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A Buddhist Approach to Patient Health Care
--
by Kusala
Bhikshu
***
"Good
health is simply the slowest way a human being can die."
-- Unknown
"To
talk of Buddhism we must first talk about its origins.
I have suggested that the origin of religion was the fear
of danger, but this is not true of Buddhism, which arose from
the fear of suffering. Please note this distinction. Dealing
with the origins of religion we talk about danger, but when
dealing with Buddhism we talk about suffering, which has a
more specific meaning. The fear of danger has its object in
external factors, such as floods, earthquakes, and so on, but
suffering includes all the problems experienced in life, including
those within
the mind." -- Bhikkhu P. A. Payutto
"The
Buddhadharma is not far off. It's as close as your mind.
Reality is not somewhere outside. How can you find it,
if you turn away from yourself. Whether you're deluded
or awake depends upon you. Make up your mind, and you will
be there. Whether you're in the light or in the dark doesn't
depend on others. Have faith and practice, and you will soon
know the truth. If you don't take the medicine of the Great
Physician, when will you see the light of the sun?" --
Ming-K'uang - Disciple of the Tientai patriarch Chang-an.
***
 Twenty-five
centuries ago a man awoke to a new reality, he was known
as the Buddha. Without the aid of gods or men, he found his
way through the tangled web of birth, sickness, old age and
death into the everlasting peace of nirvana.
Over the years many commentaries have been written to add clarity
and understanding to his teachings. Buddhist monks and nuns
have taught and still teach his Dharma (Truth). New schools
of Buddhism based on culture and meaning arose in every part
of the world spreading his message, “Suffering is Optional.”
The Buddha achieved his nirvana at the age of thirty-five.
He shared and taught his practice for forty-five years. Buddhist
practice is designed to end suffering, transform karma and
halt all future rebirths.
Buddhist practice includes both precept practice and meditation
practice. The goal of precept practice is the transformation
of speech and action. The goal of meditation practice is the
transformation of consciousness.
Buddhist practice is also about technique and discipline. Technique,
the technical methods and procedures used in Buddhist practice
are found in the eight-fold path. The eight-fold path is; right
view, right intention, right speech, right action, right livelihood,
right effort, right mindfulness and right concentration. Discipline
in Buddhism, is the control gained by the practice of
training precepts and meditation.
The training precepts are; not to kill, not to take what is
not given, not to indulge in sexual misconduct, not to lie
and not to consume intoxicants.
Buddhist meditation is composed of both tranquility meditation
and insight insight meditation. Meditation allows the cultivator
to see clearly, beyond a limited self view and facilitates
positive change through heightened awareness.
The practice of the precepts is a key support to the practice
of meditation. The training precepts are a necessary and often
overlooked component. The goal of nirvana hinges on a combination
of precept practice, meditation practice and simplicity (renunciation).
Over time a Buddhist comes to realize he or she has the power
to change certain conditions through choice, and accept other
conditions through practice. Choice and practice allow the
Buddhist to actively participate in his or her own liberation.
Skillful choice is a direct result of Buddhist meditation practice.
Meditation adds clarity and understanding to the flux and change
of everyday life. What seemed disconnected and arbitrary before,
comes together in a web of interconnected cause and consequence.
Karma is the cause, and vipaka (Pali word) is the consequence.
Karma can be thought of as the transformation of energy through
intention, speech and action. Karma is the principle of conditionality
operative on the moral plane.
The potential for suffering is found in every human desire,
according to the Buddha. To end our suffering we need to end
our desire for existence, for non-existence and for sense pleasure.
Nirvana is the end of suffering, because it brings an end to
those desires and cravings. It also brings an end to our karma
and all future rebirths.
Buddhist cosmology defines rebirth as the transmigration of
karma from one life to another. Rebirth is different from reincarnation,
as rebirth is not dependent on a soul.
All forms of existence according to the Buddha are ultimately
unsatisfactory because of impermanence. The early Buddhists
did not believe in the existence of a permanent or fixed reality
which could be referred to as God or soul. According to Buddhism
what is apparent and verifiable about existence is the continuous
change it undergoes.
Early
Buddhist teachings proclaim that in this world there is nothing
that is fixed or permanent. Every thing is subject to change
and modification. "Decay is inherent in all
component things," declared the Buddha, our existence
is in a state of flux and continuous becoming. Impermanence
and change are the undeniable truths of the human experience.
Rebirth can be viewed as a cause for suffering, sickness,
old age and death. When the Buddha entered pari-nirvana - nirvana
after death - birth was no longer a condition of his existence.
