Why some Asian families don't tell their loved ones they're dying (2023)

My Filipino-Chinese grandfather taught me many things as I was growing up — from how to make spring rolls to the importance of family.

One of the most important lessons he passed on, was that no good ever comes from lying, no matter the circumstances.

"We must obey the word of the Lord," he would tell us.

But for the last month of his life, my whole family and I withheld the truthfrom my grandpa.

In April last year, after more than two years on dialysis, he was given a month to live — and we decided not to tell him.

Why some Asian families don't tell their loved ones they're dying (1)

Being born and raised in Australia, I did not understand what was happening — I thought this was something that only happened in my family.

But families withholding information about a life-threatening diagnosis is actually common practice in Asian cultures.

It is believed that speaking openly about death can do more harm than good, bringing bad luck, fear and emotional pain.

Yongxian Luo, a professor of Chinese studies at the University of Melbourne, said Asian families regularly chose to hide the truth about a terminalillness from their loved ones to protect them.

Professor Luo calls them "non-disclosure topics".

"Certain topics, which are common for people to talk about in Anglo-American culture, are taboos or at least not preferred in discourse," he said.

"For non-disclosure topics, the major difference is that Asian cultures do not want to talk about negative things."

Why some Asian families don't tell their loved ones they're dying (2)

Dr Nicola Atkin, from the Peter MacCallum Cancer Centre in Melbourne, said Asian cultures put a greater emphasis on the importance offamily over individuals.

"Some cultures have far less emphasis on the individual and individual autonomy but more on relational autonomy and a view of the patient in the context of their family, community and culture," she said.

"This focus from family members on non-disclosure often goes hand in hand with a very strong sense of responsibility and duty to protect and care for their loved ones."

Professor Luo said this emphasis on family shapedhow people in Asian cultures engagedin most social and interpersonal relationships.

"Mutual trust is a top priority," he said.

"In Hong Kong, a number of successful family businesses don't hire outsiders because family members are more trustworthy.

"This is something Asian people would bear in mind when they think about social relationships."

Sometimes these conflicts between Eastern and Western values can happen within families, particularly those in the diaspora.

Why some Asian families don't tell their loved ones they're dying (3)

Based on her own experience dealing with her grandmother's cancer diagnosis, US filmmaker Lulu Wang wrote and directed The Farewell, a 2019 drama/comedy that explores the cultural differences in approaches to death.

In the film, the mother of the central character, Billi Wang, relates a saying in China: "When people get cancer, they die. It's not the cancer that kills them, it's the fear."

So when Chinese-born American Billi's "nai nai" (grandmother) is given a few weeks to live, her family decides not to tell her.

The family struggles with this decision, especially Billi who believes her grandmother has the right to know.

"Isn't that wrong to lie?" Billi asks her grandmother's doctor.

"It's a good lie," he responds.

In Asia, doctors will generally comply with a family's wishes when disclosing a diagnosis, using less specific and threatening terms such as "fever" or "sickness".

Dr Atkin said both the family and patients usually shared the same attitudes when it came to this practice.

"Families have stated that they believe the patient will become depressed, lose all hope or deteriorate more quickly if they know the details of their disease or their prognosis," Dr Atkin said.

"Usually the patient has been happy to delegate to family members or has wanted limited information and the family have been relatively accepting of this."

Why some Asian families don't tell their loved ones they're dying (4)

However, Dr Atkin said the practice of "non-disclosure" in Western countries could present conflicts between ethical principles which needed to be "weighed against each other".

"Modern Western cultures tend to have a strong focus on the importance of the individual patient's autonomy, and the individual making decisions about their own healthcare based on the full information provided by medical teams," she said.

"Withholding information and making treatment decisions without the patient's involvement can result in a form of paternalism, affect the patient-physician relationship and the patient's trust in the doctor."

Meanwhile, Elizabeth Utting, a senior associate in medical negligence at Law Partners, said as well as the ethical implications there were also legal ones in Australia.

"A medical negligence case could arise where withholding such a diagnosis meant that the patient could not receive medical treatment they required to improve their illness or prognosis," she said.

"A medical negligence case could also arise if a patient's prognosis was not communicated to the patient, and the patient suffered mental harm as a result of the delay in informing them of the prognosis.

"A doctor's ethical and legal duty lays with their patient, not their family members."

An act of love?

It'snot just children who withholdinformation from elderly parents.

For Filipino-Australian Sarah Jones it was the other way around.

She was 59 years old when she was diagnosed two years ago with terminal uterine cancer and given three months to live.

Her sister, Jessica Cruz, told the ABC Ms Jones decided to keep theprognosis a secret from her children.

"Only my brother-in-law and I knew," said Ms Cruz, who asked to use pseudonyms for herself and her sister.

