The summit of a moral pilgrimage: Confucianism on healthy ageing and social eldercare

Abstract

To effectively address ageing and develop adequate eldercare needs, among others, new ethical visions are much needed. One of the ways to formulate sound ethical visions for contemporary issues is to reclaim, reinterpret and revive old moral ideas and ideals rooted in different indigenous cultural traditions. Drawing thought, wisdom and inspirations from classical Confucianism, the article offers a Confucian ethical outlook on healthy ageing and social eldercare. The popular perception of ageing in the West as well as China regards old age as a period of inevitable decline. However, Kong Zi (Confucius) treats human life as an ongoing moral pilgrimage, with old age the summit of the lifelong journey. This Confucian ethical view on ageing as the culmination of a lifelong moral cultivation has various important themes. They include the primary feature of learning in healthy ageing, the essential role of social eldercare embedded in the popular Confucian norm ‘filial piety’ (xiao), intergenerational flourishing and the necessity to respect the rights and dignity of each old person. Such a Confucian socio-ethical vision can not only help identify contemporary failings in the area of eldercare but also generate novel ideas and frameworks to help China and the world to face population ageing and elderly care in a more positive way.

Introduction

Population ageing has been widely acknowledged as a major social issue not only in developed countries like the United Kingdom and New Zealand but also in an increasing number of developing countries like China. In order to effectively address population ageing and develop adequate eldercare, innovative ethical visions are much needed. Only through morally sound visions can collective political wills be motivated, sufficient economic resources organized and effective practical measures taken. One fruitful means to come up with new ethical visions for dealing with today’s bioethical issues, elderly care included, is to creatively appreciate and reinterpret old ideas and ideals in various moral traditions of different cultures and societies.

Chinese cultural traditions like Confucianism contain rich moral and intellectual resources which can and should be mined in order to formulate ethically sound and culturally sensitive visions of elderly care for China and the world today. Drawing inspiration, wisdom and thought from classical Confucianism, this article presents one fundamental but so far never explicitly identified dimension of a Confucian socio-ethical vision of eldercare. It focuses upon the notion of Kong Zi (Confucius) on ‘old age as the summit of a life-long moral pilgrimage’. And a series of themes and implications of such a perception for healthy ageing and social eldercare will be discussed.

Theoretical and methodological approach

Before elucidating the key components of Confucian ethics on healthy ageing and social eldercare, a couple of points on the theoretical and methodological approach should be made. First, the ethical vision to be presented in the following has been developed from classical Confucianism. It is based on the primary texts by Kong Zi in the 5th–6th centuries BCE and Meng Zi (Mencius) in the 4th century BCE, two founders of Confucianism. Particularly, the key texts are Lunyu (The Analects), a collection of Kong Zi’s sayings recorded by his disciples, and Meng Zi, a book written by Meng Zi himself and his close disciples according to the mainstream scholarship. Primary texts informing the background of this research are what have traditionally been called ‘liujing’ (the six most essential Confucian classics), all originally edited by Kong Zi himself. They are Shijing (Book of Songs), Shangshu (Book of Documents), Sanli (The Three Books of Rites or Three Ritual Compendia), Yueshu (Book of Music) (only fragments survived), Chunqiu (the Spring and Autumn Annals, or Chronicle of Lu) and Yijing (Book of Change).

The foremost task of this article to engage with Confucian classis is to find better answers to one of major contemporary bioethical issues. As in other civilizations, Chinese canonical texts can and have been interpreted and studied in many different manners. In the Chinese hermeneutic tradition of the Confucian classics, a Neo-Confucian thinker in the 12th century (the Song Dynasty), Lu Jiuyuan, distinguished two main methods. They are ‘wozhu liujing’ (I annotate the six classics) versus ‘liujing zhu wo’ (The six classics annotate I). ¹ The first mode is text-centred and aims at discovering the original meanings and actual contexts of the primary texts. It does so by analysing their philological features and investigating their historical background. The second approach seeks to create new interpretations of the classics. In this approach, canonical texts are treated as the living sources that continually elicit novel ideas, worldviews, wisdom and inspiration for every new generation; however, dramatically and profoundly the world has changed from that of the classical texts. The methodology taken for this article is closer to this second approach. At the same time, for any such interpretation to be Confucian, it must be founded faithfully in the primary Confucian texts and be in accord with the general spirit of Confucianism.

