In Japan, there are several practices for education on death, commonly referred to as “Death Education,” “Education on Preparation for Death,” “Inochi Education,” and “Life and Death Education. In this signpost, we collectively refer to them as “Life and Death Education”. This field can be broadly categorized into three major streams: (1) Death education within hospice and palliative care settings, (2) “Education on Preparation for Death” proposed by Alphons Deeken, and (3) Life and Death Education at school. Since these practices emerged from the growing focus on “death” in Japanese society during the 1970s and 1980s, we first review the rise of interdisciplinary studies on death in Japan, known as “Shiseigaku” (Death and Life Studies) as a background of Life and Death Education. Then we provide an overview of these three major streams, followed by an introduction to related practices within local communities and civil society.

The Rise of Death and Life Studies

In the 1960s and 1970s, a series of studies focusing on “death” emerged globally. Among them, the most influential literature were C. Saunders’ pioneering writings on hospice care (beginning in 1958) and E. Kübler-Ross’s On Death and Dying (1969). In addition, major works such as G. Gorer’s Death, Grief, and Mourning in Contemporary Britain (1965), V. Jankélévitch’s The Death (La Mort) (1966), and Ph. Ariès’s Essay on the History of Death in the West (Essais sur l’histoire de la mort en Occident) (1975) have been published. These works, when translated into Japanese in the 1970s and 1980s, had a profound impact and contributed to the rise of “Shiseigaku” (Death and Life Studies) in Japan.

In 1977, some Japanese home-care doctors visited St. Christopher’s Hospice in Sydenham, London—founded by Dame Cicely Saunders in 1967—and subsequently introduced hospice care practices to Japan. That same year, the “The Japanese Association for Clinical Research on Death and Dying” was established, bringing together multi-disciplinary experts and civil society. This momentum led to the founding of several key organizations, including the Japanese Society for Hospice and Home Care (1992), the Japanese Society for Clinical Thanatology (1995), the Japanese Society of Palliative Medicine (1996), and the Japan Society for End-of-Life Care (2016).

In 1993, Toyo Eiwa University established Japan’s first university course focused on Shiseigaku (Death and Life studies). This was followed in 2002 by the University of Tokyo’s launch of a research project titled Construction of Shiseigaku. Since then, several universities, including Sophia University and Tohoku University, have also established departments dedicated to Shiseigaku.

In recent years, international collaboration in this field has grown. A notable example is the UK-Japan joint research project End of Life Care in the UK and Japan: Intersections in Culture, Practice and Policy (also known as the MITORI project, 2018–2020), led by Prof. David Clark (University of Glasgow) and co-researcher Prof. Hirobumi Takenouchi (Shizuoka University).

Life and Death Education in Japan

1) “Death Education” in Hospice and Palliative Care

At Yodogawa Christian Hospital, a team approach ‘Organized Care of Dying Patient’ was initiated in 1973. In this hospice program, doctors, nurses, social workers, psychiatrists, and pastors form a team to provide team care for terminal cancer patients. In 1981, the first hospice ward in Japan was established at Seirei Mikatahara Hospital, followed by Yodogawa Christian Hospital in 1984.

Early death education developed alongside the hospice movement, influenced by the works of Saunders and Kübler-Ross. In postwar Japan, hospital deaths had continued to increase, surpassing deaths at home in the late 1970s. As a result, “death” became disconnected from daily life and came to be viewed as something to be avoided. Within this culture of death denial, the tendency toward hospital-centered, life-prolong treatment grew stronger. In response, palliative care physician Akio Yamazaki raised questions about the “taboo surrounding death” and “hospital death” in his book Dying in the Hospital (1990). He advocated a shift to home-based care, and the book evoked social repercussions and was made into a movie in 1993.

Against this background, the importance of death education for patients and their families has been emphasized in hospice and palliative care. According to Atsushi Kawagoe, a palliative care physician, death education means “necessary education for people to make their own choices about how to live toward the end of their lives. The medical professionals support the patient in accepting his or her impending death, sharing it with family members, and making decisions by themselves. As part of this process, they have supported patients and their families to communicate, repair the relationship when needed, and advise the family on nursing care and end-of-life care.

As viewed above, hospice and palliative care in Japan have developed in close connection with Christianity, but there had been another stream that developed in connection with Buddhism.

