If you were terminally ill, would you want to know?

Ways of understanding and expressing love vary greatly within a culture, never mind across different cultures. This morning I stumbled upon an almost unbelievable cultural difference between China and North America. I don’t understand it; I only just heard of it for the first time less than two hours ago, but here it is.

We were in the student’s break room after the first hour of class this morning. Some students had had a Chinese friend who’d just had a death in the family, and they were discussing how the family had dealt with the illness. As I listened, I actually wondered if there had been some major misunderstanding on the part of the foreigners, even though they were advanced language students with years of experience in China, so I spent the whole next hour in class asking my teacher about it.

It turns out that in China, families will often not tell a terminally ill family member that he or she is terminally ill. They’ll make up reasons for why they’re in the hospital, why they need an I.V., etc, and play it off as long as they can, often never actually discussing it with the dying person. Nor will they tell family members living elsewhere that someone has died, or is seriously sick, or is scheduled for a major operation until long (sometimes months) after the fact.

My teacher used the example of her grandfather, who died of a brain tumour. She was a little emotional in talking about it. Her mother is a nurse, and there was no question that his illness was terminal. The doctor, as usual, only discussed the illness with the family out of earshot of the grandfather. The family told the grandfather that he had some other, not-too-serious condition because, she said, they didn’t want him to lose hope (even though there was none) and they wanted him to be more comfortable. They spent more time with him, made him his favourite foods, and tried to make his last days special – but not, she said, for the purpose of implicitly letting him know that he was terminal.

Chinese people are often afraid, she said, that if the person knows there is no hope for recovery, then they will completely lose the will to live, stop eating, that sort of thing. Apparently the sense of duty to and fear of being a burden on one’s family is huge, and it’s not uncommon for terminally ill people to try to hasten their own death or commit suicide outright. She said she thinks many terminally ill people eventually figure it out, when (her examples) they can no longer move, speak, or eat and go to the bathroom unaided. She also said that people don’t have hope for the afterlife like (as she understands it) Western people do. In popular Chinese folk belief, everyone goes to the underworld – a not very nice place that you have to bribe your way through to get out of (hence the burning of paper money). It’s not anything to look forward to or celebrate. So apparently telling someone who has little hope in a next life and who greatly fears being a burden on their family that they are terminally ill is not a very loving thing to do. It’s considered more loving to withhold the information and not let the person worry about being a hopeless burden to their family.

Apparently family members also ‘protect’ one another from distressing, inconvenient bad news. When her grandfather died, my teacher didn’t know until two weeks after the fact because at the time she was living in another city and he family waited to inform her.

I can’t imagine my family withholding that kind of information from me, or withholding it from a family member myself. Exceptional circumstances aside, it just isn’t even a possibility.

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