While statistics about the medicalization of end of life care in the United States were briefly touched on in this podcast episode, statistics about end of life care in other countries were not touched on. As three of the four interviewees from the podcast were from East Asian cultures, the focus of this related article is on physician and family attitudes towards end of life care in East Asian countries—specifically Korea, Taiwan, and Japan.
A survey was conducted of nearly one thousand palliative care physicians in these three countries. Around five hundred of the responses were from Japanese physicians, over two hundred from Korean physicians, and over two hundred from Taiwanese physicians. 50% of Japanese physicians, 59% of Korean physicians, and 70% of Taiwanese physicians reported families often being hesitant to discuss issues relating to end of life care. The researchers noted that physicians in Taiwan frequently reported family members wanting to take their dying loved ones back home to die, with 50% saying this occurred often or very often. Around 40% of Korean and Taiwanese physicians reported patients wanting a religious person to come visit the dying patient, whereas no Japanese physicians reported this. The researchers, however, noted that 42% of Japanese physicians reported family members cleaning and caring for the body of a deceased loved one themselves, while only 25% of Taiwanese and 0% of Korean physicians reported the same. Finally, between 70-90% of physicians in all three of these countries reported family members being expected to care for the dying themselves at home, with the highest rate being reported in Taiwan and the lowest rate being recorded in Japan (Cheng et al 2015).
Within the context of classroom discussions, it was frequently touched upon that in the United States, people are often hesitant to discuss end of life care. Additionally, it was often discussed that within the United States, people are generally disconnected from the end of life process, as it has become very institutionalized, as can be seen in the high rates of people dying in hospitals or other institutions (APA 2018). Therefore, this research is particularly interesting, as it highlights the differences in approach to end of life care between these different cultures. What especially seems to stand out is the proximity to death in these cultures, particularly as reported by the Taiwanese and Korean cultures. This is highlighted by how frequently family members in these cultures were expected to care for the dying themselves at home, as well as the amount of people cleaning the body themselves. Although it was often reported that people were hesitant to discuss the end of life, families were more directly involved in the end of life care.
2018. “End-of-Life Care Fact Sheet.” American Psychological Association. Retrieved December 7, 2018. https://www.apa.org/pi/aging/programs/eol/end-of-life-factsheet.aspx.
Cheng, Shao-Yi et al. 2015. “A Cross-Cultural Study on Behaviors When Death is Approaching in East Asian Countries.” Medicine (Baltimore) 94(39): e1673. Doi: 10.1097/MD.0000000000001573.