Spiritual Ends: Religion and the Heart of Dying in Japan by Timothy O. Benedict (Oakland: University of California Press, 2023), viii + 191 pp., €36.00

Timothy O. Benedict’s Spiritual Ends: Religion and the Heart of Dying in Japan discusses the significance of spirituality and religion in hospice care for terminally ill patients in Japan. He surveys where and how spiritual care is practiced in Japan through broader anthropological research and interviews. The book also examines various sociocultural, historical, and religious factors influencing spiritual care and end-of-life care practices. It presents valuable data regarding the interactions among religion, spirituality, and medicine. The concept of spiritual care is put forth, which is revealed as a somewhat nebulous notion in Japan – such as how patients’ eyes glaze over in relation to words such as “chaplain” or “spiritual”. Although Benedict’s body of work is dedicated to this task, the impressions and experiences he shares also bring to life the everyday aspects of working in the hospice setting. He explains how his perspective on providing spiritual care changed such that he no longer feared making statements that might inflict emotional pain on people. One of the leading figures who inspired the modern hospital/hospice movement, Cicely Saunders, is credited with popularizing the neologism “spiritual anguish” introduced in this chapter. This term encapsulates the unique spiritual pain experienced by many patients. As Benedict argues, spiritual distress in Japan is often experienced as a void within oneself or as boringness. It is also difficult to confront this kind of pain in a culture where most people do not talk openly about religion.