Second, the research for this article has been undertaken through a socio-ethical approach or a framework of ‘ethical transculturalism’. ^2,3 In the past two decades, I have carried out a number of research projects on topics including Japan’s wartime medical atrocities, Chinese views and experiences of abortion, China’s one-child policy, medical professionalism in China, the Chinese crisis of patient–physician trust, Confucian ethics on human body and body parts, and socio-ethical issues associated with HIV cure research. While these projects differ in their subject matter, from the methodological perspective they all involve the same procedure: integrating ethical analysis with socio-historical inquiry and incorporating a Chinese–Western comparative perspective. Through such a research process, on the one hand, I have become more and more discontented about contemporary bioethics. It seems to me that, despite its great dynamic, the academic field suffers from three major malaises. It is rootless because, through focusing on general ethical dilemmas and principles, bioethics often overlooks the broader socio-cultural forces shaping bioethical issues and responses to them. And the ethical issues concerning large populations as well as the relevance of indigenous moral traditions in the non-Western and less developed world are much marginalized due to the Western dominion. Bioethics is heartless or emotionless because the vital roles of emotions and irrationality in human moral life are overlooked due to its emphasis on reason and rationality. Bioethics is soulless because the existential and spiritual matters are often downplayed due to its almost exclusive focus on body and mind.

On the other hand, to better understand bioethical issues in the Chinese socio-cultural settings within a global context and to overcome the malaise of the rootlessness of bioethics, I have put forward and I am still developing an alternative theory or methodology of transculturalism. Its key elements are these five: (1) appreciating the complexity of cultural differences, rather than stereotyping and dichotomizing any culture; (2) taking seriously the internal plurality and diversity within every culture, rather than homogenizing and oversimplifying any culture; (3) focusing on cross-cultural differences as well as transcultural commonalities, especially a common humanity; (4) promoting genuine and deeper transcultural dialogue, not subscribing to the false prophecy on clash of civilizations or cultures; and (5) upholding the primacy of morality, rather than accepting the tyranny of cultural and socio-political practices. ^2,3

Old age as an inevitable decline

Confucianism treats life as a moral pilgrimage and the old age as the summit of such a journey. This vision constitutes an arresting contrast with the fundamentally negative view of the old age that has been persistent and popular in many societies.

Nearly half a century ago, the author of Why Survive, the Pulitzer Prize–winning book and now a classic on ageing in the United States, started with a sharp observation:

Old age in America is often tragedy. Few of us like to consider it because it reminds us of our own mortality. It demands our energy and resources, it frightens us with illness and deformity, it is an affront to a culture with a passion for youth and productive capacity. ⁴ (p. xi)

The author continued,

In America, childhood is romanticized, youth is idolized, middle age dose the work, wield the power and pays the bills, and old age empty of purpose, gets little or nothing for what is has already done.…Aging is the neglected stepchild of the human life cycle. ⁴ (pp. xii, 1)

Unfortunately, despite increasing social awareness on various forms of ageism, these characterizations on the general attitudes of people towards ageing are still principally valid in not only the United States but many other parts of the world including China. ^5,6

Surely, there exist many long-rooted beliefs such as ‘the wise old person’ and ‘golden agers’ in many cultures. Nevertheless, negative images of ageing are more dominant and ubiquitous. They have been vividly reflected in countless art works, among others, since ancient times in the West. Gera, the god of old age in ancient Greece, looks shrivelled-up ugly, in striking opposition to the beauty of Hebe, the goddess of the youth. In modern Western art, Goya’s ‘Two Old Ones Eating Soup’ reflects the stereotypes on old age as being toothless, useless and lifeless eaters. While human dignity is clearly present, Van Gogh’s ‘Sorrowing Old Man’ on a chair with his bold head down on his two hands expresses the unbearable emotional and spiritual suffering associated with old age.

