愛如何存活：成年子女喪親者的倫理絆轉化

How Shall Love Survive: Ethical Bonds Transformation in Bereaved Adult Children

研究背景：家庭的倫理絆轉化（ethical bonds transformation）是臺灣本土喪親悲傷的重要現象，倫理絆轉化為喪親家庭面對逝者離世／缺席所產生的動力變化。本研究於病人逝世後半年至一年內，透過1至2次的回溯性深度訪談，嘗試勾勒照顧者的關係處境。研究方法：以詮釋現象學心理學取徑，擱置現有理論，經研究者們共同討論後，將七位成年子女喪親照顧者的逐字稿內容拆分為意義單元，形成照顧－喪親歷程轉化的置身結構。研究結果：分析結果顯示，倫理絆轉化的普遍結構為：（1）宿緣關係的顯露；（2）宿緣關係的消融；（3）死活相依（living mournfully）：絆的轉化與愛的延續；（4）待解之倫理絆（unresolved ethical bond）：漫長的關係理解之途。結論：結果發現，倫理絆轉化涉及子女內心家屋意象的破碎與轉變，當死亡剝去陳年宿緣，子女產生倫理位移，重新理解家庭關係與意義築建，將是倫理絆關係轉化的關鍵。本研究以倫理絆修正持續性連結概念，嘗試更貼近本土喪親悲傷處境，期望應用於末期疾病照護至後續家屬悲傷追蹤的心理陪伴歷程。

This study adopted a hermeneutic phenomenological psychology approach, exploring the transformation of ethical bonds in adult children caregivers who have experienced the death of a parent. While Western grief theories have evolved from stage models to continuing bonds theory, indigenous Taiwanese perspectives on grief have centered on relational transformation from the beginning. Under this context, ethical bonds transformation (EBT,倫理絆轉化) was proposed to describe the dynamic changes that occur in familial relationships when confronting the death or absence of a loved one. In the present study, EBT describes how adult children move away from their established interpersonal positions in living relationships and, through the experience of caregiving and subsequent bereavement, come to understand their parents and themselves in a more fundamental person-to-person caring relationship. The concept of EBT offers a culturally sensitive framework for understanding how bereaved adult children work through their grief within Taiwanese family contexts.
Seven adult children (three males, four females, aged 23-58) who had been primary caregivers for their terminally ill parents were interviewed 6-12 months after the parent’s death. Using a hermeneutic phenomenological psychological approach, the researchers analyzed interview transcripts through immersive reading, meaning unit analysis, thematic construction, and derivation of a situated structure. The analysis revealed a universal structure of ethical bond transformation comprising four elements:
The first element,“revelation of Situated-Yuan relationships,”occurs when terminal illness forces long-entangled family relationships to emerge from the background into focus. Family members can no longer avoid confronting painful histories, unresolved conflicts, and complex dynamics. This revelation can be distressing but also creates opportunities for authentic connection, as caregiving strips away social masks and allows direct encounters between parent and child. Several participants described profound moments of connection with their parents during terminal care, experiencing a primordial relationship and intimacy beyond pre-existing social roles.
The second element,“dissolution of Situated-Yuan relationships,”happens when terminal illness disrupts familiar relationship patterns. Delirium, cognitive decline, and the parent’s physical transformation can make pre-existing relationships unrecognizable, leading to distress for adult caregivers, which Western literature describes as“ambiguous loss.”However, this study found that relationship dissolution can sometimes facilitate healing. For instance, one participant described how her mother’s delirium—which caused her to confuse her daughter with a kind stranger who provides dedicated care—temporarily suspended their conflictual mother-daughter dynamic, creating space for genuine care and appreciation.
The third element,“living mournfully: the transformation of bonds and continuation of love,”describes how deceased parents continue to“live with”their family through the“absence-in-presence.”Adult children experience their deceased parent’s continued influence through family resemblances, personality traits, or newfound understanding of their parent’s life circumstances. Some participants stepped into family roles previously held by the deceased parent, maintaining family continuity. Others described receiving“emotional assets”that sustained them, such as one participant who began prioritizing his health to fulfill his mother's wishes for him.
The fourth element,“unresolved ethical bonds: the prolonged journey of relationship understanding,”reflects how adult children continue to process ambivalent feelings and unresolved aspects of the caregiving relationship after the parent’s death. This processing manifests through dreams, emotional responses to the parent’s belongings, or difficulty facing memorial tablets. One participant described being unable to face her mother’s memorial tablet, experiencing complex emotions of abandonment, anger, and unresolved conflict while simultaneously processing genuine grief.
This research contributes to grief literature by proposing EBT as an alternative to Western continuing bonds theory. Rather than categorizing bonds as adaptive or maladaptive based on internalization, the ethical bonds framework acknowledges the dialectical nature of grief—how bereaved individuals oscillate between the deceased’s presence and absence, gradually learning to live with this ambiguity. The framework emphasizes family relationships rather than dyadic survivor-deceased connections, reflecting Taiwan’s cultural context better.
For clinical practice, this study highlights the importance of supporting caregivers in processing relationship transformations during end-of-life care, not just after death. Understanding how terminal illness reveals and dissolves long-established family dynamics can help professionals better support families through both caregiving and bereavement. The findings suggest that grief interventions should address both care-related experiences and relationship understanding, recognizing grief as an ongoing process of making meaning within family contexts rather than a series of tasks to be completed.