That faith may inform or determine medical decision-making. In the context of ESKD faith may enter deliberations on withholding or withdrawing from dialysis, the pursuit of interventions

and discussions around mortality and bereavement. Australia and New Zealand are multicultural and multireligious societies. In terms of the cultural and religious perspectives find more on serious illness such as ESKD, dialysis and death several points are fundamental: In modern societies patients may or may not have a religious faith. All patients have spirituality. It is important to avoid two approaches: Ignoring all cultural/religious diversity and applying one approach to all patients. Assuming that all patients from an ethnic background or religious faith will act or believe identically. An example would be thinking ‘All Chinese patients believe this …’. Cultural and religious beliefs may enter discussions at critical times in the trajectory of chronic kidney disease including pre-dialysis discussions, during dialysis, discussions around withdrawing from dialysis and the care of Galunisertib mw the dying patient. It is important to enquire whether the medical decision-making is influenced partly or completely by religious beliefs as they need to be clarified and

examined. An example is where there is concern that withdrawing from dialysis constitutes suicide or be a serious affront to a deity. It is appropriate to encourage the patient or their family to seek the guidance of religious clerics or advisers within their faith. A short summary of the perspectives of the major world religions on serious illness and death follows. It is not possible to refer to all religions. In a clinical context, it is important to seek the perspective over of the individual patient and family as, even within the one body of faith, there may be divergent views. As there are a large number of denominations within the Christian faith, generalizations are difficult to make. Nevertheless, there is a common belief that Jesus Christ is the Son of God, that He rose from the dead and that

there is life after death. Attitudes to serious illness and death vary from acceptance to distress. Withdrawal from treatment, including dialysis is acceptable in Christian ethics. It is not seen as sinful or constituting suicide. Intentionally causing a patient to die is forbidden. The Jewish faith believes in one God and that the human body belongs to God. With that belief comes an obligation to heal. Jewish law is binding and Jews may wish to consult a Rabbi before making serious medical decisions. Withdrawal from treatment, including dialysis is acceptable in Jewish law and ethics if it is in the patient’s best interests. Suicide and euthanasia are against Jewish law. Islam’ means submitting to the will of God. Muslims, the followers of Islam, believe in one God. Prophets guide the faithful and the most influential was Muhammad. They believe that God spoke through Muhammad in the Qur’an.