中国人对待死亡和临终的态度
中國人的喪葬信仰
Zhōngguó rén de sāngzàng xìnyǎng
Chinese Funeral Beliefs
在华裔美国家庭中，你会发现传统信仰和现代态度的混合，传统信仰可以追溯到几个世纪以前，而现代态度则反映了西方的观念。中国与死亡和临终有关的信仰和习俗受到该国三大主流宗教的影响：儒教、道教和佛教。尽管 1949 年的共产主义革命和随后 20 世纪 60 年代中期至 70 年代的文化大革命使得在中国几乎不可能信奉宗教，但这三个宗教的价值观和习俗都渗透到了中国文化中。移民到美国的人将这些价值观和习俗带到了美国，并与基督教对死亡和临终的态度融合在一起。
儒教和道教因其本土根源而对中国人的思想和习俗影响最大。它们都表达了对生死的哲学理解以及宗教信仰体系。
儒家认为，如果一个人按照天命（即“天”）的旨意过着有道德的生活，他就不应该害怕死亡。但“天”这个词并不表示灵魂去往的来世。它应该被理解为控制生命的根本机制。孔子并没有明确讨论来世、永生、神灵或灵魂。
道教徒认为死亡是生命中自然的一部分，我们所有人都必须接受。如果一个人过着有道德的生活，并遵循道之道（包括各种冥想练习），那么他们死后就能获得永生。对道教徒来说，生命是一种幻觉，死亡是一种觉醒。
尽管中国人认为死亡是生命中自然的一部分，但他们认为谈论死亡会破坏内心的和谐，而这种和谐对于维持内心的和谐至关重要。因此，中国人尽量避免思考死亡。
孝道和祖先崇拜是儒教和道教的重要原则，甚至可能早于这些宗教在中国思想中出现。根据这些原则，孩子必须尊重父母和祖先并照顾他们。因此，在美国，中国父母临终时，其子女可能会在患病期间要求积极治疗，以履行对父母的责任。
中国人非常尊重医生。他们认为，在与病人护理有关的所有事务上，医生都值得信任和倾听。因此，医生不会受到质疑，而且通常会做出在其他家庭中由临终者或近亲属做出的决定。老年人甚至可能会听从医生的建议，而不听从子女的建议。整个家庭将做出超出医疗范围的护理决定。因此，与西方的个人自主原则不同，临终者通常会听从家人的意见。因此，指定医疗代理人可能被视为不重要，甚至与最佳决策方法相悖。
对于第一代在美国生活的华人来说，传统中医仍然是最常见的医疗保健方式。这包括使用草药和针灸。中医的重点是恢复全身生命能量的平衡。即使对于出生在美国的华裔美国人，传统中医也受到高度尊重，可以与西医一起遵循。
大多数美籍华人，尤其是老一辈，都认为死在家里会给家人带来厄运。他们可能也很难将自己的房子卖给另一个中国人。同样，家人通常会一起做出这个决定，有时甚至不需要死者发表意见。
如果死者确实在家中去世，那么家人将需要清除可能留下的停滞或负面生命能量。这可能包括打开所有窗户、移除死者的照片、彻底清扫地板和墙壁，甚至粉刷房间。床和床垫将被更换，死者的所有衣物将被赠予他人。在传统家庭中，衣物将被烧毁。
在死者的家中，所有神像都会被红纸覆盖。红色是吉祥和活力的颜色。家门口会挂上一块白布，表示家人正在哀悼。白色也是未知、纯洁、勇气和力量的颜色。
根据中国习俗，在将尸体放入棺材之前，要仔细清洗尸体，撒上滑石粉，然后穿上死者最好的衣服。衣服不能是红色的，因为红色会导致死者变成鬼魂。中国妇女通常会佩戴珠宝，尤其是玉石。中国男人可能会佩戴硬币。死者的脸可能会被黄色的布覆盖，黄色是佛教的颜色，代表着摆脱世俗的烦恼。尸体可能会被蓝色的布覆盖，代表和谐和永生。
葬礼上通常会焚烧象征性的纸钱，以确保死者来世有经济保障。葬礼上扔纸钱也是为了驱赶饿鬼，饿鬼可能会被死者吸引，给活着的人带来疾病和灾祸。
如果在死者的家中举行守灵仪式，所有镜子都会被遮住，因为看到棺材的倒影可能会导致看到倒影的人的家人很快去世。花圈、照片和礼物将放在棺材的顶部；食物将作为祭品放在棺材前面。死者的梳子被折断，一半放在棺材里与死者一起埋葬，另一半由家人保留。大米可能会撒在房子周围，将饿鬼引离家人。
中国人传统上参加葬礼时穿白色衣服，但如今在美国更西化的中国人会穿黑色衣服。通常会在与棺材一起下葬的哀悼者的衣服上放一块黑色布料。棺材下葬后，家人会把一把把泥土撒在上面；长子会从坟墓里留下一些泥土，用于家中的祭祀仪式。人们会祈祷，并给家人红包，里面有他们必须花的钱。
传统上，葬礼三天后，死者的灵魂会来拜访家人。为了准备这次拜访，家人会做死者最喜欢的食物，并把死者的一些书摆出来，让死者在午夜后前来告别。每年，家人必须通过祭祀和焚香来向死者表示敬意。有时，家人会准备烤猪，并将一些烤猪带到墓地作为祭品献给祖先。
哀悼者在 100 天内不得参加任何形式的娱乐活动。哀悼期取决于关系：子女或父母哀悼三年，配偶哀悼一年。
中国的习俗因家庭成员的宗教信仰、他们对传统的遵守程度以及对美国处理死亡和临终方式的同化程度而异。在进行规划工作时，助产士需要询问临终者和家人希望如何尊重他们的传统和信仰。了解一些中国习俗将有助于助产士了解家人的愿望，并帮助他们提出适当的问题。
The Chinese Approach to Death and Dying
In the Chinese American family you will find a mixture of traditional beliefs that date back centuries, and more modern attitudes that reflect western ideas. Beliefs and practices in China relating to death and dying have been impacted by the country’s three dominant religions: Confucianism, Taoism, and Buddhism. Although the Communist Revolution of 1949 and the subsequent Cultural Revolution in the mid 1960s to 70s made it nearly impossible to practice religion in China, values and customs from all three of those religious have seeped into Chinese culture. Immigrants to the U.S. brought those values and customs to America where they have mixed with Christian approaches to death and dying.