The most persistent and pervasive perception of ageing is to define old age as a period of inevitable or even doomed decline across one’s life span. This viewpoint is vividly portrayed in many lithographs on the life and age of man and woman from American popular culture in late 19th century. ^7,8 In these arts works, the sense of gloom and doom surrounding ageing is even more chilling in the more colourful ones than those made in black and white. In one of them, even the trees are no longer green when one becomes old. It is also worthwhile pointing out that in these lithographs, the woman is often featured to serve as the caregiver of the old man. Artists in the 20th century continued to characterize life and old age in the same fashion. In his works ‘Untitled (Stages of Life – Women)’ and ‘Untitled (Stages of Life – Men)’, Saul Steinberg (1914–1999), Romanian-American cartoonist and illustrator for the New Yorker magazine, depicts that while old age for woman is a gradual decline, life following retirement from work in old age for man is portrayed as a sharp and deep fall, like a fall off a steep cliff.

The abundance of negative images on ageing in Western visual art indicates the fact that ageism and various age-related stereotypes have long been widespread. This acknowledged fact has been documented by numerous social sciences and medical studies on attitudes in Western as well as Chinese societies and cultures. ^5,6 It should be noted that Chinese are far from immune to perceiving old age in adverse manners including the belief on old age as an inevitable decline. ⁶ For example, the first chapter of Huangdi Neijing (The Yellow Emperor’s Inner Classic of Medicine), ⁹ the earliest systematic and most influential theoretical work on traditional medicine, divides physiological development of man or woman into periods of 7 or 8 years. Women start to decline in their late thirties and men in their early forties. After this, the various parts of the body gradually degenerate until they lack all function, like withered grass and fallen leaves. In the words of the original text, in old age, ‘the body become corrupt and the jingqi (spirit) exhausted’ (p. 3). ⁹

Seen from a narrowly physiological perspective, this portrayal of ageing across the human life span is indisputable. But humans are not just animals, but social, moral and spiritual beings as everyone knows. Should old age be characterized as an inevitable decline in the social, moral and spiritual senses? The answer given by Confucianism is a resounding ‘no’.

Old age as the summit of a moral pilgrimage

More than 2500 years ago, Kong Zi summarized the progress of his own life to his disciples:

At fifteen, I set my heart to learning. At thirty, I establish myself or take my stand. At forty, I had no illusions. At fifty, I understood the Mandate of Heaven. At sixty, my ears became attuned [to Dao, the Way]. At seventy, I follow my heart’s desires without transgressing any moral principles. ¹⁰ (Book I, Chapter III; Nie’s English translation)

This passage, one of the best-known remarks from The Analects, has brought about a great deal of discussion and numerous controversies about its meanings since ancient times. ⁸ Some philological difficulties of certain words such ‘ershun’ (what does the term mean and to what the ears are attuned?) are probably unsolvable.

The question concerned here is: What does this household passage mean for ageing and eldercare? Although never recognized explicitly in the existing scholarship, a positive vision of ageing is being presented here. In total contrast to the stereotype of viewing the life span as a curve peaking in middle age, with old age as a period of doomed decline, Kong Zi defines life as an ongoing moral pilgrimage with old age being the summit of the journey. One should not stop his or her moral journey in youth, nor in middle age, but continue to old age until the end of one’s life.

For centuries, commentators have debated the precise Chinese text and meaning of the phrase ‘congxin suoyu er buyuju’ (following the heart’s desires without transgressing any moral principles). One possible interpretation is that, through constant learning and practising, one achieves in the final stage of life what philosopher Kant has called ‘freedom’ or ‘autonomy’. Although Confucianism and Chinese philosophy in general are often treated as the radical other of the West, especially in the English-speaking world, pioneering comparative studies conducted by German philosophers and sinologists have identified fundamental similarities in ideas and orientation with those of Kant’s moral thought. ¹¹

Two immediate questions suggest themselves at this point. First, Kong Zi is not recorded as saying anything after the age of 70, and he died in his early 70s. But, today, most of the ethical issues relating to ageing and eldercare are linked to the group that has been called the ‘oldest old’, that is, people aged 80 and older. They are more likely to have dementia and many other health issues. How would Kong Zi have responded to this situation? In my view, his ethical vision of ageing as the summit of a moral pilgrimage would look askance at the current trend of over-medicalizing the ageing. It would see ageing not as a disease, nor illness, but as a positive development, full of potential.

