The Japanese pilgrimage: not begun.

The modern Western hospice philosophy, with its Christian background, has tried to create a metaphorical connection between cancer patients and medieval pilgrims which implies an active attitude to an individual responsibility for pain, life and death - as one carries one's 'own cross'. This approach is not strictly relevant to Japanese people, because their culture emphasises a family or community responsibility for - and sharing of - the matter of each person's life and death, and passive acceptance of death and pain. This paper seeks to reveal the cultural differences between the Western and Japanese hospice movements in relation to the pilgrim-cancer patient metaphor, and the difficulties in bringing the Western hospice concept to Japan.