Soul Searching: Spiritual Care in the Japanese Hospice

Abstract

This dissertation examines the religious dimensions of hospice care in contemporary Japan. Historically, Japanese religions provided a cosmological framework and a ritual repertoire for the end of life that helped assure dying persons of an auspicious rebirth, or escape from this world altogether. However, Japanese hospice patients today only rarely seek out these assurances—or at least not in ways that we might expect. As a result, religious professionals who work in Japanese hospice wards are expected to draw on a very different set of practices that align more closely with ecumenical and psychotherapeutic models by which the practice of spiritual care is legitimized in secular spaces.

This project, based on ethnographic fieldwork in multiple hospices across Japan, investigates through close observation of the actual practice of spiritual care, how hospice chaplains both draw on and resist these models, as well as what kinds of spiritual concerns Japanese patients actually express as they face the end. It also examines similarities and differences in how spiritual care is interpreted and conducted at Buddhist, Christian, and other hospices and relates these findings to a broader narrative of how Japanese religious groups are seeking out new vocational roles in modern medical institutions. By illuminating how spiritual care is conceptualized and practiced in Japan from both local and cross-cultural perspectives, this study provides new insights into contemporary Japanese religion by showing how religion is both shaping and being shaped within the medical context of the hospice. At the same time, it contributes a much-needed East Asian perspective to global conversations about the practice of spiritual care for the dying.