Ministering to the Sick
and the Terminally Ill
Lily
de Silva
---o0o---
"He
who attends on the sick attends on me," declared the Buddha,
exhorting his disciples on the importance of ministering to
the sick. This famous statement was made by the Blessed One
when he discovered a monk lying in his soiled robes, desperately
ill with an acute attack of dysentery. With the help of Ananda,
the Buddha washed and cleaned the sick monk in warm water. On
this occasion he reminded the monks that they have neither parents
nor relatives to look after them, so they must look after one
another. If the teacher is ill, it is the bounden duty of the
pupil to look after him, and if the pupil is ill it is the teacher's
duty to look after the sick pupil. If a teacher or a pupil is
not available it is the responsibility of the community to look
after the sick (Vin.i,301ff.).
On
another occasion the Buddha discovered a monk whose body was
covered with sores, his robe sticking to the body with pus oozing
from the sores. Unable to look after him, his fellow monks had
abandoned him. On discovering this monk, the Buddha boiled water
and washed the monk with his own hands, then cleaned and dried
his robes. When the monk felt comforted the Buddha preached
to him and he became an Arahant, soon after which he passed
away (DhpA.i,319). Thus the Buddha not only advocated the importance
of looking after the sick, he also set a noble example by himself
ministering to those who were so ill that they were even considered
repulsive by others.
The
Buddha has enumerated the qualities that should be present in
a good nurse. He should be competent to administer the medicine,
he should know what is agreeable to the patient and what is
not. He should keep away what is disagreeable and give only
what is agreeable to the patient. He should be benevolent and
kind-hearted, he should perform his duties out of a sense of
service and not just for the sake of remuneration (mettacitto
gilanam upatthati no amisantaro). He should not feel repulsion
towards saliva, phlegm, urine, stools, sores, etc. He should
be capable of exhorting and stimulating the patient with noble
ideas, with Dhamma talk (A.iii,144).
Here
it is noteworthy that the nurse is expected to be efficient
not only in taking care of the body by giving proper food and
medicine, but is also expected to nurture the patient's mental
condition. It is well known that the kindness of nurses and
doctors is almost as effective as medicine for a patient's morale
and recovery. When one is desperately ill and feels helpless,
a kind word or a gentle act becomes a source of comfort and
hope. That is why benevolence (metta) and compassion
(karuna), which are also sublime emotions (brahmavihara),
are regarded as praiseworthy qualities in a nurse. The sutta
adds another dimension to the nursing profession by including
the spiritual element in a nurse's talk. Sickness is a time
when one is face to face with the realities of life and it is
a good opportunity to instill a sense of spiritual urgency even
in the most materialistic mind. Further, the fear of death is
naturally greater when a person is ill than when well. The best
means of calming this fear is by diverting attention to the
Dhamma. A nurse is expected to give this spiritual guidance
to the patient in his or her charge as a part and parcel of
a nurse's duty.
In
the Anguttara Nikaya the Buddha describes three types of patients
(A.i,120). There are patients who do not recover whether or
not they get proper medical attention and nursing care; there
are others who recover irrespective of whether or not they get
medical attention and nursing care; there are others who recover
only with appropriate medical treatment and care. Because there
is this third type of patient, all those who are ill should
be given the best medical treatment available, agreeable food
and proper nursing care. So long as a patient is alive, everything
possible should be done for his recovery.
According
to another sutta (A.iii,56,62), illness is one of the inevitables
in life. When faced with it, all resources available to one,
even magical incantations, should be utilized with the hope
of restoring health. Here the question of whether such performances
are effective or not is not discussed. The point seems to be
that at the time of a crisis there is no harm in trying out
even methods traditionally believed to be efficacious, but in
which one does not necessarily have faith or belief. Of course,
such methods should not clash with one's conscience. If, in
spite of these efforts, death does occur, then one has to accept
it as a verdict of kamma with equanimity and philosophical maturity.
Here
we are reminded of an episode (MA.i,203) where a mother who
was critically ill needed rabbit meat as a cure. The son, finding
that rabbit meat was not available in the open market, went
in search of a rabbit. He caught one but was loathe to kill
even for the sake of his mother. He let the rabbit go and wished
his mother well. Simultaneously with this wish, the power of
the son's moral virtue brought about the mother's recovery.
