Thanatopolitics in Monsoon Asia and its implications on Palliative Care Policy

Abstract

This paper is derived from a comparative study of thanatopolitics in Hong Kong, Taiwan and Singapore, and its historical and socio-cultural roots concerning their different forms of end-of life care. I argue that the complex decision making about dying have been influenced by similar environmental and cultural determinants in monsoon Asia. In modern times, however, the practices of such care diverged under dissimilar political economic circumstances concerning various niches of state building and health governing. The services provided to take care of dying individuals emerged roughly at the same time when charity services were established by guild halls or ancestral halls of immigrant societies to accommodate the sick and dead. The institutional transformation of end-of-life services in these three settlements, however, is related to their experiences with urbanization and the introduction of modern medicine. The change from household care, charity amenities to medical institutions illustrates not only how completely modern constitutions in these societies are, but also how much people in these societies accept and feel at ease with a type of dying originally unfamiliar to them. By studying cases in Taiwan, Hong Kong and Singapore, this paper responds to the recent “Good Death Index” report (Economist, 2015) that ranked the three health entities in the top 20s among the eighty countries surveyed, I argue that a historical and ethnographic “study up” of thanatopolitics is critical in order to identify the neglected missing links between the socio-cultural aspects of end-of-life care and the implementation of palliative medicine.