This paper examines how faith and worldview shape patient attitudes toward health, healing, and medical decision-making, with a focus on comparing Christianity and Buddhism across seven key dimensions identified by Shelly and Miller (2006). The paper argues that nurses who understand diverse religious frameworks — including beliefs about prime reality, human nature, death, morality, and knowledge — can provide more effective and respectful holistic care. It highlights shared elements between the two faiths, such as community and a belief in life after death, while acknowledging their significant theological differences. Practical guidance is offered for nurses working with patients whose religious backgrounds differ from their own.
Faith influences attitudes toward health, healing, and the role of healing practitioners in the lives of individuals and their communities. Because of this intersection between faith and wellness, it is critical for nurses to be sensitive to diverse patient backgrounds and belief systems. By understanding multiple faith systems and how those systems' worldviews impact patient attitudes, behaviors, and communication styles, nurses can provide more appropriate and effective interventions. Even if the majority of patients share the same background as the nurse, it is necessary to remain open to alternative worldviews. Moreover, even within a single faith category, individual differences will warrant careful attention to each patient's attitudes toward existential questions.
Christianity is itself a highly diverse faith. Different denominations espouse various attitudes toward illness and health, healing and wellness. Therefore, the nurse should never assume that all Christian patients share the same values. When working with patients from radically different religious backgrounds — such as Buddhism or Hinduism — the nurse faces additional challenges. Agreeing with the patient's worldview or theology is unnecessary for delivering optimal holistic care, because there are always ways to find points of reference and work with those on the path to healing. In Called to Care, Shelly and Miller (2006) point out that there are several core questions nurses can contemplate in order to understand multiple worldviews. Those questions address issues such as the nature of prime reality, the nature of daily reality, and the nature of human beings. The essential questions also pertain to critical care concerns such as belief in life after death and issues related to morality. Knowledge and authority are also key components of a patient's worldview. It is important to address all aspects of worldview in order to develop a cohesive paradigm for nursing.
As Shelly and Miller (2006) point out, Christian nurses locate the answers to critical questions in the Bible. Other religions look toward their respective sacred texts. The answers to these core questions determine an individual's fundamental assumptions, attitudes, emotions, and beliefs, and these can tremendously influence health care decisions and behaviors. When the patient's worldview differs radically from that of the nurse, finding common ground becomes essential to promoting respect and communication in health care. Buddhism, for example, is a religion that is as diverse as Christianity in that many different nations and cultures practice their own form of the faith, and several distinct sects exist. Because Buddhism differs significantly from Christianity, a Christian nurse may initially be perplexed to meet Buddhists from places like Vietnam or Taiwan and find that they do not necessarily believe in God but do believe in life after death. Finding the critical common components shared by all belief systems is a preferable and more constructive starting point than fixating on points of divergence between faiths. When working with patients from diverse backgrounds, it is also important to understand how significant faith or religion is to that particular individual, rather than assuming the person's worldview is religious in nature at all. Many patients will deny the efficacy of faith.
Common critical components to all religions and belief systems include the efficacy of religion in promoting moral behavior, health-seeking behavior, and community identity. Research has shown that religious affiliation, regardless of the type of faith, is linked with better health outcomes (Yeary et al., 2011). Some of the connection between religion and health can be explained in part by health behaviors triggered by social norms and other psychosocial factors, but the social capital generated by religion also plays an important role in ensuring individuals' access to health care and their motivation to seek care (Yeary et al., 2011). Deistic religions offer individuals the opportunity to pray to their God — or gods — with the firm belief that those deities will provide either a direct intervention in the form of healing, or the psychological means to accept the outcome, even if that outcome is death. Religions of all types assuage fears of death, and thus even non-deistic religions like Buddhism share with deistic religions an acknowledgment that the physical body is only one small part of the totality of being. Fear of death is counteracted by faith in all cases except for those who reject religion altogether.
Patients whose faith background differs from that of their health care practitioner will want respect above all else. Respect means that the nurse does not impose any particular method of prayer, but instead permits the patient to meditate or communicate with a deity in ways that are meaningful to them. Nurses can also warmly invite friends and family members who can offer spiritual support during the patient's healing process, as one of the core components of all religions is the sense of community that faith fosters.
While Buddhism and Christianity share common elements — such as a sense of community and some form of belief in life after death — these two faiths exhibit major differences across the seven key dimensions of worldview outlined by Shelly and Miller (2006). The following sections examine those differences and their potential points of convergence for clinical practice.
Prime reality for the Christian is answered relatively simply: it is God as Creator of the Universe. However, some Christians may emphasize the dualistic nature of prime reality more than others. The Buddhist concept of prime reality is, quite literally, nothingness — the Buddhist believes that all reality is temporary, fleeting, and impermanent. Unlike Christians, Buddhists do not believe in God. The Buddha is an enlightened human being, not a deity or even a prophet of God. As an enlightened being, the Buddha understood prime reality through a life dedicated to meditation and adherence to basic moral behaviors. One's view of prime reality underlies all other aspects of the worldview, influencing the broad paradigms through which a patient views health, wellness, healing, and health care systems.
The Christian and Buddhist worldviews of everyday reality are somewhat comparable, particularly for the Buddhist. For the Buddhist, the world around us is transitory and impermanent, and therefore of no lasting importance — except that human actions do have direct and tangible consequences, a phenomenon known as the law of karma (Monier-Williams, 1889). Connected with its predecessor faith Hinduism in a way similar to the relationship between Christianity and its predecessor faith Judaism, Buddhism sets out to show the practitioner that the body and all other elements of the natural world and daily life are impermanent. The goal is non-attachment, an attitude that will undoubtedly impact health behaviors among patients. Christian patients are not taught to pursue non-attachment as a goal, and yet placing all faith in Christ confers a similar type of psychological and spiritual surrender. In both cases, the patient perceives that there is more to life — and death — than what human beings are capable of fully knowing at this time.
"Point-by-point comparison of Christianity and Buddhism"
Shelly, J. A., & Miller, A. B. (2006). Called to care. InterVarsity Press.
Yeary, K. H. K., et al. (2011). Religion, social capital, and health. Review of Religious Research, 54(3), 331–347.
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