The Buddhist tradition seems to hold that under certain circumstances
moral power has healing properties that may work even in cases
when orthodox medicine fails.
The
Medicines Chapter of the Vinaya Mahavagga (Vin.i,199ff.) shows
that the Buddha relaxed a number of minor disciplinary rules
to accommodate the needs of sick monks. Though a strict disciplinarian,
the Buddha has shown great sympathy and understanding to those
who are ill. The value of health has been fully realized and
it is even recognized as the greatest gain (arogyaparama
labha, Dhp.204).
The
Buddha teaches that the patient too should cooperate with the
doctor and the nurse in order to get well. Such a good patient
should take and do only what is agreeable to him. Even in taking
agreeable food he should know the proper quantity. He should
take the prescribed medicine without fuss. He should honestly
disclose his ailments to his duty-conscious nurse. He should
patiently bear physical pain even when it is acute and excruciating
(A.iii,144).
The
suttas show that the Buddha exercised great will power and composure
on occasions when he fell ill. He experienced excruciating pain
when a stone splinter pierced his foot after Devadatta hurled
a boulder at him. He endured such pain with mindfulness and
self-composure and was not overpowered by the pain (S.i,27,
210). During his last illness, too, the Buddha mindfully bore
up great physical pain and with admirable courage he walked
from Pava to Kusinara with his devoted attendant Ananda, resting
in a number of places to soothe his tired body (D.ii,128,134).
The Mahaparinibbana Sutta also reports that the Buddha once
willfully suppressed a grave illness in Beluvagama and regained
health (D.ii,99).
It
seems that those who are highly developed mentally are able
to suppress illness, at least on certain occasions. Once Nakulapita
visited the Buddha in old age, and the Master advised him to
remain mentally healthy even though the body is feeble (S.iii,1).
There is physical and mental pain (dve vedana kayika ca cetasika
ca). If, when one has physical pain, one becomes worried
and adds mental pain too, that is like being shot with two arrows
(S.iv,208). One who is spiritually evolved is capable of keeping
the mind healthy proportionate to his spiritual development.
As an Arahant is fully developed spiritually, he is capable
of experiencing physical pain only, without mental pain (so
ekam vedanam vediyati kayikam na cetasikam, S.iv,209).
A
number of suttas advocate the recitation of the enlightenment
factors (bojjhanga) for the purpose of healing physical
ailments. On two occasions, when the Elders Mahakassapa and
Mahamoggallana were ill, the Buddha recited the enlightenment
factors and it is reported that the monks regained normal health
(S.v,79-80). It is perhaps significant to note that all the
monks concerned were Arahants, and had therefore fully developed
the enlightenment factors. The Bojjhanga Samyutta also reports
that once when the Buddha was ill, he requested Cunda to recite
the enlightenment factors (S.v,81). The Buddha was pleased at
the recitation and it is said that he regained health. On another
occasion, when the monk Girimananda was very ill (A.v,109),
the Buddha informed Ananda that if a discourse on ten perceptions
(dasa sañña) is delivered to him, he might get well.
The ten perceptions are the perception of impermanence, egolessness,
impurity of the body, evil consequences (of bodily existence),
elimination (of sense pleasures), detachment, cessation, disenchantment
with the entire world, impermanence of all component things,
and mindfulness of breathing. Ananda learnt the discourse from
the Buddha and repeated it for Girimananda and it is reported
that he recovered.
Once
the Buddha heard that a newly ordained monk who was not very
well known among his fellow monks was very ill (S.iv,46). The
Buddha visited him. When he saw the Buddha approaching him he
stirred in his bed and tried to get up, but the Buddha cautioned
him not to rise. Having taken a seat, the Buddha inquired after
his health, whether the pains are decreasing and not increasing.
