Culture as an Institution: Assessing Quality of Death in China

With the rapid expansion of palliative care across China, it is imperative to establish standardized criteria that harmonize with its swiftly evolving sociocultural landscape. This is of paramount importance for assessing the Quality of Death (QoD) and further enhancing support for the end-of-life experience. Conceptualizing culture as an institution, this chapter aims to lay the foundation for a nuanced understanding of QoD in contemporary China. It explores how the dying experience and associated needs are negotiated by all involved parties, drawing on existing research and policy dialogues. The chapter sheds lights on the interplay between traditional collectivism and emerging individualism, shaping the perception, experience and institutionalization of a ‘good death’ in China. Embracing a need-based approach, it sets overarching principles for QoD assessments’ future development, fostering a culturally attuned approach in this rapidly evolving society. The core of QoD evaluation in China is acknowledging cultural influences on diverse dying process needs. It underscores the pivotal importance of relational autonomy, treating dying care as a collaborative endeavour rooted in mutual support and understanding.