From Obligation to Compassion: The Transformation of Filial Piety in Chinese Family Caregiving at the End of Life

Abstract

This study critically examines the evolving nature of filial piety and the role that it plays in the contemporary experience of ‘living and dying with dignity’ among Hong Kong Chinese families facing the end of life.Meaning-oriented interviews were conducted with a purposive sample of 15 adult-children caregivers, aged 30 to 62, to elicit their narratives and stories in caring for a dying elderly parent. Qualitative content analysis reveals that although traditional filial beliefs provided motivation for family caregiving, contemporary experience of filial piety has evolved and reflected more equalitarian attitudes and behaviours. However, the regrets of unfulfilled filial responsibilities still create vast emotional distance between parents and adult-children, and act as a cultural barrier for reconciliation and contentment at life’s final margin. These findings underscore the importance of intergenerational dynamics and interactions in the transformation of filial attitudes and behaviors, highlighting the importance of reciprocal relationships (vs. authority relationship), mutual support (vs. complete obedience), compassionate duty (vs. obligatory duty), emotional connection (vs. task fulfillment), and appreciation and forgiveness (vs. guilt and shame) in the promotion of dignity at the end-of-life. They further pinpoint the imperative for greater homecare support, as well as the critical need of a family-driven dignity-enhancing intervention in palliative social work.