Euthanasia I

Recently there has been widespread discussion in Singapore about the pros and cons of euthanasia. The government originally broached the subject, probably in response to rising health costs, and various medical and religious bodies have given their opinions on the matter. On Nov. 4th the Straits Times reported that Christian, Muslim and Buddhist religious authorities were opposed to any form of euthanasia and that Hindus were (on going to press) unable to give an opinion one way or the other. I suspect this means that they were simply unable to find anyone who could speak authoritatively on the matter, a sad reflection on the state of Hinduism in Singapore. Venerable Kwang Phing of the Singapore Buddhist Federation was asked for the Buddhist position and said that Buddhism would consider euthanasia to be unacceptable. I do not know exactly what Ven. Kwang Phing said but I would like to give some of my own thoughts on the issue.
I will use the word euthanasia here to mean intentionally killing a terminally ill patient by performing or withholding medical procedures. Euthanasia can be either active, e.g. administering a lethal injection, or passive, e.g. no longer feeding an unconscious patient. It can also be either voluntary, e.g. requested by the patient, or non-voluntary, e.g. where the patient is unconscious and a legally competent person makes the decision. Thus there are four types of euthanasia – active voluntary (AVE), passive voluntary (PVE), active non-voluntary (ANE) and passive non-voluntary (PNE). There is also what is now called voluntary suicide (VS), where the care-giver provides the patient with the means of killing himself or herself but has no involvement beyond that.
There are three main arguments in favour of euthanasia -
The Compassion Argument. If someone is in extreme pain and going to die soon anyway, or if they are brain dead, it is compassionate to both them and their family to end their life.
The Choice Argument. Our life is our own and no one has the right to tell us what to do with it if we are not interfering with the welfare of others. If I choose to end my life I should have the right to do so.
The Economic Argument. The cost of keeping terminally ill patients or brain dead patients alive for as long as possible is driving up the health care costs for those who are only curably ill.
To my mind the first of these arguments is the strongest and the last one the weakest.

There are five main arguments against euthanasia -
The Moral Argument. Killing for any reasons is wrong. It is just another type of murder.
The Unprofessional Argument. The whole rationale of the medical profession for centuries has been and is to enhance and preserve life. In asking or allowing doctors or nurses to kill patients we are compromising the most fundamental ideal of the medical profession.
The 'How Can We Know?' Argument. We cannot know for sure that a terminal patient is going to die as quickly as the doctors predict. Doctors are sometimes wrong. We cannot know for sure that a brain dead or long-term unconscious patient is going to remain in that state. They sometimes suddenly wake up. When a terminal patient asked to have their life ended we cannot know for sure that they are making a truly free choice. Perhaps they feel guilty that their medical expenses are becoming a burden for their family.
The Slippery Slope Argument. If we allow euthanasia, where will it stop? Then there might be calls to kill the elderly or physically and mentally disabled people.
The Mythological Argument. Life was created by God and is therefore sacred and no one has the right to take it except God.
I have arranges these arguments from most to least valid. The last two are equally unconvincing in my mind.
Is there anything in the Buddha's Dhamma that could help come to some conclusion on the admittedly very complex issue of euthanasia? The usual Buddhist argument used in the euthanasia debate is that it is always negative to take a life - full stop. One text that is often used in such discussions is this one from the Vinaya which seems to directly address the question of euthanasia. 'Should any monk (or nun) intentionally deprive a human being of life, or search for a killer for them, or praise the advantages of death, or incite them to die saying, "What use is this wretched and miserable life to you? Death would be better for you than life", or with a similar idea, a similar purpose in mind, should in various ways praise the advantages of death or incite them to die, he also is excommunicated and no longer within the monastic community' (Vin.III,71-2). However, seen within its context, I feel that this text does not really contribute much to the euthanasia debate. Firstly, the origin story of this rule tells us that some monks encouraged a sick man to kill himself so that they could get up to mischief with his wife (Good God! That’s what some of the recruits to the Sangha were like then). Secondly, there is no suggestion that the man was terminally ill, that he had expressed the desire to end his life and the monks intentions in getting him to do so were clearly negative and without concern for the sick man. Thirdly, there are several passages in the Vinaya that stipulate clearly what a monastic's role is and making it clear that monks and nuns should stick to that role and not stray into other roles. So the question of counseling a patient on the pros and cons of euthanasia or any medical questions is not a monastic's job and he or she should have nothing to do with it. But what about doctors, care-givers, terminally ill patients and their loved ones who are not monks or nuns? I will continue this discussion tomorrow.

New Year Reading

If you need a bit of feel-good reading right now (and who doesn't?) please have a look at http://www.huffingtonpost.com/arthur-rosenfeld/pay-it-backwards-an-act-o_b_151793.html which is really well worth reading and thinking about. And did you know that two Buddhists have just been elected to Congress in the US? Read about this and the controversy surrounding it at http://stevensonblog.tuscaloosanews.com/default.asp?item=397872

