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In contrast to media images of lonely deaths, stereotypes of the Japanese calm acceptance of dying, and the “naturalness” of dependency in old age or illness, this paper explores the complex ways in which changing perceptions of time refocus people towards the question of how to live. Time both narrows to the level of medication schedules and bodily functions, and expands to more immediate engagement with others in the past and future. The idea of a moral timeline of such changes builds upon recent work in the anthropology of morality by recognizing shifting ideas and actions people take to retain agency through suffering. People near the end of life in Japan commonly employ cultural idioms of effort, reciprocity, and gratitude to express their continual striving to be moral persons in a social world. Ultimately, such efforts determine not only how they see themselves and are seen by others through their final days, but whether theirs will be judged to be a “good death,” and thus the nature of the person’s continued social existence in spirit and memories after death. The moral timeline expressed by many of the people I met reflected intensified concern with becoming a burden and with reciprocity as the end of life came close. For many, that deepened their sense of engagement, sometimes transforming their relationships with others who would survive them or who had preceded them in death. The ethnographic data in this article come from a participant-observation study of adults of all ages with life-threatening illnesses, and from an interview study of frail elderly and their family caregivers in the early 21 century in urban and rural settings.

Family, Time, and Meaning toward the End of Life in Japan