Htun Nan Shwe Nwe, Adhikari Bipin, Phyo Aung Pyae, Perrone Carlo, Phommasone Koukeo, Kabir Nawrin, Vanna Moul, Lubell Yoel, Peto Thomas J
Faculty of Tropical Medicine, Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand.
Nuffield Department of Clinical Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK.
Glob Bioeth. 2025 Sep 2;36(1):2550810. doi: 10.1080/11287462.2025.2550810. eCollection 2025.
Verbal autopsy research is vital for understanding community mortality, informing health interventions and policies in low- and middle-income countries. However, overlooking the community perspectives on deaths can undermine the ethical conduct and effectiveness of such research. This study explored community-based concepts of death, interpretations, and coping mechanisms in five Southeast Asian countries, with this manuscript highlighting key findings from the body mapping exercise that revealed diverse cultural and religious understandings on death. Participants' views ranged from seeing death as a cessation to life's struggles to an inevitable end, reflecting deep cultural and spiritual beliefs. Coping mechanisms, often grounded in religious practice and community support, played a crucial role in managing grief. The study also underscores the importance of addressing emotional well-being for both participants and researchers. Recommendations include integrating mental health support into research protocols and tailoring practices to local cultural contexts. These findings inform the design of more ethically grounded verbal autopsy tools and procedures that are sensitive to local beliefs and emotional dynamics, ultimately improving data quality and community trust.
口头尸检研究对于了解社区死亡率、为低收入和中等收入国家的卫生干预措施及政策提供信息至关重要。然而，忽视社区对死亡的看法可能会损害此类研究的伦理行为及其有效性。本研究探讨了东南亚五个国家基于社区的死亡概念、解读及应对机制，本手稿重点介绍了人体绘图活动的主要发现，该活动揭示了对死亡的不同文化和宗教理解。参与者的观点从将死亡视为生命挣扎的停止到不可避免的终结不等，反映了深厚的文化和精神信仰。应对机制通常基于宗教实践和社区支持，在管理悲伤方面发挥了关键作用。该研究还强调了关注参与者和研究人员情绪健康的重要性。建议包括将心理健康支持纳入研究方案，并根据当地文化背景调整做法。这些发现为设计更符合伦理、对当地信仰和情感动态敏感的口头尸检工具和程序提供了依据，最终提高数据质量和社区信任度。