The monk replied that he is feeling very ill and weak, that
his pains are increasing and not decreasing. The Buddha then
inquired whether he had any misgiving or remorse. The monk replied
that he had plenty of misgiving and remorse. The Buddha then
asked whether he reproached himself for breach of virtue. He
said no. Then the Buddha asked why he felt remorseful if he
was not guilty of any breach of virtue. The monk replied that
the Buddha does not preach the doctrine for purity of virtue,
but for detachment from lust (ragaviragatthaya). Greatly
pleased, the Buddha exclaimed Sadhu Sadhu in approbation.
The
Buddha then went on to preach the doctrine to the monk. He explained
that the sense faculties are impermanent, unsatisfactory and
egoless, therefore they should not be considered as "I"
and "mine." Understanding their true nature the noble
disciple becomes disenchanted with the sense faculties. When
this explanation of the Dhamma was being given the vision of
truth (dhammacakkhu) dawned on the monk; he realized
that whatever has the nature of arising necessarily has the
nature of cessation. In other words he became a sotapanna,
a stream-enterer.
According
to the Sotapattisamyutta Anathapindika was once very
ill, and at his request the Venerable Sariputta visited him
(S.v,380). On being told that the pains are excruciating and
increasing Sariputta delivered a discourse reminding Anathapindika
of his own virtues. Sariputta explained that the uninstructed
worldling who has no faith in the Buddha, Dhamma and Sangha
and who has not cultivated virtuous moral habits goes to a state
of woe on the destruction of the body. But Anathapindika has
unshakable conviction in the Buddha, Dhamma and Sangha, and
has cultivated noble moral habits. Sariputta told him that when
these noble qualities are mindfully appreciated the pains would
subside.
Further,
Sariputta pointed out that uninstructed worldlings reach a state
of woe on the disintegration of the body as they have not cultivated
the Noble Eightfold Path. But on the contrary Anathapindika
has cultivated the Noble Eightfold Path. When attention is paid
to them and the noble qualities are appreciated the pains would
subside. It is reported that the pains subsided and Anathapindika
recovered from that illness. So much so, that Anathapindika
got out of bed and served the Venerable Sariputta with the meal
that was prepared for himself.
The
Sotapattisamyutta records an account of another occasion
when Anathapindika was ill (S.v,385). The Venerable Ananda was
summoned to the bedside and he delivered a discourse. Ananda
explained that uninstructed ordinary people who have no faith
in the Buddha, Dhamma and Sangha and who are given to immoral
habits are seized with trepidation and fear at the approach
of death. But the noble disciple who has deep conviction in
the Buddha, Dhamma and Sangha and who has cultivated moral habits
does not experience trepidation and fear of death. Anathapindika
then confessed unshakable conviction in the Buddha, Dhamma and
Sangha, and declared that he is endowed with the spotless virtue
of a householder. Ananda exclaimed that it is indeed a great
gain that Anathapindika has disclosed the attainment of the
fruit of stream-entry. It is, however, not reported whether
Anathapindika recovered straight away.
The
Buddha recommends that a monk should not relax his energy and
determination for spiritual progress even when he is ill (A.iv,335).
It is possible that the illness might deteriorate, and before
that happens care should be taken to advance spiritually as
much as possible. After recovering from an illness, too, one
should not be negligent, because, should there be a relapse,
the chances of gaining higher spiritual attainments diminish.
The
Buddhist method of ministering to the sick, as is evident from
the canonical texts cited above, attaches great importance not
only to proper medical and nursing care, but also to directing
the mind of the patient to wholesome thoughts. There seems to
be a belief that attention paid to doctrinal topics, especially
the recitation of virtues which one has already cultivated,
is endowed with healing properties. In the case of the Buddha
and Arahants the recitation of the bojjhangas has restored
normal health. In the case of the monk Girimananda, who was
probably not an Arahant at the time of his illness, it was a
discourse on the ten perceptions that restored his good health.
Anathapindika was a sotapanna and a discussion on the
special qualities of a sotapanna was instrumental for
his speedy recovery. It may be that when one is reminded of
the spiritual qualities one has already acquired, great joy
arises in the mind. Such joy is perhaps capable even of altering
one's bodily chemistry in a positive and healthy manner.
