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Conceptual Barriers to Palliative Care and Enlightenment From Chuang-tze’s Thoughts

Published online by Cambridge University Press:  02 June 2020

Abstract

This paper claims that palliative care (PC) is a suitable approach for offering comprehensive support to patients with life-threatening illness and unavoidable asthenia, to enhance their quality of life in aging and chronic illness. There are however some conceptual barriers to accessing that care on the Chinese Mainland: (1) Death-denying culture and society; (2) Misguidance and malpractice derived from the biomedical model; (3) Prejudice against PC and certain deviant understandings of filial piety culture. To counter these obstacles, the study introduces the philosophy of Chinese Taoist Chuang-tze to enlighten the public from ignorance and remove some illusions about death and dying; inspire people to face and accept illness and death calmly, and keep harmony and inner peace of mind to alleviate suffering, with the aim of providing wisdom and a shift of attitude toward life and death. Chuang-tze’s thoughts are consistent with the provision of palliative care, and to a certain degree, can promote its acceptability and delivery, and the conception of good death in practice.

Type
Special Section: Death, Dilemmas, and Decisions
Copyright
© Cambridge University Press 2020

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References

Notes

1. De, LL, Pastrana, T. Opportunities for palliative care in public health. Annual Review of Public Health 2016;37(1):357.Google Scholar

2. Adler, ED, Goldfinger, JZ, Kalman, J, Park, ME, Meier, DE. Palliative care in the treatment of advanced heart failure. Circulation 2009;120(25):2597.CrossRefGoogle ScholarPubMed

3. Sepúlveda, C, Marlin, A, Yoshida, T, Ullrich, A. Palliative Care: The World Health Organization’s global perspective. Journal of Pain & Symptom Management 2002;24(2):91–6.CrossRefGoogle ScholarPubMed

4. Adler, RH. Engel’s biopsychosocial model is still relevant today. Journal of Psychosomatic Research 2009;67(6):607–11.CrossRefGoogle ScholarPubMed

5. Hsu, C-Y, O’Connor, M, Lee, S. Understandings of death and dying for people of Chinese origin. Death Studies 2009;33(2):153–74.CrossRefGoogle ScholarPubMed

6. Novy, DM, Aigner, CJ. The biopsychosocial model in cancer pain. Current Opinion in Supportive & Palliative Care 2014;8(2):117.CrossRefGoogle ScholarPubMed

7. Temel, JS, Greer, JA, Muzikansky, A, Gallagher, ER, Admane, S, Jackson, VA, et al.Early palliative care for patients with metastatic non-small-cell lung cancer. Chinese Journal of Lung Cancer 2010;363(9):733.Google ScholarPubMed

8. Clark, D. From margins to centre: A review of the history of palliative care in cancer. Lancet Oncology 2007;8(5):430–8.CrossRefGoogle ScholarPubMed

9. Connor SR, Bermedo MCS. Global atlas of palliative care at the end of life. World Health Organization; 2014; available at https://www.who.int/nmh/Global_Atlas_of_Palliative_Care.pdf (last accessed 3 Mar 2020)Google Scholar

10. Caruso, AB, Howard, SC, Baker, JN, Ribeiro, RC, Lam, CG. Reported availability and gaps of pediatric palliative care in low- and middle-income countries: A systematic review of published data. Journal of Palliative Medicine 2014;17(12):1369-83.CrossRefGoogle Scholar

11. Barclay, JS, Blackhall, LJ, Tulsky, JA. Communication strategies and cultural issues in the delivery of bad news. Journal of Palliative Medicine 2007;10(4):958–77.CrossRefGoogle ScholarPubMed

12. See note 5, Hsu et al. 2009:153–74.

13. Higginson, IJ, Koffman, J. Public health and palliative care. Clinics in Geriatric Medicine 2015;21(1):4555.CrossRefGoogle Scholar

14. Engel, GL. The need for a new medical model: A challenge for biomedicine. Science 1977;196(4286):129–36.CrossRefGoogle ScholarPubMed

15. Wu, Y, Li, L, Su, H, Yao, X, Wen, M. Hospice and palliative care: development and challenges in China. Clinical Journal of Oncology Nursing 2016;20(1):E16.CrossRefGoogle ScholarPubMed

16. Weinstein, MC, Skinner, JA. Comparative effectiveness and health care spending--implications for reform. New England Journal of Medicine 2010;362(19):1845.CrossRefGoogle ScholarPubMed

17. Cormier, JN, Askew, RL. Assessment of patient-reported outcomes in patients with melanoma. Surgical Oncology Clinics of North America 2011;20(1):201–13.CrossRefGoogle ScholarPubMed

18. Pujol, N, Jobin, G, Beloucif, S. ‘Spiritual care is not the hospital’s business’: A qualitative study on the perspectives of patients about the integration of spirituality in healthcare settings. Journal of Medical Ethics 2016;42(11):medethics-2016–103565.CrossRefGoogle Scholar

19. Wachholtz, AB, Fitch, CE, Makowski, S, Tjia, J. A comprehensive approach to the patient at end of life: assessment of multidimensional suffering. Southern Medical Journal 2016;109(4):200–6.CrossRefGoogle ScholarPubMed

20. Dezutter, J, Luyckx, K, Wachholtz, A. Meaning in life in chronic pain patients over time: Associations with pain experience and psychological well-being. Journal of behavioral medicine 2015;38(2):384–96.CrossRefGoogle ScholarPubMed

21. Covic, T, Adamson, B, Spencer, D, Howe, G. A biopsychosocial model of pain and depression in rheumatoid arthritis: A 12-month longitudinal study. Rheumatology 2003;42(11):1287–94.CrossRefGoogle ScholarPubMed

22. Huang, QS. A review on problems of China’s hospice care and analysis of possible solutions. Chinese Medical Journal 2015;128(2):279–81.CrossRefGoogle ScholarPubMed

23. Chengtek Tai, M. Natural and unnatural: an application of taoist thought to bioethics. Etica & Politica/Ethics & Politics 2004;6(2):19.Google Scholar

24. Hsin, DH, Macer, D. Comparisons of life images and end-of-life attitudes between the elderly in Taiwan and New Zealand. Journal of Nursing Research 2006;14(3):198208.CrossRefGoogle ScholarPubMed

25. Wang, R, trans. Zhuangzi . ChangSha: Hunan People’s Publishing House; 1999:363.Google Scholar

26. Taosim, Hansen C.. In: Zalta, EN, ed. The Stanford Encyclopedia of Philosophy Spring 2017 ed. State of California: Metaphysics Research Lab, Stanford University; 2017.Google Scholar

27. See note 25, Wang 1999, at 289.

28. See note 25, Wang 1999, at 91.

29. See note 25, Wang 1999, at 103.

30. See note 25, Wang 1999, at 43–5.

31. Khroutski, K. Towards the bioethics of individual’s health: introduction of the cosmist philosophical fundamentals. Theoretical Medicine & Bioethics 2002;12(1):28.Google Scholar

32. Puchalski, C, Ferrell, B, Virani, R, Otis-Green, S, Baird, P, Bull, J, et al.Improving the quality of spiritual care as a dimension of palliative care: The report of the Consensus Conference. Journal of Palliative Medicine 2009;41(1):885904.CrossRefGoogle Scholar

33. Jonas, H. The Phenomenon of Life: Towards a Philosophical Biology. Evanston, IL: Northwestern University Press; 2001.Google Scholar

34. See note 25, Wang 1999, at 125.

35. See note 25, Wang 1999, at 127.

36. See note 23, Tai, Chengtek 2004;6(2):19.Google Scholar