In 1985, Hitoshi Tamiya of the Jodo Shinshu (the True Pure Land) sect proposed the idea of “Vihara”, a Sanskrit term meaning “resting place” or “monastery,” to refer to the place of terminal care within the Buddhist context. In 1987, the Buddhist Hospice Association was established at the Buddhist Information Center in Tokyo, and the Honganji Temple of the Jodo Shinshu sect launched the Vihara movement. Since then, “Vihara” has become a Buddhist term equivalent to “hospice” and has been adopted by many Buddhist hospitals and facilities, including Nagaoka Nishi Hospital. Various approaches have been developed not only in end-of-life care, but also in the fields of life and death education and grief care.

2) “Education on Preparation for Death” by Alphons Deeken

Alphons Deeken was a German-born Jesuit priest. While a student at Berchmans-Kolleg in Germany, he volunteered at a hospital, where he met a terminal cancer patient who had fled from East Germany. This encounter led him to begin a lifelong exploration of the theme of death. Subsequently, he wrote a master’s thesis on Thomas Aquinas’s doctrine of virtues and was awarded a Master of Philosophy from the same university. In 1959, he came to Japan and submitted a master’s thesis on the ethics of Tetsurō Watsuji to the Graduate School of Theology at Sophia University, where he was awarded a master’s degree in theology. Later, he completed his doctoral dissertation on the moral philosophy of Max Scheler in the United States, earning a doctorate from Fordham University. Other ideological influences on Deeken include Gabriel Marcel, Karl Rahner, and Mary Aikenhead.

With this philosophical and theological background, Deeken developed “Education on Preparation for Death” in his philosophy classes at Sophia University (1977–2002). Facing death means re-examining how we live own life, and through that, we are led to the insight that one can live fully and meaningfully until the very end. Therefore, we should promote education that encourages people to reflect on how to live their lives until death.

In November and December 1982, he organized a public seminar on life and death, which led to the establishment of the “Association for Life and Death Reflection” in March 1983. This Association sets three goals: (1) to promote “education on preparation for death,” (2) to improve end-of-life care and support the hospice movement, and (3) to create spaces where those who had experienced bereavement could share their experiences. The movement received a strong response; by 1996, membership in Tokyo alone exceeded 1,500, and 35 branches had been established throughout Japan, holding regular grief work gatherings.

In April 2005, the Fukuchiyama Line train derailment accident occurred, killing 107 passengers and the driver and injuring 562 others. This tragic accident brought widespread attention to the issues of “grief” and “grief care” in Japanese society. In response to the growing need, the Institute of Grief Care was established in 2009 at the University of St. Thomas (Amagasaki City, Hyogo Prefecture), due to the effort of the members of Hyogo Association for Life and Death Reflection. The Institute was later transferred to Sophia University.

(3) Practice in School Education

“Education on Preparation for Death” is not widespread in school education. There have been exceptional attempts to implement life and death education based on the curriculum of the Hyogo Association for Life and Death Reflection, including Haruhiko Furuta’s practices at Kwansei Gakuin High School. However, in general, education on preparation for death is subject to critical voices in the field of education that ask, “Can we prepare for death?” and “Can we teach death?” According to one study (2018), teachers who oppose the classes on death tend to avoid the topic and thought of death in their daily lives. To begin with, the word “death” is not found in the Fundamental Law of Education and the School Education Law in Japan, while the word “life” appears. In the curriculum guidelines for elementary, junior high, and high schools, “life” is mentioned in the subjects of moral education and science, but there is no mention of “death” at all. Only in the nursing school curriculum does the term “terminal stage” appear.

In Japanese school education, against this backdrop, education on life and death is carried out by emphasizing the importance of life and emotional education. Let us introduce two representative educational practices.

One is “Education of Inochi” proposed by Sadako Tokumaru, a professor at Joetsu University of Education. Tokumaru sees a Christian view of life and death behind the “education on preparation for death” advocated by Deeken. In distinction, she proposes an education of life and death rooted in Japanese religious and cultural traditions. The Japanese word “Inochi” symbolizes this guidance. She has developed a wide variety of teaching materials that can be introduced into school education, based on experiences that are familiar to pupils – for example, the bereavement of a pet or traditional events such as the Bon and Higan holidays.

Another is “Inochi education” advocated by Taku Kondo. He is a clinical psychologist who worked as a school counselor for a long period of time. Based on his experiences, the purpose of his “Inochi Education” is “to help children confirm to themselves that their lives are precious and irreplaceable, and that they are allowed to live unconditionally. In this practice, he introduces the work of listening to each other’s heartbeat using a stethoscope and the work using self-esteem cards.