Here
we are reminded of a relevant episode contained in the Papañcasudani
(MA.i,78). A monk while listening to the Dhamma was bitten by
a snake. He ignored the snake bite and continued to listen.
The venom spread and the pain became acute. He then reflected
on the unblemished purity of his virtuous conduct (sila)
from the time of his higher ordination. Great joy and satisfaction
arose within him when he realized the spotless nature of his
character. This healthy psychological change acted as anti-venom
and he was immediately cured. These episodes seem to reveal
that when attention is drawn to one's own spiritual qualities
at times of serious illness, and pious joy wells up in the mind
thereby, health-promoting factors become activated in the body,
perhaps by way of the secretion of health-restoring hormones.
That may be the mechanism by which spiritually advanced individuals
regain health when appropriate suttas are recited.
There
is much material in the Pali Canon on counseling the terminally
ill. Speaking about death to a terminally ill patient is not
avoided as an unpleasant topic. On the contrary, the reality
of death and perhaps its imminence are accepted without any
pretense and the patient is made to face the prospect of death
with confidence and tranquillity.
The
advice given by Nakulamata to Nakulapita is extremely valuable
in this connection (A.iii,295-98). Once Nakulapita was seriously
ill and his wife Nakulamata noticed that he was anxious and
worried. She advised him thus: "Please, sir, do not face
death with anxiety. Painful is death for one who is anxious.
The Buddha has looked down upon death with anxiety. It may be
you are anxious that I will not be able to support the family
after your death. Please do not think so. I am capable of spinning
and weaving, and I will be able to bring up the children even
if you are no more. Perhaps you are worried that I will remarry
after your death. Please do not think so. We both led pure wholesome
lives according to the noble conduct of householders. So do
not entertain any anxiety on that account. It may be you are
worried that I will neglect attending on the Buddha and the
Sangha. Please do not think so. I will be more devoted to the
Buddha and the Sangha after your death. Perhaps you are worried
that I will neglect keeping to the precepts. Please do not have
any doubts on that account. I am one of those who fully practice
the moral habits declared for the laity, and if you wish please
ask the Buddha about this matter. Perhaps you fear that I have
not gained inner mental composure. Please do not think so. I
am one of those who have gained inner mental composure as much
as a householder could gain. If you have any doubts about this,
the Buddha is at Bhesakalavana, ask him. Perhaps it occurs to
you that I have not attained proficiency in the Buddha's dispensation,
that I have not gone beyond doubt and perplexity without depending
on another. If you wish to have these matters clarified ask
the Buddha. But please do not face death with anxiety, for it
is painful and censured by the Buddha." It is reported
that after Nakulapita was thus admonished by Nakulamata, he
regained his health, and gone was that illness never to recur.
Later on this whole incident was narrated to the Buddha, who
commended Nakulamata for her sagacious advice.
The
Sotapattisamyutta contains a valuable discourse on the
question of counseling the terminally ill (S.v,408). Once Mahanama
the Sakyan inquired from the Buddha how a wise layman should
advise another wise layman who is terminally ill. Here it should
be noted that both the counselor and the patient are wise lay
Buddhists. The Buddha delivered a whole discourse on how this
should be done. First, a wise layman should comfort a wise layman
who is terminally ill with the four assurances: "Be comforted
friend, you have unshakable confidence in the Buddha, Dhamma
and Sangha, that the Buddha is fully enlightened, the Dhamma
is well proclaimed, and the Sangha is well disciplined. You
also have cultivated unblemished virtuous conduct which is conducive
to concentration." Having thus comforted the patient with
the four assurances, he should ask him whether he has any longing
for his parents. If he says yes, it should be pointed out that
death will certainly come whether he has longing for his parents
or not. Therefore it is better to give up the longing. Then,
if he says he gives up his longing for his parents, he should
be asked whether he has longing for his wife and children. With
the same reasoning he should be persuaded to give up that longing
too. Then he should be asked if he has any longing for the pleasures
of the senses. If he says yes, he should be convinced that divine
pleasures are superior to human pleasures, and should be encouraged
to aspire for divine pleasures. Then he should be gradually
led up the scale of divine pleasures and when he comes to the
highest heaven of the sense sphere, his attention should be
diverted to the Brahma-world. If he says he has resolved on
the attainment of the Brahma-world, he should be admonished
that even the Brahma-world is characterized by impermanence
and the rebirth personality. Therefore it is better to aspire
for the cessation of the rebirth personality. If he can establish
his mind on the cessation of the rebirth personality, then,
the Buddha says, there is no difference between him and the
monk who is liberated.
