Used simply in the United States, the word “karma” is widely used, even if usually misunderstood. Though there are many synonyms for the word, its most common sense of use regards the idea that “what goes around comes around.” In other words, the actions we may engage in today will have results sometime in the future that we cannot predict today. The religious use of karma in Hinduism, however, is vastly more complicated. Recently, I ran into the use of this word that resulted in my insulting a case worker at the hospital.

We were discussing a case in which the patient was being discharged back home under the care of a local hospice. She was the social worker active on her case and was telling me about how difficult the discharge had been. In her view, the family had been very hard to work with. They all seemed comfortable with their matriarch going home in the full knowledge that she would likely die soon from her cancer. But something had got in the way according to her. She worked for the palliative care service at the hospital. The patient’s care had been well managed by the palliative care team and it did not appear there were any problems with moving back home and taking up with the local hospice. The patient and her family were clearly Hindu and I had already worked with our spiritual care department to make sure that our Chaplain, who was most well informed and connected in the Hindu community, was working with them. The case worker, however, was not tuned in to the religious realities of the patient and her family.

The case worker and I were reviewing the case because the hospital patient experience department had received a complaint about her work. According to the family, something had gone wrong during one of her conversations so we were going over it in very close detail. I had asked her what religion the family was and she replied that she was not sure but did not think they were Christian. In describing her conversation with me, she said at one point, “I told them hat I thought they might want to consider the State’s new Assisted Suicide law, but that karma on that sort of thing might be a bitch.” I paused slightly before asking her in response, “What is karma?” She said something about destiny and reincarnation, so I asked again, “What is karma?” Looking a bit confused, but working with me, she said, “Well, it’s when you do something wrong, eventually something wrong will happen to you.” So, I changed my question ever so slightly, “Where does the word ‘karma’ come from?” Now clearly upset, she responded that she did not know, but that it had something to do with reincarnation.

Questions for Reflection

1. Do licensed clinical social workers have any responsibility to know anything about Hinduism?

2. Can we fault someone growing up in America these days for using common vernacular that has come to us from particular religious traditions through the process of immigration?

3. Clearly the case worker does not know the significance of karma, nor does she know that her patient and the patient’s family were Hindu. What are some of the deeper implications of karma that might have caused the family to be so offended by the case worker’s claim that “karma may be a bitch if you consider assisted suicide?”