As with other aspects of Indigenous health, healing and well-being, Indigenous death and dying are strongly linked with community, cultural practices, and spiritual significance (Duggleby et al., 2015). There has been an increase in literature that examines culturally sensitive approaches to end-of-life care and how Indigenous people view and discuss the issues of death and dying amongst themselves (Castleden, Crooks, Hanlon, & Schuurman, 2010; Duggleby et al., 2015; Kelley, 2010; Kelly et al., 2009).
First Nations, Inuit and Métis people are a very heterogeneous group and this diversity is apparent in the care and practices around the last stages of life. Indigenous communities have a long history of practicing palliative care – caring for and supporting each other. While the final walk of one’s journey to the spirit world presents challenges, it remains an auspicious opportunity for healing (Anderson, Chalklin, Downey, Lee, & Rodin, 2017). Healing is a process aimed at restoring balance among the spiritual, mental, emotional, and physical realms of self (Clarke & Holtslander, 2010; Hunter, Logan, Goulet, & Barton, 2006). This is not simply about healing the individual but also encompasses healing families, communities, and ancestral relations. In other words - it is about healing “all my relations.”
Death is not a medical event. It is about culture and community. To realize the opportunities for healing, Indigenous culture, knowledge, and constructs of community need to be respected and valued. The path to decolonizing palliative care can be approached by building meaningful relationships which support harmony and understanding between Indigenous and biomedical worldviews. Paradoxically, the biomedical system is premised on maintaining distance in the relationships between healthcare provider and patients. It is important for healthcare professionals and institutions to be culturally competent in order to create culturally safe spaces. Only when dying individuals’ and their families’ cultural beliefs, values, practices, and spiritual ceremonies are respected and valued will culturally safe care be realized.
To further the discussion about issues surrounding death and dying, the International Journal of Indigenous Health is requesting papers that have primary research in the following areas (but not limited to these areas):
• Cultural and/or spiritual issues of Indigenous death and dying
• Healthcare professionals and their influence on Indigenous death and dying
• The role of family in death and dying
• Differences and similarities of Indigenous death and dying around the world
• Examination of discussion in community(s) around sudden death(s)
• Death and dying rituals, ceremonies, spirituality
• The role of traditional healing and/or medicines in death and dying
Anderson, M. A., Chalklin, L., Downey, B., Lee, L., & Rodin, G. (2017). A Search for Solutions: A Gathering
on Palliative and End-of-Life Care for First Nations, Inuit, and Metis Peoples. Retrieved from
Castleden, H., Crooks, V. A., Hanlon, N., & Schuurman, N. (2010). Providers' perceptions of Aboriginal
palliative care in British Columbia's rural interior. Health Soc Care Community, 18(5), 483-491.
Clarke, V., & Holtslander, L. F. (2010). Finding a balanced approach: incorporating medicine wheel
teachings in the care of Aboriginal people at the end of life. J Palliat Care, 26(1), 34-36.
Duggleby, W., Kuchera, S., MacLeod, R., Holyoke, P., Scott, T., Holtslander, L., . . . Chambers, T. (2015).
Indigenous people's experiences at the end of life. Palliat Support Care, 13(6), 1721-1733.
Hunter, L. M., Logan, J., Goulet, J. G., & Barton, S. (2006). Aboriginal healing: regaining balance and
culture. J Transcult Nurs, 17(1), 13-22. doi:10.1177/1043659605278937
Kelley, M. L. (2010). An indigenous issue: why now? J Palliat Care, 26(1), 5.
Kelly, L., Linkewich, B., Cromarty, H., St Pierre-Hansen, N., Antone, I., & Giles, C. (2009). Palliative care of
First Nations people: a qualitative study of bereaved family members. Can Fam Physician, 55(4),