Spiritual care in Taiwan: 

Introducing the Clinical Buddhist Chaplain in palliative care

Posted on October 8, 2014 by pallcare

To acknowledge World Hospice and Palliative Care Day on 11 October, the European Association for Palliative Care (EAPC) is delighted to present current developments in hospice and palliative care in Taiwan as part of a special series of posts. In June this year, Professor Sheila Payne, President of the EAPC, was invited to Taiwan; we are very pleased that three of the many palliative care practitioners and academics she met during her visit have agreed to share their experiences of research, spiritual care and clinical practice. 

Dr Chien-An Yao, Director of Palliative Care Unit, Department of Family Medicine, National Taiwan University Hospital, and Secretary General of Taiwan Academy of Hospice Palliative Medicine, continues our special series on Taiwan.

About 15% of the Taiwanese believe in Christianity. However, most people believe in folk religions, including Buddhism, which account for about 80%-90% of the population. They also accept the Buddha Dharma and the care model of Clinical Buddhist Chaplains.

Professor Tai-Yuan Chiu, Professor Ching-Yu Chen and Dr Chien-An Yao

Taiwanese indigenous spiritual care began in 1995 when the Hospice and Palliative Care Unit of the National Taiwan University Hospital was first established. The unit received research grants to study the possibility of applying Buddha dharma in terminal care, resulting in the launch of the training programme for Clinical Buddhist Chaplains (CBC) in 2000. While Western hospice care, based on the life structure of the body, mind, and soul as conceived of in Christianity, focuses on the spiritual care of the patient, Buddhists may concentrate on the four establishments of mindfulness regarding the body, feelings, states of mind, and phenomena, or focus on the life structure of the body, mind, and wisdom.

Spirituality is thus defined as: “the ability to respond to, to realise and to understand the right dharma.” It is a power, and manifests the maturity of the mind. It emphasises the importance of regarding the patient as demonstrator – someone who not only receives care but also shows us how to face death. Qualified CBCs are required to successfully complete a training programme consisting of lectures as well as bedside practicum on applying Buddhist practices to end-of-life care. According to the Four Noble Truths, clinical diagnosis and treatments can be stated as follows:

• spiritual suffering is identified from the sickness categorised into physical, psychological, family, social and spiritual aspects;
• the goal of care is planned according to ‘Four Dwellings in Mindfulness’;
• the effects of the practice of Buddhist methods are carefully evaluated and recorded.

Huimin Bhikshu gives a bedside teaching demonstration for Clinical Buddhist Chaplains

CBCs have been involved in hospice palliative care for more than 10 years and have now become core members of the hospice palliative care team in Taiwan. A CBC does his/her best to help patients based on their needs to improve their life quality. After learning the basic experiences of being alongside a dying patient, CBCs develop their own skills in teaching Buddha dharma. Training programmes to be a professional CBC are divided into four stages:

• a basic three-month clinical training programme on hospice wards;
• continuing education programme and advance study;
• teaching skills training programme; and
• a faculty development programme.

There are now 35 qualified CBCs working in 39 units across 13 areas of Taiwan. In palliative care units, CBCs who have completed the training provide bedside care to terminally ill patients, resolve patients’ spiritual sufferings, promote their spiritual status and reduce their death fears. These practices help patients to transcend the worldly dharma, discover their ‘inner’ power, improve their life quality and achieve a good death. CBCs also provide life education to family members, transform obstacles into practical assistance, reduce grief, and boost the morale of the palliative care team.

References
Ching-Yu Chen 2012. Clinical Buddhist chaplain based spiritual care in Taiwan. Taiwan Journal of Hospice Palliative Care 17 (3), 300-309.

Huimin Bhikshu 2012. The role of mindfulness in hospice & palliative care in Taiwan. Taiwan Journal of Hospice Palliative Care 17(2), 200-209.

Jonathan S. Watts and Yoshiharu Tomatsu (2012). Buddhist care for the dying and bereaved. Simon & Schuster.

Links and resources

• Lotus Hospice Care Foundation.
• The XVIth Congress of the International Association of Buddhist Studies (IABS).

Follow the EAPC blog on Friday 10 October
To catch the final post in our special series to celebrate World Hospice and Palliative Care Day, please visit the blog on Friday. Dr Ping-Jen Chen, a consultant geriatrician and hospice palliative medicine specialist from Taiwan will be writing about cross-cultural experiences of palliative care.

World Hospice and Palliative Care Day 11 October 2014 – Achieving Universal Coverage of Palliative Care: Who Cares? We Do!
With just four days to go, people across the world are preparing to celebrate World Hospice and Palliative Care Day. Anybody can get involved and raise awareness and funds for their local hospice and palliative care service. These services need your help to ensure that people living with life-limiting illnesses, their families, friends and carers receive the care and support that they need. Let’s get involved and support World Hospice and Palliative Care Day now. Please visit the World Day website for information, ideas and inspiration…