Kiang Wu Nursing College of Macau released two research outputs, showing that current Macao residents have a high demand for quality end of life care. However, insufficient awareness of palliative and end of life care might have affected residents’ own end of life related decision-making, and how they would make end of life care related decisions for their parents. 

Funded by the Higher Education Fund, the "Filial Piety & End of Life Care" research outputs series presented two studies: “An investigation of the perception of “Good Death” and “Filial Piety” expression in end-of-life care: Perspectives of the Chinese in Macao” and “Public knowledge and attitudes towards palliative and end of life care in Macao”. The first study demonstrated that 85% of the participated Macao residents agreed that a “Good Death” required preparation for death; more than 90% believed that “filial obligations” meant that they should accompany their parents and fulfil their needs; more than 50% believed that they should not hide parents’ illnesses from them nor should they only report good news and not the bad ones. However, when Macao residents were asked to make end of life decisions for their parents, less than 70% of them were willing to initiate discussion about death with their parents, reflecting attitudinal differences between their own pursuit of “Good Death”, and their behaviours towards parents’ end of life decisions under the influence of “filial obligations”.

The second study illustrated that 62% of the participated Macao residents tended to choose palliative care at the end of their lives, and 74% agreed to set up “Advance Directive” . Most Macao residents understood the purpose of palliative care is to alleviate pain and discomfort of the terminally ill, however, almost half of them believed that life-sustaining treatments should not be stopped under any circumstances, reflecting people’s knowledge gap regarding palliative care and life-sustaining treatments.

Primary Investigators, Assistant Professor Ng Wai I and Associate Professor Leong Sok Man pointed out, both research reflected that Macao residents have high demand for palliative and end of life care, and strong wish to prepare for death in achieving “Good Death”; however, they do not know how to make suitable end of life care related decisions. The wish to pursue “Good Death” has been impaired by the lack of understanding of palliative care, end of life care and life-sustaining treatments, leading to a conceptual and decisional dilemma amongst the residents of Macao. 

KWNC’s research suggested that it is necessary to enhance public education on palliative and end of life care, and encourage family members to discuss death related topics. It is essential to strengthen specialist training for healthcare professionals, enabling them to confidently assist patients and their families to discuss end of life care plans. Furthermore, the Macao government should consider increasing its resource allocation in palliative care services, and should explore the feasibility of introducing “Advance Directive” in Macao.