To illustrates the principle of body intactness in Chinese society through the example of a palliative care discussion with a pediatric neuro-oncological patient family regarding end of life care, highlighting the importance of cultural competency in providing patient-centered care.  

Body intactness is deeply connected to filial piety in Confuscian teaching and ancestor worship where a person’s body is considered a gift from their parents, and desecration in life or death is regarded as highly disrespectful. Understanding the psychosocial contexts of body intactness is immensely helpful in coordinating treatment goal discussions and holistic care to a diverse patient population.

Case:  

PL is a 2 year old boy with diffuse intrinsic pontine glioma admitted for status epileptcus, with hospital course complicated by intubation, multiple antiepileptic drugs and phenobarbital drip. MRI brain showed global hypoxic ischemia with poor prognosis for recovery. After goals of care discussions, his parents decided to withdraw care on two specific conditions: terminal extubation to be performed within the next day before the start of a calendar new year, and removal of the implanted port and suturing the wound in accordance with Chinese burial rites. Withdrawal of care was performed in accordance with their requests and the patient passed shortly afterwards.

In Chinese society, burial of an intact body demonstrates respect to one’s parents and ancestors, and is believed to allow the host to enter the next life intact without carrying ailments from their current lives. Death is a particularly taboo subject during holidays such as Lunar New Year and portends more deaths in the family for the upcoming year. When possible, providers should ask about specific rites or practices that families wish to observe to help with the grieving process.