Application of signs of dying identified in traditional Chinese, Tibetan, and modern Western medicine in terminal care

Objectives: The purpose of this study was to promote culturally sensitive hospice care by understanding the concepts of approaching death in traditional Chinese and Tibetan medicine. Materials and Methods: We searched for information on signs of dying in Western medicine using MEDLINE and the Cochrane Library Database. We conducted in-depth interviews using a semi-structured questionnaire with six traditional Chinese medical doctors qualified to practice both Western and Chinese medicine. A literature review of Chinese and Tibetan medicine included an analysis of the classical textbooks of these traditional medicine systems. The literature was analyzed using qualitative analysis software. Results: Western medicine uses physiologic phenomena to describe signs of dying, while traditional Chinese medicine believes that signs of dying can be summarized as different symptom complexes and can be used to predict disease prognosis. Tibetan medicine views dying as a complex and interdependent process in which the patient's body and mind simultaneously disintegrate. Traditional Chinese and Tibetan medicine pay more attention to the observable signs of disease. Conclusions: In Taiwan, Western medicine is the main treatment option delivered during hospice care, but many patients and families are still influenced by traditional medicine concepts. The understanding of traditional medicine can provide culturally sensitive care for terminally ill patients of different cultures.