From Religious Rituals to Indigenous Healing Practices: Spiritual Care in Chinese Palliative Care

Spiritual care is central to palliative care. It helps patients nearing the end of life to maintain a sense of meaning, hope, and dignity, while alleviating existential anxiety and emotional distress as they face death. This study analyzes spiritual care practice in palliative care in China. It explores how religion supports spiritual healing by adapting and reconfiguring localized rituals. These adaptations are particularly important where overt religious expression and formal rituals are hard to include in healthcare settings. Based on semi-structured interviews with 14 professional carers in Shanghai, this paper examines how religious resources are translated into spiritual care in the Chinese healthcare context and analyzes the mechanisms behind their therapeutic effects. Research finds, first, that spiritual care in Chinese palliative care is not usually labeled as “spirituality” but is more often called “psychological care.” Second, religion in practice has not disappeared; instead, it has moved from public ritual and belief to the private sphere. Its roles (providing meaning, reconciling relationships, and supporting the transition from life to death) are transformed into care practices such as life reviews, the “Si Dao Ren Sheng” (the “Four Themes of Life”: expressing gratitude, offering an apology, expressing love, and saying farewell), family support, body donation, and end-of-life planning. Third, these therapeutic practices are effective not because of religious dogma, sacred stories, or explanations of the afterlife, but because they reconnect the patient to the “past–present–future.” Looking to the past, life reviews help patients integrate their narratives and affirm self-worth. In the present, repairing family relationships and expressing emotions help patients feel seen, accompanied, and needed. Looking to the future, end-of-life planning and the assignment of responsibilities give patients some control and peace of mind. Based on the thematic analysis, this paper therefore inductively constructs a “past–present–future” model of meaning-making in Chinese spiritual healing. Drawing on the Chinese cases examined, it offers a theoretical contribution to the global study of spiritual care.