April 3, 2026*
COMMENTARY
The famous lines from Kipling’s poem, “The Ballad of East and West,” are often taken out of context and interpreted to mean that there are irreconcilable differences between Eastern and Western cultures. Actually, the subsequent lines of the poem suggest the opposite, that these cultural divisions vanish when individuals of equal strength meet, “tho’ they come from the ends of the earth!"
Perhaps so—but in the matter of assisted suicide and euthanasia (AS/E), there are indeed serious and perhaps irreconcilable differences between many countries of the “West” and those of the Asian “East.” To be sure, the terms East and West are rough and imprecise designations. In broad terms, for the purposes of this discussion, we include in the West primarily the European countries, such as Belgium, Luxembourg and the Netherlands, along with the US, the UK, and Canada.
Some would include Australia and New Zealand. Included in the East are, among others, China, Japan, India, and Korea. But as we will explain, the terms East and West in this article refer primarily to historically different cultural, philosophical, and spiritual traditions—all of which have great bearing on the matter of AS/E. These matters are of more than academic interest to psychiatrists, since patients of Eastern and Western cultural heritage may view end-of-life care—often involving psychiatric interventions—quite differently.1