Philosophy, ethics, and humanities in medicine : PEHM · 2026
Phenomenology and the ethics of dying: reclaiming the lived meaning of death in contemporary clinical practice in South Asia - a narrative review.
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Silva Shehan, Ramadasa Udayangani, Jayasinghe Saroj
Аннотация
Advances in biomedical technology have transformed dying into a prolonged, technological process in which clinical attention can drift from the person to physiological parameters. This narrative review argues that phenomenology offers an essential ethical corrective by foregrounding the lived experience of dying and complementing procedural bioethics, with particular attention to South Asia, where cultural, spiritual, and familial dimensions strongly shape end-of-life decisions. Drawing on classical phenomenologists and contemporary scholars of illness experience, the review synthesises insights on embodiment, finitude, relationality, and the disruption of worldhood in illness. These perspectives clarify how clinical objectification can eclipse the lived body, why accompanying the dying may be ethically preferable to the futile escalation of treatment, and how vulnerability calls forth responsibility, presence, and restraint. The review translates these themes into practical implications for critical and palliative care, emphasising temporal empathy, humanised communication, respectful touch, and the cultivation of homeliness through family presence and meaningful ritual. It further examines how dying is shaped across South Asia by overcrowded and under-resourced health systems, family-centred decision-making, and culturally mediated truth-telling. Particular attention is given to the region's religious and philosophical horizons of death: Hindu conceptions of karma, mokṣa, and the good death; Buddhist teachings on impermanence, non-self, and mindful dying in both Theravāda and Vajrayāna settings; and Islamic understandings of divine trust, patience, and the limits of intervention. Phenomenological ethics, the review concludes, supports end-of-life care that is clinically responsible, morally intelligible, and culturally resonant.