Death, Dying and Bereavement
A Hong Kong Chinese Experience
Publication Year: 2006
Published by: Hong Kong University Press, HKU
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Although death, dying, and bereavement are obviously universal phenomena, the meanings and practices with which people respond to them are intricately cultural and personal. This is perhaps most obviously true with respect to the immense diversity of secular and spiritual frameworks with which human communities conceptualize the state of death, but it is no less true of the variety...
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Yet the subject of death is such a taboo — a phenomenon that is associated not just with mystery, but with misery and fear. This feeling is global, irrespective of race or religion. "Death stalks the night" is something to shudder about. The Chinese are perhaps more sensitive to the issue. The mention of the word death...
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My first encounter with bereavement counselling was during the 1970s when I was engaged in prenatal diagnosis and perinatology. I was struck by the strong sense of denial among Chinese parents such that practices borrowed from the West were not well received. Since then, the Tsan Yuk and Queen Mary Hospital perinatal team has developed a culturally sensitive programme for those undergoing the most traumatic experience...
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Both of us have a passion for helping people who are grieving, because we are terrified by the thought of the death of our loved ones. Through decades of serving patients confronting death, we have learnt so much, both from them and from their family members. Now, we are willing to accept the notion of "why not me?" and probably will not be stuck in the state of "why me?" for too long. As we serve patients living with a life-threatening illness, we want to...
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Fear marks the boundary between the known and the unknown. Some Chinese people believe that talking about death will increase the likelihood of occurrence. Also, by talking about death, evil spirits will be attracted to haunt people.1,2 In facing death, individual response is inevitably moulded by the values, attitudes, and beliefs of one's culture.3,4 Despite the large Chinese...
PART ONE: DEATH
2. Our Memorial Quilt: Recollections of Observations from Clinical Practice on Death, Dying and Bereavement
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Traditionally, filial piety is regarded as the greatest virtue in Chinese culture. When parents are elderly or living with chronic illness, adult children are supposed to care for them. Not hearing a parent's last words or failing to witness the death is regarded as unfilial. Yet, because of increased business travel and migration to different parts of the world, it is becoming harder and...
3. A Personal Journey: The Physician, the Researcher, the Relative, and the Patient
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Palliative care is not about dying, and bereavement is not about crying. Rather, they are about connecting, caring, and respecting — the essence of living. If you dare to add some passion, you might even be seduced by them, as I have been. Health-care professionals involved in palliative care often find their work rewarding and inspiring, whereas others not familiar with its beauty often...
4. "Letting Go" and "Holding On": Grieving and Traditional Death Rituals in Hong Kong
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It is now generally agreed that coping with grief involves not only accepting the reality of death,1 developing the ability to live without the deceased,2 relinquishing old attachments to the deceased and the old assumptive world,3 and withdrawing emotional energy from the deceased so that it can be reinvested in other people and other things.1 Coping with grief also...
5. Making Peace with the Unknown: A Reflection on Daoist Funerary Liturgy
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The term "Daoism" has different connotations and content for scholars as well as believers in Daoism, including aspects relating to philosophical mysticism, mythology, immortals, nourishing life, meditations, and liturgies.1 Daoism, in this chapter, is seen as a religious and liturgical institution profoundly rooted in the social life of local Chinese...
6. Death from the Buddhist View: Knowing the Unknown
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Our lifespan is controlled by our biological clocks, which continually tick away. When they run down, there is little we can do to gain extra time. We must be prepared for the natural process of death. Death is inevitable. Many people believe death brings an end to everything. But, according to Buddhism, our life does not begin only at the moment of birth, and death does not imply...
7. Autopsy in Chinese: A Forensic Pathologist's View
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In 2003, 30,000 people died in Hong Kong. Out of these deaths, nearly 7,000 were reported to the Coroner by the doctors caring for the deceased persons prior to their death, or by the police, when the deaths occur outside a hospital. Table 1 shows details for the five-year period 1999-2003. Table 2 shows details...
8. Death Metaphors in Chinese
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As Feifel1 remarked, one of humanity's most distinguishing characteristics is the capacity to grasp the concept of a "future and inevitable" death. The meanings of death and life are actually interdependent. Individuals' perceptions of death affect their priorities and life choices; whereas individuals' accomplishments, failures, changes and the cumulative effects of diverse...
9. What Is Good Death: Bridging the Gap between Research and Intervention
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Death is inevitable. But in view of this impossibility of further possibility, people still hope for "good death". Different cultures may construct different definitions of "good death", and Chinese culture is no exception. Our traditional Chinese philosophical and religious thought provides important cultural insights into the perception of death. Recent studies have tried to...
PART TWO: DYING
10. Impact of Palliative Care on the Quality of Life of the Dying
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Palliative care has been developing in Hong Kong for more than twenty years, gaining wider coverage and more sophisticated service.1 The modes of delivery include in-patient care, home care, out-patient care, day care and hospital consultative services, looking after cancer patients as well as patients in the advanced stage of other diseases such...