Second, apparently different from the other major world religions, Confucianism articulated by Kong Zi and Meng Zi pays little attention to the question of what occurs after death. However, Heaven and especially the Mandate of Heaven are extremely important concerns for Confucianism. If Kong Zi were pressed to say where he would go after his life’s pilgrimage, it is likely he would say ‘Heaven’ or ‘the stars’. Although the Christian belief in the paradise is alien to Confucianism, the journey of life including the last stage should and can be upwards, not downwards.

The Confucian ethical vision of ‘old age as the summit of a life-long moral pilgrimage’ contains a number of important themes and implications. In the following, I will elaborate on four of these themes: the essential role of learning in healthy ageing, the importance of social eldercare, intergenerational flourishing and the need to respect the rights and dignity of each old person. Such an elaboration, albeit sketchy, aims to flesh out what the Confucian perception of old age purports for healthy ageing and social eldercare in practice.

Learning to be human: life as a moral pilgrimage

Confucianism has always emphasized lifelong learning. The Analects opens with advice on learning and practising what one has learnt and ends with the need to appreciate other people’s words. Kong Zi frequently speaks about learning and the joy of learning. Nevertheless, departing from the current notion of lifelong learning, for Kong Zi learning is a moral undertaking, not merely the acquisition of knowledge and skills.

According to Confucianism, becoming human does not end at birth; we learn to become human through the entire journey of life. Daxue (The Great Learning), an elementary Confucian text, presents the moral and social programme of Confucianism based on learning in a nutshell. ¹² Traditionally, this programme is divided into ‘Three Items’ and ‘Eight Steps’. The ‘Three Items’ are as follows: manifesting the clear character of personhood; loving other people or renewing oneself continuously; and abiding in the highest good. The ‘Eight Steps’ includes investigating the world; making one’s heart to be sincere; rectifying the mind; cultivating one’s personal character; regulating the family; governing the nation; and promoting world peace or promoting humankind as a moral commonwealth. Among others, Confucianism has a strong stand in ethical universalism. The programme articulated in The Great Learning succinctly summarizes the ladder and goals of one lifelong moral pilgrimage.

Individually, learning is a means of cultivating personal character with the aim of ‘abiding in the highest good’. As we saw in the passage quoted earlier, for Kong Zi, learning has important moral ends: establishing oneself with the capability of making competent moral judgements, stripping oneself of illusions or misguided ethical beliefs, understanding the Heavenly Mandate, and seeking and following Dao (the Way).

All this forms the basis of Confucianism. As for ageing and elderly care, Confucian emphasis on the role of learning in living a fulfilled life is significant. It endorses such international programmes and movements as Third Age Learning and the University for the Third Age. Confucianism provides also a philosophical and ethical foundation for such developments related to healthy ageing and social eldercare. Without continuing learning motivated by individuals and supported by societies, one can hardly live old age as the summit of a moral pilgrimage.

In this article, the word ‘pilgrimage’ is employed in the metaphorical sense. For, unlike other religions, including Buddhism, Hinduism, Judaism, Christianity and Islam, the notion and practice of pilgrimage are not an inherent element in Confucianism. Some comparative points with the influential Christian allegory originated in England, The Pilgrim’s Progress, can help clarify what the Confucian vision means. While Confucianism has its own existential and spiritual outlooks, ¹³ it does not have a strong orientation of otherworldliness. The spirit vividly expressed in the subtitle of The Pilgrim’s Progress, ‘from this world to that which is to come’, is alien to Confucianism. So are the beliefs in God incarnate and the doctrine of the Trinity.

However, with regard to old age, there are some important similar insights and viewpoints. Due to the limit of space, let me mention two only. First, old age is a stage of life that should be treated positively and that one should look forward to. Confucians would share with King Solomon whose proverbs in Old Testament praise that ‘Gray hair is the crown of glory’ to be found in the way of righteousness, virtue and wisdom. Second, Christians would agree with Confucians that ‘loving other people or renewing oneself continuously, and abiding in the highest good’ as well as ‘promoting world peace or promoting humankind as a moral commonwealth’ constitute the fruits of a life as a pilgrimage for this world. Their difference lies in how these fruits can be reached, one by the grace from God and the other by lifelong learning, constant moral cultivation and following earnestly the examples of sages.