His existence was now established in nirvana, beyond birth
and death. Pari-nirvana is the ultimate transformation, beyond
space and time. It is existence without birth!
At
the age of eighty the Buddha passed and left this advice:
“O
bhikshus! Do not grieve! Even if I were to live in the world
for as long as a kalpa (336,000,000 years), our coming together
would have to end.
You should know that all things in the world are impermanent;
coming together inevitably means parting. Do not be troubled,
for this is the nature of life. Diligently practicing right
effort, you must seek liberation immediately. Within the light
of wisdom, destroy the darkness of ignorance. Nothing is secure.
Everything in this life is precarious.
Always wholeheartedly seek the way of liberation. All things
in the world, whether moving or non-moving, are characterized
by disappearance and instability.
Stop
now! Do not speak! Time is passing. I am about to cross over.
This is my final teaching.”
When
the Buddha was young, he learned the science of medicine.
He became knowledgeable about the nature and cure of diseases.
The Buddha’s realization of the perpetual cycle of rebirth
and the stages of aging, illness, and death, enabled him to
guide others to live a healthy life.
His
pragmatic approach includes the insistence on proper hygiene
and medicine, but more to the point, he never resorted to
what might be considered "faith healing." Instead,
he offered rational, practical instruction for dealing with
both physical injury and mental illness.
Early Buddhism gives us the five Niyamas, or the five aspects
of cosmic order. These Niyamas deepen our understanding, and
give meaning to why things happen. Niyama is a Pali term for
cosmic order. The Niyamas show how certain conditions, laws
of nature, work at different levels of cause and effect.
The First Niyama (Utu
Niyama) is the law of physical matter.
It is the physical, inorganic order of existence. Seasonal
changes, earthquakes, floods, gravity and heat are some of
the many examples. It roughly embraces the laws of physics
and chemistry.
The Second Niyama (Bija
Niyama) is the law of living matter,
the physical organic order, like cells and genes, whose laws
are similar to the science of biology.
The Third Niyama (Kamma
Niyama) is Karma. Karma is the activity
of transforming energy through intention, speech and action.
The result of this energy transformation is only considered
wholesome or skillful if less suffering or no suffering is
produced. Karma is the cause, and Vipaka is the result. It
is the principle of conditionality operative on the moral plane.
This sequence of cause and consequence replaces a divine law
giver. In Buddhism there is a moral law, but no lawgiver and
no one to administer it. This Niyama pertains to the world
of ethical responsibility.
The Fourth Niyama (Dhamma
Niyama) is the Spiritual or transcendent.
This principle of conditionality operates on the spiritual
level. The natural phenomenon that occurs with the birth of
a Buddha, and the reasons for Buddhist Practice are in this
group. This Niyama has to do with the spiritual laws that govern
ultimate reality.
The Fifth Niyama (Citta
Niyama) is mind. This Niyama implies
mental activity such as consciousness, perception, conception,
etc. Mental phenomenon arises because of conditions; the mind
is not an independent agent. This is like the science of psychology.
The Utu, Bija, Kamma, and Citta Niyamas are types of conditionality
in the relative sense, the cause and consequence of everyday
life. Dhamma Niyama has to do with the spiritual laws that
govern ultimate reality, like emptiness, not-self or our progress
through the different stages of the Buddhist path.
These ever changing physical, biological, psychological, ethical
and spiritual components give life to our pain and suffering.
Our existence and ultimately our death and rebirth, or nirvana
depend on a complex combination of aggregates. There is no
'One Thing' that determines anything in Buddhism it is always
the interconnected and interdependent flux of many things.
The Buddhist approach to health and healing is its emphasis
on spiritual practice. Buddhism asserts that spiritual practice
makes it possible for an individual not only to see opportunity
for practice in the face of adversity, including sickness and
injury, but use the opportunity for personal transformation
and transcendence.
Buddhist practice allows for a deep awareness of cause and
consequence, and insight into the nature of conditioned interdependence.
Choice and practice, are the two factors the Buddhist patient
has most control over. As a result of precept practice, meditation
practice and skillful choice, the Buddhist patient suffers
less and has a greater sense of confidence and well-being.
Practice can replace the feelings of being a victim with being
a victor. Inspire the patient to view the world as being interconnected
and living beings as brothers and sisters, and lastly to turn
his or her thoughts towards nirvana and the welfare of all
living things.
Buddhism
doesn’t tell the patient the meaning of sickness,
so much as it tells him what he needs to do. Buddhism is a
present moment path of action in life, sickness and death.
The Buddhist patient can't change the past, but he does have
some control over the future, if he can act with skill and
clarity in the present moment.
