Abstract
Terminal care can be done without advanced medical technique, but attention must be paid to holistic care focusing on the three indivisible facets of the human condition-body, mind and spirit. In Japan many advances have been made in the physical treatment of terminal patients, but psychosocial care is lagging behind. The aim of this study was to examine terminal care in ancient societies, such as India, Greece, and Egypt, that emphasized support for the mind and spirit rather than the body alone. The research was carried out by analyzing terminal patients with incurable diseases in the ancient Ayurvedic literature, Hippocratic collection, and Egyptian medical papyri. In ancient India, the physician should not treat patients with the signs of impending death, because a physician, treating an incurable disease clearly could suffer from loss of wealth, academic knowledge and reputation and from censure and unpopularity. He should not disclose the approaching death to a patient or his relatives if it is liable to result in the patient's collapse or distress to somebody else. Hippocrates said the physician should refuse to treat those who are overwhelmed by their diseases, realizing that medicine is powerless in such patients, and he should learn and declare beforehand those who will die and those who will get better. In ancient Egypt, observation of the patient's condition was stressed before making a prognosis which was unfavorable. Conclusions: All texts in these three ancient countries showed the physician should not treat terminal patients. In India the physician should not disclose the diagnosis and possible fatal outcomes to a patient and his or her relatives; however in other countries, the physician should reveal their opinions. This may show a cross-cultural difference, and might provide new perspectives on terminal care in Japan.
