East Asian Attitudes toward Death— A Search for the Ways to Help East Asian Elderly Dying in Contemporary America

The art of dying well has been a quintessential subject of ethicoreligious matters among the people in the West and the East. Most of us wish to die at home; however, about 50% of Americans die in acute care hospitals. Furthermore, immigrants from East Asian cultures feel more uncomfortable near death, because their physicians are not familiar with their traditions.This article is written to help American physicians understand the unique aspects of East Asian Confucian Ethics for the better care of the dying elderly. Western attitudes toward death are briefly reviewed and the six East Asian concepts related to death are elaborated from Confucian Chinese philosophy. To widen the horizon of bioethics and to embrace the Confucian wisdom of dying well, three pearls of wisdom from classical Confucianism are proposed: the relational autonomy of family, Confucian creative self-transformation, and the unity of transcendence and the human being.