Comparative Study and Integrative Approach in End-of-Life Care: Thai Traditional Medicine versus Western Medicine

Abstract

Death, being an inevitable aspect of life, is envisaged as a hopeful transition for all individuals.Various methodologies have been proposed, including those from Thai traditional medicine (TTM) and Western medicine (WM), to maximize benefits in caring for terminally ill patients approaching the end of life. This article aims to review a comparative analysis of TTM and WM on key aspects, including indicators of impending death, and last-hours management; and to present a critique on an analysis and integrative approach of both medical paradigms in transitioning towards a good death. TTM defines death as the cessation of heartbeat, breathing, and body warmth, with signs of impending death primarily relying on patient-reported symptoms. The primary objective of last-hours management in TTM is to facilitate peaceful passing, utilizing principles of holistic health along with herbal remedies and therapeutic interventions. Conversely, WM conceptualizes death as permanent brain cessation, characterized by complete lack of sensory perception and brainstem reflexes, with indicators of impending death predominantly derived from medical assessments. The primary goal of last-hours management in WM is to optimize the patient’s end-of-life experience, focusing on comprehensive care for both patients and families across all dimensions of humanity, coupled with pharmacological interventions and multidisciplinary communication. End-of-life care encompasses two stages: diagnosis of impending death and provision of last-hours management. Through the integration of TTM and WM approaches, it is evident that both medical paradigms can mitigate each other’s limitations in diagnosing impending death and synergistically contribute to last-hours management. While they share the common goal of enabling patients to experience a dignified end-of-life journey and peaceful passing, they differ in their management approaches.