Both in the educational programs of the Hyogo Association for Life and Death Reflection and Tokumaru’s program, the policy is to learn the importance of “life” from “death” and to nurture the “power to live”. In contrast, Kondo’s program recommends fostering the “power to live” by enhancing basic self-esteem. Rather than making students reflect on the “negative issue of death”, the program promotes education on life through the experience of feeling “Inochi” together.

In addition, Toshihiko Fujii, a professor at the Faculty of Education at Hiroshima University, is promoting “life education” as part of peace education. At the End-of-Life Care Association, palliative care doctor Taketoshi Ozawa, who serves as the representative director, is leading “life lessons to cultivate a resilient heart” in schools and companies. While medical school curricula in Japan include subjects such as “medical ethics” and “bioethics,” and nursing faculties and vocational nursing schools include “nursing ethics” and “bioethics,” educational practices that specifically focus on the theme of “death” remain limited.

Efforts in Local Communities and Civil Society

Since the beginning of the 21st century, the Japanese government has been promoting home medical and nursing care, and local governments have been offering various programs for comprehensive community care systems. At community comprehensive care centers, housing, medical care, nursing care, prevention, and education and support for healthy daily living are provided so that elderly people can continue to live their own lives in their own familiar communities until the end of their lives.

Death Cafe, which originated in Europe, are also spreading in Japan. More than 20 Death Cafes are active in Tokyo, Yokohama, Kyoto, and elsewhere, as well as online. Alongside these efforts, Shiseigaku cafe—which emphasize “exploration through dialogue”—are also actively engaged. The first Shiseigaku cafe began in Shizuoka City in 2015, and since 2022 in Fukuoka and from 2025 in Fukushima, they have been promoting dialogue-based practices aimed at “learning to live with death” and “loss”. Additionally, since 2024, an event called Death Festival (Death Fes) has been held in Shibuya, Tokyo. The number of participants reached approximately 2,000 in its first year (2024) and 4,200 in its second (2025). Lastly, the organization Compassion & Dialogue hosts an online program titled Compassionate Cities & Communities Lecture Series, offering learning and dialogue centered on the themes of “death” and “loss“.

Reference Books (All in Japanese)

• Higuchi, Kazuhiko & Hirayama, Masami (Eds.). (1985). Education of Life and Death: An Introduction to Death Education. Sogensha.
• Deeken, Alphons. (1996). How to Face Death. NHK Library. (Amazon link)
• Kawagoe, Atsushi. (1996). For Those Starting Home Hospice Care. Igaku-Shoin.
• Deeken, Alphons. (2001). Education of Life and Death. Iwanami Shoten. (Amazon link)
• Furuta, Haruhiko. (2002). The Practice of “Education of Life and Death”: Focusing on the Curriculum of the Hyogo Association for Life and Death Reflection. Shimizu Shoin.
• Kondo, Taku (Ed.). (2007). Theory and Practice of Inochi Education. Kaneko Shobo.
• Tokumaru, Sadako (Ed.). (2008). Unraveling “Inochi Education”: Japan and the World. Gendai Tosho.
• Shimazono, Susumu & Takeuchi, Seiichi (Eds.). (2008). Thanatology 1: What is Thanatology? University of Tokyo Press.
• Okabe, Kakeshi & Takenouchi, Hirobumi (Eds.). (2009). How to Live and How to Die: Constructing Thanatology  from the Field. Porano Publishing.
• Takenouchi, Hirobumi. (2023). Learning to Live with Death: The Philosophy of the Mortals (2nd ed.). Porano Publishing.

Written by Hirobumi Takenouchi, Professor, Shizuoka University, with Chisato Masuda, May 2025

Notes:

Inochi: The Japanese word “inochi” has a variety of meanings, including life, lifespan, lifetime, destiny, sole reliance, and the most important thing. Etymologically, like the English word “spirit,” it is closely related to breath (“iki” in Japanese). The word “life” has a conceptual breadth that is not confined within an individual life, and it is a word that views human life in terms of the interconnectedness of all the livings.

Bon (Obon): A Buddhist holiday in mid-August where families honor the spirits of their ancestors, who are believed to return home during this time. People visit graves, offer food, and take part in traditional dances.

Higan: Observed during the spring and autumn equinoxes, Higan is a time for visiting graves and holding a memorial service for the dead.