A Thought For the New Year

Final Farewell

A funeral (matakicca) is a ceremony related to disposing of the body of someone who has died. Funerals for ordinary people at the time of the Buddha were fairly simple. Four men would carry the body to the charnel ground (susana) followed by a procession of relatives and friends who would be carrying torches and weeping and wailing (Ja.VI,464; Sn.580). The usual way of disposing of the body was by cremation or exposure to the elements. If the first of these was done the body was placed of the pyre (citaka), flowers, incense and garlands were placed on the body, the participants circumambulated the pyre three times and then it was ignited. On the 12th or sometimes the 13th day after the death the saddha ceremony was held where food, clothing and other gifts were given to brahmans in the name of the deceased (D.I,97). If you go to Gaya even today you can see pilgrims doing the saddha puja for their parents, probably not much different from how it was done at the Buddha's tome.
The Buddha’s funeral was arranged by the Mallas, the people of Kusinara, and was conducted very similar to they way royal funerals are described in the Ramayana and other later literature. The Mallas erected tents and awnings and spent several days honoring the Buddha’s body with incense and garlands and to the accompaniment of music and dancing. After six days of this, they washed their heads, dressed in new clothes and then put the body in an iron coffin, smeared it in oil and wrapped it in several layers of fine cloth (D.III,161-4). Then body was taken through the town, out through the gate and then cremated. The ashes or eminent people were usually then interned under an earthen mound (thupa) often situated at a crossroads (catumahapatha). In the case of the Buddha, his ashes were divided into eight, each portion being placed in such a mound.
Today, different Buddhist cultures conduct their funerals in different ways – from simple and dignified as in Sri Lanka or elaborate and colorful as in Thailand. In China, Vietnam and Tibet, the bodies of esteemed monks are sometimes mummified and in Tibet the bodies of ordinary people are sometimes dismembered and fed to vultures.

Hot Bods

When I first heard this term recently I misheard it as 'hot rods'. Then I noticed it in the newspaper in the sentence 'the beach was crowded with hot bods' and thought it was referring to sunbathers, you know, as in 'odd bods.' Finally someone filled me in. It's a term for sensuous, desirable or if you like, sexually stimulating, human bodies. In Rubin's time that meant being pale and slightly flabby, for the Edwardians it meant having high breasts, a wasp-waist and huge buttocks. Today it means being muscular, tanned and having as few clothes as possible without getting into trouble with the law. That's okay. It fits well with our overly-sexually stimulated pleasure-dominated, body-oriented society. Related to this, just the other day I found this comment on a local Buddhist's blog which I thought rather useful - 'A hot bod is definitely nice, but a cool head and a warm heart is far more important. However, there is no reason why a hot bod cannot contain a cool head and warm heart. I just must not loose sight of the fact that even a hot bod is nothing more than a "stinking skin bag" to contain the heart and mind'.

Aborted Exhibition

Almost exactly a year later and the dust has still not settled and the ill-feeling and disappointment have still not faded. On the 25th December 2007, after four years of negations, signed protocols and agreements, the government of Bangladesh suddenly canceled its collaboration with the Paris' Musée Guimet to hold an exhibition of art from Bangladesh. It was discovered that somewhere between the National Museum and the Dhaka Zia International Airport, two 1500 year old statutes of Vishnu which were about to be transported to Paris had disappeared. The government demanded the immediate return of the 143 other pieces which had already been sent to Paris on 1st December. At a loss of thousands of dollars to itself, the Musée Guimet had to cancel the exhibition which was to be called 'Masterpieces from the Ganges Delta, Collections of Bangladesh Museums' and which was to have opened on the 9th January this year. After the statues disappeared the airport was surrounded by police and 15 people were arrested. Some months later the stolen statures were found in a Dhaka rubbish dump. Being too hot to handle, the robbers had smashed them up to hide their identity before disposing them. The proposed exhibition had already led to demonstrations in Bangladesh where there was great fear that these national treasures once sent to France may never come back. This typical paranoia about the wicked West is interesting given that the theft and the numerous other problems that had plagued the organization of the exhibition all took place in Bangladesh and under the of auspices of Bangladeshi officials. It was also revealed that the items to be transported to Paris had not been properly identified, that some had no accession numbers and that the French list of artefacts contained fewer items than the Bangladeshi list. Anyone who has ever seen the shabby and neglected state of Bangladesh's museums and archaeological sites will not be surprised by any of this. Bangladesh is a basket case. So much so that it can't even organize a museum exhibition. And whose fault is that? Someone else's! As a result of all this the French and the wider European public have been deprived of seeing some of the most exquisite and little-known examples of South Asia's Buddhist heritage. Other museums will be wary of ever dealing with Bangladesh's Dept of Culture and so such an exhibition is unlikely to ever to take place outside the country. What was them Gauda or Bangala, then Bengal and now Bangaladesh was once a great centre of Buddhist civilization. Atisa, the great reviver of the Dhamma in Tibet was a Bengali. The most we can do now is flick through the recently published catalogue of the aborted exhibition.

Picture Of The Month

I would like to share with you pictures of two Buddhist sculptures that I have always deeply admired. The first is of a pensive and meditative Maitreya from Korea. The second is of Avalokitesvara from Sri Lanka. He is depicted as a beautiful youth, strong but not vaulting, relaxed but not soft, masculine but not macho. This exquisite statue was found near Kurunagala just a few years ago together with two equally beautiful golden statues of the Buddha. From the 1st of January I will be looking at the issue of euthanasia (mercy killing) from the Buddhist perspective. This subject has been hotly debated in Singapore of late but as is often the case the Buddhist position got exactly one line in the press, whereas other faiths got much wider coverage. I am not sure there is a clear 'Buddhist' stand on euthanasia but I would like to contribute some Dhammic thoughts on the subject.