This,
no doubt, is the highest form of counseling that can be given
to a highly advanced person who is terminally ill by an equally
spiritually advanced person. It is very clear from the discourse
that the patient must be one who is as advanced as a stream-enterer,
as the four assurances or the consoling factors mentioned at
the very beginning of the discourse are identical with the qualities
of a stream-enterer.
The
Cittasamyutta contains an interesting episode of the
death of a spiritually advanced learned lay disciple (S.iv,302).
Citta the householder was a non-returner (anagamin, A.iii,451).
When he fell critically ill, a group of sylvan deities invited
Citta to set his mind on becoming a universal monarch (cakkavattiraja)
because the aspirations of the virtuous come to pass. He refused,
saying that that too is impermanent. Though lying on his deathbed
he admonished his relatives, who had assembled round him, on
the importance of cultivating faith in the Buddha, Dhamma and
Sangha, and on the importance of charity, then he passed away.
According
to the Sotapattisamyutta the Buddha once visited the
bedside of Dighavu the lay disciple who was terminally ill (S.v,344).
The Master advised him to fix his attention on unwavering confidence
in the noble qualities of the Triple Gem and to will that he
be endowed with spotless virtuous conduct. Dighavu replied that
these qualities of a stream-enterer are already found in him.
Then the Buddha advised him to be established in those virtues
and develop the six qualities conducive to understanding, namely,
the perception of the impermanence of all component things,
the unsatisfactoriness of all that is impermanent, the egolessness
of what is unsatisfactory, the perception of elimination, detachment
and cessation. Dighavu replied that these qualities too are
found in him, but he is concerned that his father will be sad
when he dies. Then Jotipala, his father, advised him not to
be worried on that account, but to pay heed to what the Buddha
says. The Buddha, having admonished him, left and Dighavu died
soon after. Later the Buddha declared that Dighavu passed away
as a non-returner.
The
brahmin Dhananjani was an unscrupulous tax collector who exploited
both the king and the public (M.ii,184-96). The Venerable Sariputta
met him once and exhorted him on the evil consequences of an
unrighteous life. Shortly thereafter Dhananjani was seriously
ill and Sariputta was summoned to his bedside. On being inquired
about his health, Dhananjani informed Sariputta that he has
an unbearable headache. Sariputta then engaged him in a conversation
gradually drawing his attention from lower to higher realms
of existence as far as the Brahma-world. Having thus diverted
the attention of the near-death patient to the Brahma-world,
Sariputta went on to explain the path leading to the attainment
of the Brahma-world, namely, the full development of the brahmaviharas
-- loving kindness, compassion, altruistic joy and equanimity
-- to suffuse all quarters. At the end of the discourse Dhananjani
requested Sariputta to convey his respects to the Buddha. Sariputta
departed and shortly afterwards Dhananjani died. It is reported
that he was reborn in the Brahma-world. Later when the matter
was related to the Buddha, he found fault with Sariputta for
not having led Dhananjani further on the spiritual path.
This
sutta shows that a man who had been unscrupulous in his dealings
could also be guided to a happier rebirth by counseling during
the crucial period just prior to death. It is highly doubtful
whether any and every evil doer could be thus guided towards
rebirth in a happy realm. Perhaps Dhananjani's good qualities
outweighed his evil deeds (Dhp.173) and that may be the reason
why it was possible to lead him to rebirth in a happy state
by counsel offered by a noble Arahant at the hour of death.
That
this may have been so can be inferred from the facts reported
in the sutta (M.ii,185). Sariputta made it a point to inquire
about Dhananjani's spiritual zeal, soon after inquiring about
the Buddha's health, from a monk coming from Rajagaha, when
he himself was touring in the far away Dakkhinapatha. It is
very likely that Dhananjani was a faithful patron of the Sangha
when his first wife, a lady full of faith, was alive. His second
wife was a faithless woman. When Sariputta heard that Dhananjani
was negligent he was dismayed, and made up his mind to talk
to Dhananjani should the occasion arise to meet him.