"She begged us not to tell her children about it. She continued to tell her kids that it was curable."

Ms Jones worried about her children'smental health and was afraid they would get depressed.

"She just wanted them to live a normal life," Ms Cruz said.

When Ms Jones lost the ability to walk, Ms Cruz told her it was timeto tell her children.

"I told her that they had the right to know and that they would understand — but really, I just wanted them to stay with their mum because time was running out," she said.

Why some Asian families don't tell their loved ones they're dying (5)

Her children found out about her condition from their father, and after seeing her son cry Ms Jones was upset.

But the next day she felt better about the situation.

"They were now prepared," Ms Cruz said.

"There were no more secrets."

Deputy director of palliative care at Melbourne's St Vincent's HospitalJennifer Weil said there were many cultural, religious, and personal factors that went into decisions about how much information people wanted shared, especially in relation to terminal illness.

"The challenge for us as doctors is to seek to explore and understand, and avoid our own beliefs and values directing how we share information," she said.

Why some Asian families don't tell their loved ones they're dying (6)

Dr Atkin said if a patient, based on their cultural beliefs, decidednot to have their diagnosis or prognosis disclosed to them, it did not necessarily go againstthe principle of autonomy.

"My approach is to understand the wishes, preferences and concerns of the family and the patient regarding medical information, explore these sensitively and reassure the family that their loved one will not be given information they don't want to receive," she said.

A good lie?

During the first few days after we got my grandpa's prognosis, I did not want to lie to him — but I felt I had to respect my family's decision.

Then, towards the end, I began to understand where my family was coming from.

We lied to him because we loved him. We wanted my grandpa to live his last remaining days in happiness instead of pain and grief.

And he did.

Why some Asian families don't tell their loved ones they're dying (7)

The last time I saw my grandpa was the daybefore he died at a hospital in Melbourne's western suburbs.

Surrounding his bed was his wife, children and grandchildren. We all stood quietly.

"Thank you, my wonderful family," he said as he looked up at the faces of his loved ones.

"I'd like to go home now."

He closed his eyes.

"You will go home soon," my sister told him.

"We will be at home waiting for you."


Why some Asian families don't tell their loved ones they're dying? ›

It is believed that speaking openly about death can do more harm than good, bringing bad luck, fear and emotional pain. Yongxian Luo, a professor of Chinese studies at the University of Melbourne, said Asian families regularly chose to hide the truth about a terminal illness from their loved ones to protect them.

How does Asian culture view death? ›

Death is part of natural life. Some Asian see death as extinction while most of them see death as a beginning of life after death. Grief and mourning is relational and familial. The view of life and death was deeply influenced by Confucianism, Buddhism and Taoism.

What is the Chinese attitude towards death and dying? ›

Death and funerals are considered inauspicious in China, and the idea of evil spirits keeps people from talking about it,” Tan says.

Is death taboo in China? ›

There is no systematic and convincing evidence that death is a taboo subject. Many scholars simply assume death is taboo for Chinese. Meanwhile, Chinese research participants say death is a cultural taboo among Chinese, but they still talk about it.

Which cultures don t talk about death? ›

  • Inuit.
  • Chinese.

Why can't you cut your hair after a funeral? ›

Trimming hair and nails

Generally, this emanates from the belief that nails and hair were given to the children by the deceased as a parent and as such they shouldn't be trimmed during the mourning period and after the burial. At least you should wait for 49 days.

What do Japanese believe about dying? ›

Terminal illnesses, dying and death are considered “negative” or impure and akin to “contamination.” Frank discussions on death and dying may be difficult at first. However, at some point most Japanese are said to embrace Buddhism in later life. As such, death is considered a natural process, a part of life.

What is the Chinese belief about soul? ›

hun, in Chinese Daoism, the heavenly (and more spiritual) “souls” of the human being that leave the body on death, as distinguished from po, the earthly (and more material) souls. These souls are multiple; each person is usually said to have three hun and seven po.

What do Chinese people believe about life? ›

They believe in reincarnation and that life is impermanent and full of suffering and uncertainty; the way to find peace is through reaching nirvana, a joyful state beyond human suffering. There are many different sects that place different emphasis on various aspects of Buddhism.

What is considered most disrespectful in China? ›

Do not touch, hug, lock arms, back slap or make any body contact. Clicking fingers or whistling is considered very rude. Never put your feet on a desk or a chair. Never gesture or pass an object with your feet.

Why can't you wear red to a funeral in China? ›

Guests at a Chinese funeral wear somber colors like black. Bright and colorful clothing, especially red, must be avoided as these colors are associated with happiness. White is acceptable and, if the deceased was 80 or above, white with pink or red is acceptable as the event is cause for celebration.