Xiao (filial piety) and social eldercare

Learning should be communal and social as well. So should elderly care. The older people, especially those in the ‘oldest old’ cohort, are in need of greater care from the community and society so that for them old age will indeed be the summit of a lifelong moral journey. Let me illustrate this point by reinterpreting Meng Zi’s notion of xiao (commonly translated as ‘filial piety’).

Partly due to its prominence in Confucianism, the moral norm of xiao has been widely characterized as a salient feature of East Asian cultures. It has been frequently invoked in discussions of the ethical, legal and public policy issues related to eldercare in East Asia. Conventional discussions of xiao focus on young people’s duties to the older people within the family unit – the word ‘filial’ in the English translation of the term captures this focus clearly.

However, based on the primary text Mengzi the book, one should redefine xiao as the essential duty of the state to every senior citizen in its jurisdiction and, even more broadly, in the world. The highest goals the Confucian moral ladders aim to achieve, as we have just seen in The Great Learning, include promoting humankind as a moral commonwealth.

To re-conceptualize xiao in such a manner may appear very strange or inauthentic. Yet, for Mengzi, this is an essential dimension of xiao, although one yet to be appreciated. A household Chinese proverb first put forward by Mengzi states,

Lao wulao yiji renzhilao, you wuyou yiji renzhiyou (Treat with the care due to age the elders in your own family, so that the elders in the families of others should be similarly treated; treat with the care due to children the young in your own family, so that the young in the families of others should be similarly treated). ¹⁴ (Book I, Chapter VII; Nie’s English translation)

This statement underlines the need of extending the virtue of filial piety to the wider community and society. Meng Zi made this statement when advising a king on how to realize good governance and benevolence in everyday practice. King Shun, one of the greatest legendary kings in Chinese civilization, was highly praised by Meng Zi for respecting and caring for his father, stepmother and stepbrother despite their abusive behaviours towards him. More importantly, King Shun extended his practice of filial piety to the people of his kingdom, particularly the older people and those in need. According to Meng Zi, the eldercare programmes set up by King Wen, another legendary king, were something similar to community-based care or social eldercare today. ¹⁵

Meng Zi’s thought does not automatically endorse the contemporary polity of the welfare state, nor socialism and statism. The key point here is that, for Meng Zi, it is the people, not the state itself, who should be empowered. The old people should and can be empowered through their active individual and communal participation in giving and receiving care. In other words, the state has a moral and political duty to create favourable economic, social and institutional environments in which people are able to cultivate and practice the cardinal virtue of filial piety – not only with respect to their own parents and grandparents, but for the good of other older people in one’s community and society.

Therefore, Confucianism highlights that, paraphrasing the well-known proverb from Africa on child care, it takes ‘a whole village’ for each older person to live a fulfilled old age, a culmination of life.

Intergenerational flourishing

In the global discourse on ageing and elderly care, an underlying assumption and sentiment, if not explicit conviction, is that elderly care constitutes a burden for individuals, community and society. It is doubtless that providing adequate care for each old person in need is a challenge, especially in the economic and social senses. Elderly care, like that for old persons with dementia, is emotionally challenging too for other family members and professional caregivers.

The Confucian outlook on old age as a summit of a lifelong moral pilgrimage defines elderly care more positively through underscoring intergenerational independence, reciprocity and flourishing. Without care and support from younger generation, it would be difficult, if possible at all, for the older people to flourish and thus live their old age as the summit of their life journey. At the same time, giving care is essential for the moral development of the young as the notion of filial piety and other Confucian values argue. Furthermore, living a fulfilled old age as a summit of a long moral journey offers the embodied examples for the young people to live their old ages as in the similar manner and spirit.

In the West and China alike, Confucian ethics has so often been contrasted to mainstream Western one in a dichotomized way. About the intergenerational ethical issues, it appears that the Western perspectives focus more on the duty to future generation, while Chinese ones, as exemplified in the idea of filial piety, focus on the duty of the young owned to old generation. There may be certain truth in this general Chinese-Western comparative observation. But a more accurate, rather than oversimplified, presentation on Chinese ethics in this context is that Confucianism emphasizes intergenerational flourishing.