There
is a story about an Indian king on the battlefield shot through
the chest with an arrow. The medic ran to his side, prepared
to pull out the arrow. The king said, “No, not
yet. I need to know from what caste the archer came, what type
of feathers were used, and who made the bow.” The medic
said, “If we take the time needed to answer those questions,
you will die.”
In
Buddhism it's not about, "Why me?” It's about, “How
can I use this in my practice?”
When medical professionals and Buddhist clergy work together,
the Buddhist patient will have a greater sense of acceptance,
be encouraged to focus on both mind and body, and in the process
transcend pain and suffering.
----------------------------------------------------
*
A note on Buddhist words. Pali (Language of Early
Buddhism) and Sanskrit (Language of India) are often
used in the place of English when explaining Buddhism. It can
be a bit confusing at first because of there similarity. For
instance; Sutra (Sans) Sutta (Pali), Karma (Sans) Kamma (Pali),
Dharma (Sans) Dhamma (Pali), Nirvana (Sans) Nibbana (Pali).
----------------------------------------------------
Buddhist Beliefs and Practices Affecting Health Care - Chaplaincy
Services
University Virginia Health System - Charlottesville, VA ©
2004
Overview of Health/Illness: The goal of Buddhist practice
is to develop the mind to its fullest potential which involves
the perfection of compassion and wisdom. Spiritual well-being
involves developing a compassionate mind and working with the
suffering of illness and death in a maximally optimal way. Buddhist
clergy, as well as lay practitioners are available to assist
those who are interested in these practices.
Birth: Buddhists believe in rebirth. In accordance with
this belief, human birth is viewed as the beginning of a highly
precious opportunity. Human birth is unique in that it is a
rare opportunity for the complete development of the mind and
practice of compassion.
Abortion and Birth Control: Buddhists believe that conception
occurs when consciousness enters a fertilized egg. This is considered
the beginning of life and it is regarded as killing if the life
of the future person is aborted after that point. Birth control
that prevents conception is acceptable.
Death: The time of death is extremely important to a
Buddhist since this is a transition point to the next life.
Buddhists devote considerable religious practice to preparing
for death. It is very important for everything possible to be
done to provide as much peace and quiet for the dying person,
as possible. For the Buddhist, death is a series of stages involving
disintegration of physical elements into more and more subtle
elements until finally the consciousness leaves the body. The
more composed and calm the mind is at death, the greater the
opportunity for a better rebirth. Prayers are said for the person
who is dying and sometimes a special text is read to the dying
person.
After Death: Once all of the stages of death have occurred,
some Buddhists believe the consciousness enters a “Bardo”
or intermediary spirit body, which is the precursor to the next
life. The consciousness may remain in this intermediary form
a very brief time or up to 49 days before the new life is begun.
Immediately following signs of physical death, Buddhists believe
that it is best to keep the body in a peaceful state. Traditionally,
the body is taken to the home and for a period of 3 days or
so, the body is not touched and extensive prayers are said.
This facilitates the process of the person’s consciousness
letting go of its prior body and life and all of its attachments
and more easily moving to the next.
Bereavement: At the time of and following the death of
a loved one (particularly the first 49 days), prayers are said
for the person to achieve the most auspicious rebirth possible.
Buddhists also meditate on the Truth of
Impermanence -- a key Buddhist teaching, as a precious loved
one leaves this life.
Dietary Regulations: Within various branches of Buddhism,
there are vegetarians, as well as non-vegetarians. Some branches
have strict dietary regulations, while others have few.
Personal Devotions: Buddhist devotions involve verbal
prayers, mantra repetition, analytical meditations, as well
as a variety of other meditation practices.
Religious Objects: Common religious objects involve prayers
beads and images of Sakyamuni Buddha as well as other Buddhist
deities. Other religious objects are utilized for specific meditation
practices.
Special Care of Women: While men and women are viewed
as equals in Buddhist philosophy, mothers are regarded as even
more important than fathers due to their more primary role in
bringing children into the world and traditionally taking care
of them. Thus, when a mother is sick, special kindness is shown
towards her.
Holiday Observance: The major Buddhist holy day of the
year is Vesak which is the observance of Sakyamuni Buddha’s
birth, enlightenment and parinirvana. This holiday falls on
the full moon day of May. It varies from year to year as it
is determined by a lunar calendar. In observance, some Buddhists
fast for part of or all of this day.
Bioethical Decision-Making: While Buddhists believe that
it is good to continue living as long as possible, it is not
believed that this should be done under all circumstances. For
example, life support machines are not believed to be helpful
if the person’s mind is no longer alert. Having an alert
mind and not being in excessive pain are the two primary factors
that affect a Buddhist decision regarding the appropriate time
of death. Once the conditions are quite difficult, it is believed
that it is better to die. Allowing the person to die in a natural,
peaceful manner is considered more essential.