11. Dying: The Last Month
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Good comfort care for dying patients at the final stage of life is crucial, though of course palliative care does not begin only from the countdown of the patient's last month. Palliative care should commence right from the moment of the diagnosis of any incurable illness that is expected to deteriorate with inexorable progression. It is essential to ensure early integration of the...
12. Euthanasia and Forgoing Life-sustaining Treatment in the Chinese Context
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Euthanasia is derived from the Greek euthanatos, which means a good or peaceful death.1 There have been many definitions of the term, and many forms of euthanasia have been described, including active euthanasia, passive euthanasia, voluntary euthanasia, non-voluntary euthanasia and involuntary euthanasia. When used without qualification, the term euthanasia...
13. Community Palliative Care in Hong Kong
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The purpose of palliative care is to enhance the quality and meaning of life and death for both terminal patients (those with cancer or non-cancer disease) and their family members and in their bereavement period. As a modern health-care specialty, palliative care has rapidly developed in the last decade in Hong Kong. The Co-ordinating Committee (Hospice) of Hospital Authority...
14. The Role of Chinese Medicine in Cancer Palliative Care
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Despite rapid advancements in medical science, a number of complementary and alternative medicines (CAM), including Chinese medicine, remain popular. According to WHO1 figures, seventy-five percent of people in a number of developed countries used CAM in 1997. In the US, it was estimated that the percentage of Americans using CAM increased from thirty-two...
15. Providing End-of-Life Care: Enhancing Effectiveness and Resilience
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My ICU [intensive care unit] patient just passed away. I had to perform post-mortem care. This patient of mine, a "man" with a human name moments before, now became a lifeless "it"—a mass of flesh. The pale white body felt cold. I removed all lines and tubes and gave "it" a quick wash. I tied tags on "its" big toe, making sure "it" was correctly...
16. Care for Chinese Families with Patients Facing Impending Death: Nurses' Perspectives
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The hospital is an amazing place where most of us are born. It is supposed to be the place for quick fixes when we are injured or sick. Advanced medical technology can save lives and relieve human suffering most of the time. Yet, this miracle place may fail us when patients die. Though death is a certainty of life, not every one of us acknowledges this fact. After hearing the bad...
17. Walking a Tightrope: The Loss and Grief of Parents of Children with Cancer in Shanghai
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Childhood cancer is one of the ten leading causes of death among children in China. Blood-related cancers such as acute lymphobastic leukaemia (ALL) and acute nonlymphobastic leukaemia (ANLL) are the most common types.1-3 It is estimated that there are around 13,000 to 15,000 new cases of blood-related cancer in China each year.4 The treatment of...
PART THREE: BEREAVEMENT
18. Bereavement Care in Hong Kong: Past, Present and Future
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Death marks a permanent separation from our loved ones. It hurts because we are socially, emotionally and psychologically attached to the deceased, and our loved one may feel like a part of us. His or her death is equivalent to the amputation of a limb from our body. It is an irreversible loss. As there is no Chinese term to describe bereavement, we use the literal translation of...
19. When East Meets West: Implications for Bereavement Counselling
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Bereavement can be understood as a social construction.1 It is shaped by our current socio-cultural environment. A mourner constructs and makes sense of grief within the cultural and social context. Therefore, in order to understand one's grief, it is important to first understand the socio-cultural environment. However, it should be noted that our environment is ever-changing and...
20. The Use of Structured Therapeutic Bereavement Groups
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The Jessie and Thomas Tam Centre of the Society for the Promotion of Hospice Care, the first community-based bereavement counselling centre in Hong Kong, established in 1997, has adopted group work as one of the main intervention modalities in supporting bereaved clients. By understanding the conceptual framework of bereavement groups, as well as the grief process from...
21. The Use of Volunteers in Bereavement Care
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Volunteer participation is widely developed in many sectors in Hong Kong. To volunteer is to give service willingly of one's own accord. Volunteers give their time, skills, thoughts and talents to contribute to the community, without any monetary reward. Volunteering is probably a feature of an affluent society, but it is also a mark of a society in which the people are lucky and want to...
22. The Day After: Experiences of Bereaved Suicide Survivors
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Although suicide may appear to be an individual decision and action in ending one's life, the effect and the subsequent pain of bereavement on family members may be phenomenal. Suicide bereavement has a higher chance of eliciting complicated bereavement responses1,2 than do other forms of bereavement. The focus of studies on suicide is mainly on attempters...
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We can learn about life through the death of our loved ones.2 Knowing death reminds us of the treasures in life, the importance of relationships as well as our connectedness with people and nature. The journey of loss and grief can be a joyous one if we can cultivate a sense of awakened awareness of unpredictability and vulnerability, learning to be mindful with non-attachment...
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Page Count: 384
Publication Year: 2006