The Lack of Spirituality in End of Life Care in Japan

Abstract

As the modern hospice movement developed in divergent directions, early principles relating to spirituality changed as the movement entered Japan. How did this development occur? This paper seeks to answer this question by examining changing notions of spirituality in UK/US and Japan during the development of the hospice movement. The history of the hospice movement is divided into four temporal/chronological stages: A. development of the hospice movement in the UK and US; B. the institutionalisation of the hospice movement in the UK/US; C. development of the Japanese hospice movement; and D. the institutionalisation of the hospice movement in Japan. Attitudes towards and policies regarding spirituality during each of these stages is examined in detail, along with associated approaches to diagnosing, disclosing, and accepting death. I argue that in Japan, the processes of standardisation and institutionalisation of hospice care have resulted in the loss of spirituality as its organizing principle.