‘Chết phải toàn th'y’: belief in Vietnamese culture and its impact on organ donation

Journal of Medical Ethics (forthcoming)
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Abstract

The phrase ‘chết phải toàn thây’, which has no direct English translation, can be roughly interpreted as ‘one must die with an intact body’. This belief, deeply rooted in Vietnamese culture, significantly influences how the body is treated after death. It is often linked to the idea that the body must remain whole for the soul to rest peacefully or transition smoothly into the afterlife. While many societies, particularly in the Western world, view the donation of organs after death as a noble act, the belief in ‘chết phải toàn thây’ poses a significant barrier to promoting organ donation in Vietnam. This essay highlights the cultural origins of this belief and explores a broader interpretation of ‘toàn thây’ or ‘intact body’ in the modern era. The phrase ‘chết phải toàn thây’, firmly ingrained in Vietnamese culture for thousands of years, reflects the influence of religious and philosophical traditions, particularly Confucianism, Buddhism and Taoism.1 Confucianism emphasises filial piety (xiao), which includes preserving bodily integrity after death as a sign of respect for one’s parents and ancestors.2 Taoism, with its focus on the soul’s immortality and harmony with nature, regards the body as a sacred vessel crucial for maintaining a balance between the physical and spiritual realms.2 Together, these traditions form a cultural framework that assigns profound spiritual and emotional significance to the body, making its preservation a deeply held …

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