Meanings of dying and death among patients and practitioners : a qualitative study in a Tibetan Hospital

Abstract

The People's Hospital of Tibet Autonomous region is the largest hospital in Tibet, situated in Lhasa, capital of Tibet. The objective of the study was to explore the cultural meaning, expectation, practice, cultural sensitivity of dying and death in the hospital. This research was based on a qualitative method consisting of in-depth interviews with 4 lay Tibetans, 4 health practitioners and 1 monk, document review and observation. The perception of Tibetan patients and relatives in the modern hospital showed clearly the influence of Tibetan culture and belief deeply rooted in Tibetan Buddhism. The meanings of dying and death included impermanent life, preparedness for accumulation of positive karma, the path of spiritual transition, reincarnation or liberation. In contrast, the meanings of dying and death in the view of health practitioners were terminal illness, the failure and ceased function of the organs based on advanced technology. Due to the different constructions between them, unmatched expectation and ignorance of spiritual care emerged when health practitioners provide intervention in the hospital. The culture, the belief and the life of the patients were devalued and intentionally neglected on account of modern medicalized system and training. Therefore, the researcher strongly recommends seriously taking into account the culture and belief and balancing technical intervention with a humanistic approach to their dying patients in the hospital