Another
important noteworthy feature in this discourse is that the Venerable
Sariputta starts the discourse from the lowest state of existence,
and works upwards as far as the Brahma-world. Perhaps he started
from the hells because Dhananjani had deteriorated to that level.
Sariputta may have helped to remind him of his former good deeds,
and also may have drawn his attention to a relevant Dhamma discourse
Sariputta had delivered to him, perhaps only a few days prior
to his illness. Thus by drawing on the spiritual potential that
was hidden in him, Sariputta may have been able to help Dhananjani
attain a happy rebirth by last minute counseling.
Here
we are reminded of the episode of young Mattakundali (DhpA.i,26).
When he was lying on his death-bed the Blessed One appeared
and Mattakundali, being greatly pleased, generated much faith
in the Buddha. Dying soon after, he was reborn in a celestial
realm.
A
sutta in the Sotapattisamyutta (S.v,386) maintains that
when an uninstructed ordinary person at the threshold of death
sees that he has no faith in the noble qualities of the Buddha,
Dhamma and Sangha, and that he has led an immoral life, great
fear of death and trepidation arise in him. But a person who
has deep unwavering faith in the noble qualities of the Triple
Gem, and who is spotlessly pure in his conduct, experiences
no such fear of death and trepidation. It seems to be the guilty
conscience that causes much anguish at the moment of death.
When there is fear and anxiety at this crucial moment rebirth
must take place in a sphere that is proportionate and commensurate
to that experience of anguish.
It
is appropriate to record here a relevant discussion Mahanama
the Sakyan had with the Buddha regarding the fate of one who
meets with a violent death (S.v,369). Mahanama tells the Buddha
that when he comes to the serene atmosphere of the monastery
and associates with pious monks of noble qualities, he feels
quite calm and self-possessed. But when he goes out into the
streets of Kapilavatthu, busy with constant traffic, he feels
frightened over the future birth that would await him should
he meet with a violent death in a traffic accident. The Buddha
assures him that a person who has cultivated moral virtues and
led a righteous life need not entertain such fears. He explains
the situation with the help of a simile. If a pot of ghee is
broken after being submerged in water, the potsherds will sink
to the riverbed, but the ghee will rise to the surface. Similarly,
the body will disintegrate, but the cultured mind will rise
up like the ghee.
It
is the same idea that is emphasized in suttas such as Sankharuppatti,
(M.iii,99) Kukkuravatika (M.i,387) and Tevijja (D.i,235). Rebirth
usually depends on the thoughts that are most often entertained
during a life-time. If one entertains thoughts and dispositions
that are suitable for an animal, for a dog or a cow as given
in the Kukkuravatika Sutta, then it is likely one will be reborn
among these animals, i.e. among beings who have similar dispositions.
If, on the other hand, one has entertained thoughts and dispositions
comparable to those among the Brahmas, by the cultivation of
sublime emotions such as universal love and compassion, one
has a good chance of being reborn among the Brahmas. Therefore
preparation for death really has to be done while living. Even
to be guided in thought to a higher rebirth when death is imminent
one needs the prior requisite of faith in the ideal of human
virtue and understanding -- for this is what is meant by having
faith in the Buddha, Dhamma and Sangha -- and the cultivation
of moral habits. If one lacks virtue, guidance of thought patterns
at the hour of death to a higher level will be difficult to
the extent that one is deficient in virtue. But however difficult
and effective the actual guidance may be, it is a Buddhist custom
to invite a monk to the bedside of a terminally ill patient
with the hope that the chanting of certain protective suttas
(paritta) will help the patient to develop faith and
elevate his thoughts to a higher plane of spirituality.