The rights and dignity of every older person matter

To ensure that every older citizen enjoys a fulfilling final stage to their lifelong moral pilgrimage, it is necessary to safeguard their personal rights and dignity, as well as their rights and dignity of older populations as groups. Many scholars have convincingly argued for this viewpoint in their writings.

Yet, as seen in the heated debates over the ‘Asian values’ thesis regarding human rights, a stereotypical representation of Confucianism stresses the absolute loyalty and blind obedience owed by the people to the state and other secular authorities. The Confucian moral and political worldview has frequently been oversimplified as collectivist in character, thus serving as the ‘radical other’ of the West, particularly the modern Western liberal tradition. But individual rights and human dignity do matter in the Chinese socio-political context. And moral and political thought of classical Confucianism articulated by Kong Zi and Meng Zi is not at all incompatible with these key liberal ideas and ideals. Nevertheless, I am not able to expand on this subject here. In addition to many other scholars in East and West, I have myself explored related bioethical issues in depth from the angle of human rights elsewhere – in relation to China’s one-child policy, informed consent and patients’ rights and elderly care in particular. ^{2,15 –17}

A failure of eldercare: elderly suicide

One of many stereotypes on Confucianism is that it requires and promotes a sort of blind and absolute obedience to the authorities. This may be true for what can be called ‘popular Confucianism’ as practised in late imperial China. But this is certainly not the case for classical Confucianism. In fact, both Kong Zi and Meng Zi are highly critical of the moral and social failings of their contemporaneous kings, officials, states and policies from their ethical principles and ideals. There are aspects in elderly care in China which have seriously failed Confucian ethics. For many old people in China, their old age is not at all a summit of his or her life.

China has been ageing fast, faster than most other societies. Eldercare poses a daunting challenge for China today, which will only become more acute in the coming decades. Two striking phenomena in China in the past several decades are the country’s astonishing economic growth and the remarkable decline in fertility. While population ageing is a global issue, one demographic factor unique to China is its widely known ‘one-child policy’. The most ambitious and intrusive population programme ever undertaken in human history is a typical example of modern social engineering. The claimed decline in fertility has been achieved at extraordinary human and social costs. It is highly questionable how effective the policy has been because the demographic data indicate that the dramatic decline in fertility set in before the introduction of the one-child policy, not after. ¹⁶

One of major ironies of the one-child policy is that it was designed to improve living standards and help relieve poverty and underdevelopment. However, China’s birth control programme or ‘planned reproduction’ has imposed enormous suffering on the Chinese people, especially women. It has resulted in or contributed to many unintended and far-reaching negative consequences, including a seriously distorted sex ratio at birth, the problem of over 40 million ‘missing’ females. ¹⁸ Of course, rapid population ageing, like abnormal sex ratio, is not caused by the one-child policy alone. The main causes of population ageing in China have been the significant increase in life expectancy, as in other parts of the world. Nevertheless, the one-child policy has significantly accelerated the advent of an ageing society, radically altered the structure of the population and made eldercare a more difficult task. ¹⁷

The most alarming issue for eldercare in China is the rising elderly suicides. Suicide has long been a major issue of public health globally and constitutes the fifth leading cause of death in China. Studies shows that while in general suicide rates have been declining in China over the past two decades, self-inflicted deaths among the older people have been increasing rapidly. Among numerous studies, one nationwide investigation for the decade 2002–2011 found that suicide rates increased along with age and peaked in the oldest group; victims aged 65 and over accounted for 44% of all suicides. These figures also indicate elderly suicides in rural areas are highest, ¹⁹ which has much to do with the systematic and structural inequality and injustice in China. ¹⁷

There are complicated economic, social and existential causes involved in elderly suicides in China. ^17,19 A major demographic factor for rural eldercare is the massive outflow of young people from the countryside to urban areas. More than 200 million young rural migrants are now working and living in the cities. A significant proportion of young women from countryside work as baomu (housemaids) whose duties include caring for the older people and young children of urban families. This has significantly eased the difficulties of eldercare in the cities, but has greatly worsened the problem in rural areas. ¹⁷

These suicide figures from China are in marked contrast with suicide patterns in other parts of the world, which reach a peak around either youth or middle age, depending on the income level of the countries. It should be noted that elderly suicides have been increasing worldwide. For instance, elderly suicide has been rocketing up in South Korea.

