A quarter of a million bedbound elderly people are kept alive in Japan, often for years, by a feeding tube surgically inserted into their stomach. A few months ago, my 96-year-old grandmother became one of them.
Feeding tubes are so common in Japan that my family wasn't initially consulted about the procedure, which is effectively irreversible. When my mother walked into Grandma's room the next morning and saw a tube, she dropped to her knees by the bedside and stayed there for hours, crying.
"I am sorry. I didn't mean to do this to you," my mom repeated over and over.
As medical science becomes more sophisticated, we're finding new ways to prolong life. When my grandma, Hisako Miyake, was born in 1916, life expectancy in Japan was around 43 years; now it is 83, the longest in the world.
When it comes to death, Japan doesn't score so well. In 2010, the Economist Intelligence Unit ranked 40 developed and developing countries on "quality of death," based on criteria such as end-of-life cost and care and, more broadly, how well societies faced issues of death. Japan was 23.
In Japan, there's not much talk about death. Living wills, or even discussions about end-of-life decisions, are rare. Historically, hospitals focused on extending lives of patients with little chance of recovery, said Tetsuo Kashiwagi, president of Japan's Hospice Palliative Care Foundation.
"That's still the mainstream," he said..