Praxiological Approach for Home-Based Community Dining Service for Senior People 6. Lotha Naga Communitarian Affirmative Values for Public Health Care System 6.1. Eyanta osi Pitalonta: Communitarian Sharing of Resources in Public Healthcare 6.2. Kyotarungta osi Nzanchita: Solidarity-based Public Healthcare Approach 6.3. Janthechita: Home-Visitation Based Public Healthcare Approach 6.4. Nijupsujup osi Tanungta: Nurturing and Caring Based Public Healthcare Conclusion Overall Conclusion Bibliography Dr. O. James Kithan hails from Wokha Village, Nagaland. He completed his B.D from Clark Theological College, Aolijen, Mokokchung in 2008; Master of Theology (Christian Ethics) in 2013; and Doctorate of Theology from United Theological College, Bangalore in 2021. From the last 10 years, he has been involved in Church Ministry; 3 years in Youth Ministry and 7 years in pastoral ministry at Wokha Village Baptist Church. Presently he is serving as the Vice Principal at Witter Theological College, Vankhosung, Nagaland, India. He is married to Jandeno and they are blessed with two children, Ronachan and Kumroni.