Sunday, January 4, 2009

Euthanasia IV

If we accept that the intentions of a terminal patient in great pain who wants to deliberately shorten their life would not be much different from a patient in a similar position who does not think of or is not in a position to kill themselves (and this is what I posited as a possibility yesterday), what about the care-giver who decides to end the life of such a patient? What would their intentions and thus their vipaka, be? Now the kin of a terminal patient could have plainly negative reasons in wanting such a patient euthanatized – to limit the hospital bills, to end their own grief and distress or perhaps just ‘to get it over and done with.’ But let's say the care-giver has had a long, close and loving relationship with the patient and they have bee been asked by their loved one to end their life. I honestly cannot see how they would have anything but compassion and fellow-feelings for their loved one in agreeing to and carrying out their request. Surely, in acquiescing to their loved one's request they would be doing what the Buddha said we should try to do, putting themselves in the place of the other (attanam upamam katva, Dhp.129), feeling for them, feeling with them, and acting out of compassion. I cannot see in what way this would be, as Archishop Chia called it, ‘false compassion’ other than that it contradicted some dogma. In the past, before the rise of our litigatious society, this is exactly what doctors did. Their years of experience told them when the kindest thing to do was to withhold treatment or even administer a lethal does of medicine. It was not taught, it was never talked about, but it was widely done and it no doubt prevented untold pointless suffering. A doctor's reason for not doing this now is the fear of being sued, hardly a positive or noble reason in allowing a patient to end their days in unendurable pain.
Just to sum up the main points I made or tried to make -
From the perspective of Buddhism, what gives any behavior its ethical quality is primarily the intention (cetana) behind it and also the effect it will have on oneself and the other.
Under most circumstances, killing is morally wrong because it requires strongly negative intentions on the part of the killer and it goes so much against the victim most cherished desires, thus causing great terror, distress, etc. and such suffering is intrinsically evil.
Killing oneself in order to save the lives of others could be motivated by compassion and thus not have negative vipaka.
If killing oneself could be done out of positive intentions it is conceivable that killing another (at their request and to save them from great pain) could be done with the same or similar intentions.
This last point is reinforced by the universalizability principle – applying to others one’s own wishes. I would not like to spend my last days suffering great pain so I will (when requested to do so) relieve the pain of someone in that position.

The theistic faiths’ objection to any type of euthanasia is based on the myth of a life-giving, life-taking deity. Speaking with Buddhists on this issue, it seems that their objections to it (when they do object to it and by no means all do) are derived from the idea that killing is wrong because it is wrong in itself, it is intrinsically wrong. But my understanding is that this is not what the Buddha taught. For example to unintentionally and unknowingly kill something has no kammic consequences (vipaka) because it is not intentional. It is intention that makes an act moral or immoral. It is this point that needs to be kept in mind when thinking about euthanasia. I am undecided on the pros and cons of euthanasia but I do think the issue is much more complex and nuanced that the usual ‘it’s wrong’ stance. What do you think?


Konchog said...

Bhante-la, I'm afraid my teachers disagree with you, if the person ending the life, no matter how well-intentioned, is not enlightened to the point where they can completely perceive the karmic patterns of others. If not, ending the life may not be as compassionate as it seems on the surface. Why? Because you do not know if that being (could be person or animal) has exhausted the dominant karmas to be in that form with that condition. It may be that you are condemning them to another round of suffering of birth, so that they will then exhaust the karma in another, shorter life. We run into this dilemma a lot with our pets. It sounds very nice to "put them to sleep," but karmically it might just be kindest to afford them every comfort, do prayers, etc., but let the karma exhaust itself to the very end.

Anonymous said...

Interesting point. In my native country (Sweden) they are having the debate about whether to allow euthanasia or not. There are a few EU countries where it's allowed.
Disregarding the standard theistic faith arguments, it's still a very tricky and complicated issue. How can you make sure that an individuals intentions are compassionate or not? Most individuals are more or less unaware of their own moral intentions, or so it seems. Checking ones motivation is hard unless you have some type of mental training and are used to observing your mind. And how do you avoid the situation where a terminally ill patient is coerced into asking for euthanasia by his or hers relatives?
I agree that, from a Buddhist point of view, euthanasia might not automatically be dismissed as 'wrong'. But there will always be situations or cases where the underlying motivation is unclear and thus capable of producing a kammic taint.

Justin Choo said...


It's nice to read your last question:
"What do you think?"

I think by taking off a life supporting system, should not be term euthanasia. In the first place, it was purposely attached to the patient. So by taking it off, is not depriving the patient's life. It should not be there in the first place.

dyannne said...

I have long supported euthanasia when a physical condition has deteriorated to the extent described in your blog. A friend of mine committed suicide on Tuesday, Dec. 30. He shot himself. He told my son that his mental suffering was unbearable. He leaves behind a wife and 11 yr. old boy. To quote your statement: "But we know that there are situations where someone can choose death because circumstances have made it a worse option that remaining alive." I would not have included him in this category, but the description is accurate. I am devastated by his act and the suffering that has been caused.

Paulo said...

Bhante, I think I can call euthanasia what happened at Channovada Sutta.

If so, the Buddha has nothing against euthanasia, since the tooking of live happens in a pure way - I mean, without aversion or craving.

Shravasti Dhammika said...

Thanks for your interesting comments and observations. I will reply to some of them tomorrow.

Ken and Visakha said...

Won't the mind be full of feelings of aversion for the pain, the suffering, and the delusion that it is "substantial" and "permanent"?