Privacy/Space: A quiet and peaceful atmosphere is most
beneficial when one is sick or dying. This allows for the sick
person to rest better, as well as to practice meditation and
prayer.
Visitors/Connecting With Community: Maintaining a calm
and peaceful atmosphere for the sick person is again the essential
aspect.
Ethnic (Language) and Cultural Sensitivity: Maintaining
a positive, caring attitude when interacting with the patient
is the traditional cultural norm.
----------------------------------------------------
How to Practice Buddhism in the Hospital.
It's
important to have a practice before you get sick, the more months/years
of practice the better. The hospital is not the place to find
Buddhist practice, it's the place to practice Buddhism. The
practice of Buddhism starts with precept practice and meditation.
Buddhism is about building a foundation of skillful Karma and
the cultivation of mind; the five
precepts and mental training. I encourage anyone new to
meditation to start with Mindfulness
and Loving-Kindness.
"Mindfulness is a doorway to the present moment experience
of life... Love is the profound unconditional acceptance of
the way things are... This unconditional acceptance is expressed
through the activity of kindness... Love is acceptance... Kindness
is activity... Love is Mind... Kindness is Body... Loving-Kindness."
-- Kusala Bhikshu
Mindfulness and Loving-Kindness meditation can transform both
the Buddhist patient and those around him.
Below
is an eBook packed with useful tips and insights on Mindfulness
and Loving-Kindness meditation... It's a great place to start,
and it's free. You can read it online or download it to your
computer. It's 58 pages @ 2.7 MB... If you're like me with phone
modem it may take a minute or two to download, but it's worth
the wait.
Be
Well and Happy... Kusala Bhikshu
***
Loving-Kindness and
Mindfulness Meditation
58 Pages - (2.77 MB)
Hello
- With Love & Other Meditations — Ven. Visuddhacara.
Contents:
Traffic Jam Meditation, Eating Meditation, And Drinking Too,
Sleeping and Walking, Talking, More Tips: Note the Intention,
Changing Moods, A Special Note on Anger and Sorrow, Sorrow,
The Place of Loving-Kindness, Wise Reflection.
The three most important things in life are love, kindness
and wisdom. If we have made these three values the priorities
of our life, then our life will have been well-lived. When
we die we can only have happiness when we look back at our
lives with no regrets. Wealth, fame, power, status, worldly
success and pleasures — these are insignificant compared
to love, kindness and wisdom. Cultivate the latter. If we
spend our life cultivating this trio, our birth and life will
have been worthwhile; it will not have been in vain. In this
booklet, Ven. Visuddhàcàra
shares his understanding of this practice of mindfulness and
lovingkindness with a view to encourage all of us to walk
the path. -- Download Now
***
Daily
Readings -- Buddha's Words of Wisdom
284 Pages - (1.8 MB)
Daily
Readings -- Buddha's Words of Wisdom — by Ven. S. Dhammika.
For over two thousand years the discourses of the Buddha have
nourished the spiritual lives of countless millions of people.
This book contains extracts of the early Buddhist discourses
from the Pali Tipitaka, and also from some post-canonical
writings. Presented so that one reading can be reflected upon
each day of the year. This book is an indispensable companion
for anyone trying to apply the Buddha's gentle message to
their daily life. -- Download Now
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Also
See:
Using
Meditation to Deal with Pain, Illness and Death -- Ven.Thanissaro
Bhikkhu
My
topic today is the role that meditation can play in facing
issues of pain, illness and death – not a pleasant
topic, but an important one. Sadly, it's only when people
are face-to-face with a fatal illness that they start thinking
about these issues, and often by that point it's too late
to get fully prepared. Although today's conference centers
around what medicine can do for AIDS, we shouldn't be complacent.
Even if AIDS or its adventitious infections don't get you,
something else will, so it's best to be prepared, to practice
the skills you'll need when medicine – Chinese, Western
or whatever – can
no longer help you, and you're on your own. As far as I've
been able to determine, the only way to develop these skills
is to train the mind. At the same time, if you are caring
for someone with a fatal disease, meditation offers you
one of the best ways to restore your own spiritual and emotional
batteries so that you can keep going even when things are
tough. -- Full Article
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Also by Kusala
How
I Became a Buddhist
Do
Buddhists Go to Heaven
Do
Buddhists Believe in God
The
Problem with Sex in Buddhism
Buddhist
Enlightenment - VS - Nirvana
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