Confucianism and Taoism have had the greatest impact on Chinese thinking and practices because of their native roots. They both express a philosophical understanding of life and death as well as a religious belief system.
In the Confucian understanding a person shouldn’t be afraid of death, if they live a moral life according to the dictates of Tien Ming, referred to as “heaven.” But this use of the word “heaven” doesn’t denote some afterlife place the soul goes to. It should rather be understood as the underlying mechanism that controls life. Confucius didn’t explicitly discuss an afterlife, eternal life, gods, or spirits.
Taoists see death as a natural part of life that we all must accept. If a person lives a moral life and follows the path of Tao, which involves various meditative exercises, they will achieve immortality after death. For Taoists, life is an illusion and death is an awakening.
In spite of seeing death as a natural part of life, Chinese think talking about death will upset the inner harmony that is so important to maintain. So, Chinese try to avoid even thinking about death.
Filial piety and ancestor worship are important principles of both Confucianism and Taoism, and may even predate those religions in Chinese thought. According to those principles, children must respect their parents and ancestors and take care of them. As a result, here in the U.S., children of a dying Chinese parent may push for aggressive treatment throughout an illness to honor their duty to that parent.
The Chinese have great respect for doctors. They believe they should be trusted and listened to in all matters that relate to care of the sick. So doctors are not questioned and will often make decisions that in other families would be made by the dying person or the closest relative. Elders may even listen to a doctor over the advice of their children. The whole family will make caregiving decisions that go beyond the medical. So, unlike the western principle of autonomy of the individual, a dying person will often defer to the family. Therefore, naming a healthcare proxy may be seen as unimportant or even contrary to the best approach for decision-making.
Among first generation Chinese in the U.S. traditional Chinese medicine is still the most common form of healthcare. That includes the use of herbs and acupuncture. The focus of Chinese medicine is to restore balance of the life energy that flows throughout the body. Even for Chinese Americans born in the U.S. traditional Chinese medicine is well respected and may be followed alongside western medicine.
Most Chinese Americans, particularly the older generation, believe that dying at home will bring bad fortune to the family. They may also have difficulty selling their home to another Chinese person. Again the family will often make this decision together, sometimes even without the dying person offering an opinion.
If the person does die at home then the family will need to clear the stagnant or negative life energy that may be left behind. This may involve opening all the windows, removing photos of the deceased, sweeping and then washing the floor and walls thoroughly, even painting the room. The bed and mattress will be replaced and all of the clothing from the deceased will be given away. In a traditional family the clothing will be burned.
In the home of a person who died all the statues of gods will be covered in red paper. Red is the color of good fortune and vitality. A white cloth will be hung outside the front door of the house to announce that the family is in mourning. White is also the color of the unknown, purity, courage and strength.
Chinese customs dictate that before a body is placed in a casket it will be carefully washed, dusted with talcum powder, and then dressed in the dead person’s finest clothes. The clothing won’t be red because that will lead to the person becoming a ghost. A Chinese woman will often be buried with jewelry, particularly jade. A Chinese man may be buried with coins. The dead person’s face may be covered with a yellow cloth, which is the Buddhist color and represents freedom from worldly concerns. The body may be covered with a blue cloth, which represents harmony and immortality.
Symbolic paper money is often burned at a funeral to make sure the deceased will be financially taken care of in the next life. Paper money is also thrown at funerals to keep hungry ghosts away who may be attracted by the dead and can bring illness and mischief to the living.
If a wake occurs in the home of the deceased, all the mirrors will be covered, because seeing a reflection of the casket may cause a death soon in the family of the person who saw the reflection. Wreaths, photos, and gifts will be placed at the head of the casket; food will be placed in front of the casket as an offering. The person’s comb is broken, half placed in the casket to be buried with the person and the other half kept by the family. Rice may be spread around the house to lead the hungry ghosts outside away from the family.
Chinese traditionally wear white to a funeral, although today the more westernized Chinese in the U.S. will wear black. Often a piece of black material will be placed on the clothes of mourners that will be buried with the casket. After the casket is placed in the ground family will throw handfuls of dirt on top; the eldest son will keep some dirt from the grave to be used in worship ceremonies at home. Prayers will be said and family members are offered red packets with money that they must spend.
Traditionally, three days after the burial, the spirit of the person who died will visit the family. To prepare for this visit the family makes the person’s favorite food and sets it out with some of the person’s books for him or her to come and say goodbye after midnight. Annually the family must pay their respects to the deceased by making offerings and burning incense. Sometimes roast pig may be prepared and some of it brought to the cemetery as an offering to the ancestor.
Mourners are not supposed to participate in any form of entertainment for 100 days. The period of mourning depends on the relationship: three years for a child or parent, one year for a spouse.
Chinese customs will vary from one family to another depending on the religious orientation of the family members, their adherence to tradition, and the degree of assimilation to American ways of dealing with death and dying. When doing the planning work, doulas need to ask how the dying person and family want to honor their traditions and beliefs. Being aware of some of the Chinese customs will help the doula understand the family’s wishes and help them ask appropriate questions.
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