What is the number one cause of death in China? ›

All changes in mortality were greater than 30%. The greatest increases in males were violence (98.02%), upper respiratory infections (93.60%), and fires (89.65%). The greatest increases in females were upper respiratory infections (147.11%), fires (109.73%), and poisonings (72.53%).

What do the Chinese think of death? ›

For Taoists, life is an illusion and death is an awakening. In spite of seeing death as a natural part of life, Chinese think talking about death will upset the inner harmony that is so important to maintain. So, Chinese try to avoid even thinking about death.

Which religion is not afraid of death? ›

They find that atheists are among those least afraid of dying...and, perhaps not surprisingly, the very religious. Religion has long been thought to be a solution to the problem of death. Notions of an afterlife are nearly universal, though there is great diversity in the details.

Which is the last sense to leave a person? ›

Research suggests that even as your body transitions into unconsciousness, it's possible that you'll still be able to feel comforting touches from your loved ones and hear them speaking. Touch and hearing are the last senses to go when we die.

Is it okay to touch a body at a funeral? ›

If you have an adult with you at the funeral home, it is ok to touch a dead body, and you will not get in trouble. You are naturally curious, and sometimes when you see and touch a dead body it helps you answer your questions. Remember to be gentle and have an adult help you.

Why can't you shower after a funeral? ›

Some cultures believe that you should ritually cleanse yourself after services for the dead, but that is religious/cultural, rather than biological. You should not get anything on you at a funeral that would require bathing right away. How do you want to be buried?

Why should you not touch a body at a funeral? ›

Some Evangelical Christians are adamant that guests at a viewing should not touch their deceased loved one's body at all. They believe touching or kissing the body at a viewing can be spiritually dangerous.

How long do Japanese mourn? ›

The family of the deceased will be in a period of mourning for 49 days after the funeral. Once a week they will visit the grave to place fresh flowers and to burn incense. On the 3rd, 7th and 49th days they will have a short memorial service at the site, led by the Shinto priest.

Do Japanese believe in afterlife? ›

Generally speaking, Japanese believe in the existence of the life after death. Most of them believe there is another life after death. It is natural for bereaved families to think the deceased will have a tough time in another world if they lost their body parts such as limbs or eyes.

Why is death impure in Japan? ›

Despite the importance of death rituals, in traditional Japanese culture the subject is considered unclean as everything related to death is thought to be a source of kegare (defilement). After coming into contact with the dead, individuals must cleanse themselves through purifying rituals.

What do the Chinese think of heaven? ›

The concept of Heaven (Tiān, 天) is pervasive in Confucianism. Confucius had a deep trust in Heaven and believed that Heaven overruled human efforts. He also believed that he was carrying out the will of Heaven, and that Heaven would not allow its servant, Confucius, to be killed until his work was done.

Where does the soul reside in the human body? ›

The soul or atman, credited with the ability to enliven the body, was located by ancient anatomists and philosophers in the lungs or heart, in the pineal gland (Descartes), and generally in the brain.

What is the Chinese philosophy on God? ›

Chinese scholars emphasise that the Chinese tradition contains two facets of the idea of God: one is the personified God of popular devotion, and the other one is the impersonal God of philosophical inquiry. Together they express an "integrated definition of the monistic world".

Are Chinese friendly to foreigners? ›

Although Chinese society is welcoming and Chinese people are friendly to foreigners, regularly failing to understand the culture or language can make you feel isolated.

Do so Chinese believe in God? ›

The People's Republic of China is officially an atheist state, but the government formally recognizes four religions: Buddhism, Taoism, Christianity (Catholicism and Protestantism) and Islam.

Is eye contact rude in China? ›

Making eye contact in China is a sure-fire way to make enemies, not friends. The Chinese people view eye contact as a necessary tool, but not in the same way that other cultures do. In China, people make eye contact when they are angry. It is meant to challenge the other person and is a sign of disrespect.

What are 3 things that are banned in China? ›

The PRC bans certain content regarding independence movements in Tibet and Taiwan, the religious movement Falun Gong, democracy, the 1989 Tiananmen Square protests and massacre, Maoism, corruption, police brutality, anarchism, gossip, disparity of wealth, and food safety scandals.

Why is it rude to eat all your food in China? ›

6 China: Leave Food On Your Plate

This is the case in China. It's considered rude to eat everything on your plate because doing so implies that you're still hungry, even if you're not. That means that the host hasn't done a satisfactory job of providing enough food and can make them feel bad.

What not to do at a Chinese wake? ›

Wakes and funerals are generally sombre affairs. While chatting with the bereaved family or other attendees is acceptable, there shouldn't be loud laughter or chatter, as this could be seen as disrespectful to the family. In Buddhist belief, death is taken with a calm acceptance rather than loud or devastated mourning.

