The telling and knowing of dying: philosophical bases for hospice care in Japan.

This article describes the historical and cultural factors that led to the modern definition of hospice in the United States and Japan. It also raises questions about the import of western hospice philosophy into Japan by examining some traditional values and cultural norms of behaviour surrounding dying in that country. The ethics of disclosure and open discussion, as a prerequisite to and foundational value in western hospice care, differs in Japan. If traditional Japanese values remain strong, expectations regarding hospice care based on this western ethics may be misplaced. This report ends with a suggestion of replacing the western imported hospice philosophy with an (as yet not explicated) Japanese philosophical ethic of the good.