We
are reminded here that, according to the Vinaya (iii,8), some
previous Buddhas such as Vessabhu, whose dispensations did not
last long, used to instruct their disciples by looking into
their minds with telepathic powers and guiding their thought
patterns thus: "Think thus, do not think thus, pay attention
thus, do not pay attention thus, give this up, develop this,"
etc. Perhaps this may be the technique used by Gotama Buddha
and his eminent disciples to guide thought patterns of amenable
adherents at the hour of death. They seem to have mainly used
more general techniques with lengthy doctrinal discourses at
other normal times in preference to guided meditation with insight
into the thought patterns of individuals.
The
question may arise of how effective spiritual guidance will
be if the terminally ill patient is unconscious. Here what is
actually important is that we are really unaware of the patient's
mental condition at the hour of death. The doctors and onlookers
might conclude that the patient is unconscious because he does
not respond to his surroundings and to the questions put to
him. His five faculties may have become partly or completely
defunct, but nobody can be certain whether or not his mental
faculty is active. We certainly do not know what special potentialities
the mind harbors on the occasion of death. It is quite likely
that the mental faculty is most active at this crucial hour.
Perhaps this is the time that one has the most violent mental
struggle, yearning for life with the firm habitual resistance
and protest against death.
It
is our conjecture that yearning for life is greatest when the
fear of death is greatest. The fear of death is greatest when
one's sense of guilt is greatest, the fear that one has squandered
the great opportunity of human life, an opportunity which could
have been well utilized for spiritual growth. If, on the other
hand, one has well utilized the opportunity of human life for
spiritual growth, one can face the inevitability of death with
relative calm, contentment and happy satisfaction. One's rebirth
seems to be commensurate with one's spiritual potential, which
in Buddhist terminology is called kamma.
It
is appropriate to conclude this essay by giving thought to what
we should do when we visit a terminally ill patient. Our normal
attitude is one of sadness and pity, but Buddhism holds that
it is wrong to entertain negative thoughts at such a moment.
It is my opinion that it would be helpful to the terminally
ill patient, and to any patient for that matter, if we radiate
thoughts of metta, loving kindness to him. As the dying
person's mind may be working at this crucial hour, unencumbered
by the limitations imposed by the physical sense faculties,
it is possible that the person's mind will be sensitive and
receptive to the spiritual thought waves of those around him.
If negative thought waves are generated by grief and lamentation
the dying person may be adversely affected. But if gentle thoughts
of love and kindness are extended, such thoughts may function
as a subtle mental balm that allays the distress and anxiety
brought on by the approach of death and envelops the dying person's
mind in a warm protective cloak of consoling peace.
Abbreviations
All
references in text are to the editions of the Pali Text Society,
Oxford.
A.
Anguttara Nikaya
D. Digha Nikaya
Dhp. Dhammapada
DhpA. Dhammapada Atthakatha
M. Majjhima Nikaya
MA. Majjhima Nikaya Atthakatha
S. Samyutta Nikaya
Vin. Vinaya Pitaka
About
the Author
Lily
de Silva is Professor of Pali and Buddhist Studies at the University
of Peradeniya in Sri Lanka. A regular contributor to Buddhist
scholarly and popular journals, she is also the editor of the
Digha Nikaya Tika, published by the Pali Text Society. Her previous
BPS publications include One Foot in the World (Wheel
No. 337/338), The Self-Made Private Prison (Bodhi Leaves
No. 120), and Radical Therapy (Bodhi Leaves No. 123).
The
Buddhist Publication Society
The
Buddhist Publication Society is an approved charity dedicated
to making known the Teaching of the Buddha, which has a vital
message for people of all creeds.
Founded
in 1958, the BPS has published a wide variety of books and booklets
covering a great range of topics. Its publications include accurate
annotated translations of the Buddha's discourses, standard
reference works, as well as original contemporary expositions
of Buddhist thought and practice. These works present Buddhism
as it truly is -- a dynamic force which has influenced receptive
minds for the past 2500 years and is still as relevant today
as it was when it first arose.
A
full list of our publications will be sent free of charge upon
request. Write to:
The
Hony. Secretary
BUDDHIST PUBLICATION SOCIETY
P.O. Box 61
54, Sangharaja Mawatha
Kandy
Sri Lanka
or
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149 Lockwood Road
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