What is the Chinese tradition for death in the family? ›

Loved ones will take turns to sit with the body at the family home, temple or funeral parlour, while mourners may bring offerings of things like incense or food. This can last up to seven days. During this period, it's traditional for mourners to offer money as a donation to the soul of the dead person.

Why can't you wear red shoes to a funeral? ›

Wearing red to a funeral would be considered inappropriate because it would clash with the somber atmosphere and be viewed as disrespectful. In some eastern cultures, red is also seen as a positive color, but it carries different connotations. Red represents luck, good fortune, and happiness.

What is the main disease in China? ›

China has more people with diabetes than any other country – more than 110 million – in what the World Health Organization (WHO) has described as an “explosive” problem. This number will climb to 150 million by the middle of the century.

What natural event killed the most people in China? ›

On August 18, 1931, the Yangtze River in China peaks during a horrible flood that kills 3.7 million people directly and indirectly over the next several months. This was perhaps the worst natural disaster of the 20th century.

What is the No 1 cause of death worldwide? ›

Cardiovascular disease is the top cause of death globally. In the map we see death rates from cardiovascular diseases across the world.

What are Japanese beliefs about death? ›

Generally speaking, Japanese believe in the existence of the life after death. Most of them believe there is another life after death. It is natural for bereaved families to think the deceased will have a tough time in another world if they lost their body parts such as limbs or eyes.

How is death represented in Japanese culture? ›

Traditional Japanese attitudes towards death include a belief in the afterlife. Throughout the history of Japanese culture, people have traditionally believed that when a person dies, their soul lives on in the land of the dead. The land of the dead in Japanese culture is another realm not far from our own.

What is the Korean view on death? ›

Koreans generally believe in expressing emotions outwardly after a death, which includes wailing as a form of announcing the death of a loved one. This show of emotions is known as kok and can take place at the time of death and will likely also take place during the burial or interment.

How does culture play a role in death? ›

Culture and the meaning of death

Each culture has its own beliefs about the meaning and purpose of life and what happens after death. This informs how people in those cultures approach death. For example, people may find death more bearable if they believe in a life after death.

How do Japanese express grief? ›

The wake itself, where family and friends is called tsuya, which literally means “the passing of the night.” The wake is held as soon after the death as is possible. During this time intense grief may be expressed and friends gather to offer support to the family. Mourners wear only black clothing from head to toe.

Is death considered impure in Japan? ›

Death is seen as impure and conflicting with the essential purity of Shinto shrines. For the same reason, cemeteries are not built near Shinto shrines. The result of this is that most Japanese have Buddhist or secular funerals, and cremation is common.

What is the Japanese demon of death? ›

Shinigami (Japanese: 死神, lit. 'kami of death') are kami that invite humans toward death in certain aspects of Japanese religion and culture. Shinigami have been described as monsters, helpers, and creatures of darkness. Shinigami are used for tales and religions in Japanese culture.

What color represents death in Japan? ›

White (shiro) traditionally symbolized mourning and death, though today a woman (the bride or a guest) might also wear a formal white kimono to a wedding (though perhaps with a brightly-colored obi belt).

What animal represents death in Japan? ›

Much like the dog, crows are a major player across Japanese folklore and have a heavy symbolic meaning. Traditionally known as spiritual birds that carry spirits, a famous folklore depicts crows as the birds of death. It was believed that when a crow cawed loudly, there was a death nearby.

What is the main cause of death in Korea? ›

Korea ranks first in the mortality rate due to intentional self-harm, with 23.5 in 2020, among 38 OECD countries. the average mortality rate due to intentional self-harm in the 38 OECD countries is 10.9 [13].

What is the No 1 cause of death in South Korea? ›

The top cause of death and disability in 2019 is Stroke, of type Non-communicable diseases, which has increased by 5.70 percent since 2009. The axis shows the percent change from -30 percent to 33 percent.

What is the color of mourning in Korea? ›

Black is known as the formal color for funerals. For the family mourning, the men wear suits and the women wear black hanboks with a white ribbon hairpin. The chief mourner always has an arm board. Black suits are worn by every other person in attendance.

What culture does not bury the dead? ›

The Toraja of Sulawesi keep the bodies of the deceased in their homes for as long as a few years, believing “that a dead person who is still at home is not dead.” National Geographic documented the culture's sacred tradition in a video, revealing their lavish celebrations for the dead.

How does the American culture view death? ›

American society is considered a death-denying culture. In general, we do not like to think about, talk about, or acknowledge death as an inevitable reality.

How is death viewed in Mexican culture? ›

' The concept of death in Mexican culture is one unlike any other in the world – as we mourn death, we also celebrate it with humour and joy. One of Mexico's biggest and most widely known traditions is 'Día de los Muertos' which means 'Day of the Dead.


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