The issue of elderly suicide is a matter that basic rights and dignity has been violated, a matter that the Confucian social and political norm of renzheng (benevolent policy) is far from realized. ^15,17 Also, it is a matter that the Confucian ideal of old age as a summit of a lifelong moral pilgrimage has been failed, failed gravely.

Further transcultural comparisons: Proust and Rembrandt

Earlier in this article, I mentioned a series of negative and depressing images of ageing from the West, some art works particularly, to demonstrate the popularity of the view on the old age as an inevitable decline. But it is not my point that Confucian idea of old age as the summit of life is thus alien to the West, a comparative view that can be generated in the habit of thought of dichotomizing cultural difference. The Confucian vision presented above has Western counterparts just as the negative view has been part of Chinese culture.

Many positive works on ageing exist in literature and arts in the West. In the final volume of his penetrating novel, In Search of Lost Time (formerly translated as Remembrance of Things Past), French writer Marcel Proust described in terrifying details on the effects of old age, or Time, upon humans. For him, old age is ‘after all the most miserable of human condition’ (p. 591). ²⁰ He did call old age ‘the summit’, but a ‘giddy’ one or a ‘living stilt’. Yet, in one of his little-known essays, Proust imaged that John Ruskin, a 19th-century British critic of arts and architecture and whom Proust greatly admires, visited an exhibition of the paintings of 17th-century Dutch artist Rembrandt when Ruskin was very old and sick. ²¹ Old and dying Ruskin was deeply touched and spiritually uplifted by Rembrandts’ paintings. While the visit was fictional, Proust’s intended message is certainly true. This is, Rembrandt’s portraits reveal the dignity of ageing.

Indeed, the powerful portraits by Rembrandt offer a vision of the dignity of the old age – actually, the dignity of human existence in general. A significant portion of his painting feature old people, contemporaneous and historical figures. The works like ‘Aristotle with a bust of Homer’ and ‘The Apostle Paul in Prison’ portray the contemplative virtue and the spiritual pursuit that are often associated especially with old age. The paintings like ‘Old woman reading’ (more than one) and ‘Two old man disputing’ indicate the extraordinary concentration and intensive intellectual engagement that old people are still able to have and enjoy. One of Rembrandt most well-known creations, ‘The return of the prodigal son’, depicts powerfully that old people serve as a source of love for the young – or, to be more accurate, as a channel for the greatest love to be found in and beyond this world. Like other ages, the old age has hardship and sadness as ‘The portrait of an old woman’ has captured. But each and every face and gesture of old people in the world of Rembrandt’s art demonstrate human dignity, despite ageing.

There are similar art works in China. For example, the once-controversial contemporary Chinese painting, ‘My father (1978)’ by Luo Zhongli, conveys the same spirit of the dignity of ageing, despite social deprivation, economic poverty, physical frailty and physiological degeneration.

One may ask: What is the point of bringing in Rembrandt’s paintings in a paper on Confucianism? The point is that Rembrandt’s dignified portraits of elderly people vividly illustrate what the insightful Confucian metaphor of old age as the summit of a moral pilgrimage means and aims for. Moreover, just as people not living in the 17th-century Netherlands can appreciate Rembrandt’s paintings, so one has not to be a Chinese to appreciate thoughts and insights of Confucianism. Against the popular characterization of old age as an inevitable decline, Confucianism endorses and promotes a far more affirmative attitudes towards ageing and eldercare underlying many great works by artists, both Chinese and non-Chinese.

Conclusion

Negative attitudes towards old age such as viewing it as an inevitable and even doomed decline are everywhere and long rooted. But, alternative ethical visions are necessary and possible. Centred on the concept of old age as the summit of a lifelong moral pilgrimage, this article presents a Confucian ethical vision of healthy ageing and social elderly care, one that is insightful, inspirational and far more positive. I hope and believe that Confucian ethics, especially moral and social thoughts of classical Confucianism, can not only help identify contemporary failings in the area of eldercare but also generate new ideas, wisdom and frameworks that will enable China and the world as well to face ageing and eldercare in a more positive way.