The Buddhist Concept of Life, Suffering and Death, and Related Bioethical Issues
Though the present constitution does not make it compulsory for every Thai to follow the Buddhist beliefs and practices, for the majority of the Thai population one cannot be a true Thai without being a Buddhist.
The institution of kingship, sangha and nation are considered as the basic triad of social solidarity and identity. They have been so intermingled in the course of history and are so deeply meaningful to the hearts of the people as to form the core of what may be called the civic Thai culture.
The Buddhist perspective on life, suffering and death can never be truly understood apart from the Buddhist laws of causality (Paticcasamuppada) and mutation. For the Buddhist these two laws are natural laws that operate universally in all physical and mental phenomena.
The law of cause and effect is thus expressed: "when this exists, that exists, when this arises, that arises, when this is not, that is not, when this ceases, that ceases."1 This is interpreted as meaning that all that exists is the result of antecedent causes.
Therefore, in the context of this natural law, life consists of many psychophysical factors.2 It is a fabric of causes and effects, arising existing and continuing by the concatenation of these factors mutually conditioning one another.
The frailty and insecurity of life
In addition to this cause-and-effect nature of life, there is also an emphasis placed on its impermanence (anicca) and insubstantiality (anatta), through another law of mutation also referred to as the law of change.
That change is the very essence of existence is implied by the law of mutation, and this is applied to the life process. In this process the apparent unity of existence is divided into five aggregates, known as the khandhas.
These five aggregates are material form (rupa), feeling (vedana), perception (sanna), disposition (sankhara) and consciousness (vinnana) and they include three traits : arising, remaining and passing away.7 Owing to its ephemeral nature, life is like a dream, quite brief and fleeting.
By emphasizing that the present moment is of paramount importance, Buddhism defines this moment as both cause and effect. As an effect the present is the product of the past, and as a cause it is the building block of the future.
This void is the result of the insubstantial nature of life, and the aggregates, although forming a recognizable and perceivable object, do not produce a substance " all of them are insubstantial, a part of the endless movement of life.
The unity arises from continuity.
It is the spectator who perceives this series as a single person. In the same way there is no identity in the process of change. What exists is the rapid change and unbroken line of causes and effects.
Despite this plain fact of experience people still believe in ego-consciousness, clinging to the fallacy that there is a permanent, abiding substance of Soul in and behind consciousness. Life for them is therefore a reality and an illusion.
The term "self" is a name for the linkage of all five aggregates just as the term "human being" refers to an aggregate of body and mind. For Buddhism this term "self" is a societal invention for the purpose of communication.
This understanding encourages us to look at life objectively and to refrain from viewing it in terms of self-centeredness. By negating the self in life Buddhism tries to eliminate the vanity caused by self-absorption.
There is also one additional trait which must be mentioned. This is suffering (dukkha).8 Suffering is used in Buddhism as a broader concept to include pain, grief, misery or unsatisfactoriness, which would normally be seen by most people as suffering, as opposed to happiness; it refers also to a unique phenomenon of the universe.
Some elements of suffering, such as grief, pain, misery, are inherent in the experience of living and cannot be avoided. Should a person be fortunate enough to avoid most forms of suffering, there is no question that death as the final form of suffering is inevitable. And one's own death or the death of one who is deeply loved causes suffering. Owing to this reality of death, Buddhism concludes that human existence is insecure, fragile and filled with suffering.
The very transitory nature of life is a cause of suffering, for even happiness is seen to be temporary. While experiencing happiness, which by definition is the absence of pain, one has expectations of the continuation of the state of joy. But these expectations can never be met.
Buddhist texts list various kinds of pleasures, including sensual pleasure and the joy of family life, that one can enjoy, comparable to the list of the common experiences of suffering.9 However, Buddhism does not want us to accept happiness uncritically.
Similarly, these objects of pleasures (such as a new motor-car, a glass of beer, a girl friend) cannot last long for they contain within themselves the potential for change and decay. Having undergone change and decay, they cease to give us happiness in their new forms.
One should always remember that life contains a number of undeniably unpleasant experiences, which nobody could ever pretend are enjoyable, such as old age, disease, death, being separated from what we like, and being associated with what we dislike.
Buddhism accepts the fact that, like happiness, suffering is subject to change. But at the same time Buddhism points out that there is no balance of happiness and suffering. The painful side of experience usually outweighs happiness. However pessimistic it may seem, Buddhism tries to address the reality of suffering, without any pretence or deception, so as to focus on this painful side of life. At the same time it tries to probe beneath the fact of suffering in search of its causes and a way to end.
The Buddha's insight, in its concentrated form, is found in the Four Noble Truths (ariyasacca). They are the truth of suffering (dukkha), the causes of suffering (samudhaya) the method to end suffering (nirodh), and the Noble Eightfold Path that leads to the cessation of suffering (magga).
In order to cease from suffering one should not project suffering on to others. Nor should one become a masochist or a martyr and enjoy suffering. Nor should one find attachment to a substitute whether in the world of art or of such other pleasure-giving areas as sex, drugs and liquor. Substitutes are to be avoided because they feed ego gratification (tanha). In Buddhist thought fulfilling the ego's needs is itself a cause of suffering.
As mentioned earlier, lacking a permanent Ego at the center of our being and transitory in our nature, we long to find and to cling to something substantial in the ceaseless flow of change. We therefore project reality onto an illusory Ego for the purpose of gratification. Possession is used as a means of ego-gratification to fill this void. The use of people as objects to be manipulated for our needs is another way in which we attempt to solidify ourselves.
But it is like building a house on sand. There is nothing substantial there. The grains fall apart and dissolve, and the house crumbles into dust. We still feel inadequate or unsatisfied, no matter what we get, because our ego-desires (tanha) are by nature insatiable.
It is seen in Buddhism that much of the misery of life is caused by self-centeredness and the constant desire to satisfy one's own needs. These ego-desires are the very root of all evil, including greed, lust, hatred, lying, deceit, and crime. It is the delusion of the Ego that begets all forms of these ego-desires.
Because ego-desires are the cause of most human suffering, it is the elimination of the Ego that is necessary to end our unhappiness. And because the Ego has no reality of its own we are able to abolish it through our efforts. This is not seen as an easy process.
Buddhism discourages ego-focus because it wants us to realize our nonpersonal potentialities. Besides, self-concentration does not allow the pursuit of truth and righteousness. The value of life does not depend on quantity but on quality.
Any life lived solely for the self is a life not worth living, as there is no room for the highest goal of attaining nibbana, the liberation from the endless life-cycle, samsara existence. It is this ultimate goal that makes life worth living. Thus to be absorbed and engrossed in the temporal, impermanent part of life matters little.
The Sanctity of life
Since life is so worthwhile the first precept in Buddhism prohibits the taking of life. Within this precept all killing for whatever reason is not allowed.10 But there is room for taking life for just cause.
As a rule suicide is prohibited. Even when one is suffering from a painful and incurable disease, or when one's life is unsatisfactory, one should bear it quietly and patiently while simultaneously trying to rid oneself of the pain and suffering in all possible ways.
The giving of one's own life to save the lives of others, as a bodhisatta gave himself to a hungry lioness to save her from eating her own cubs, is one example of this exception. Another is suicide to escape from an incurable illness that is an obstacle to the attainment of nibbana.12
Aside from these rare cases killing cannot be justified. Killing is killing even if it is called mercy killing. As the means for killing nowadays has become easily available one has to wonder whether the so-called mercy killing is truly for the sake of the patient or for those who accept killing and encourage it.
In the light of such understanding Buddhism strongly opposes assisted suicide. In the Buddhist view assisted suicide is not an act of compassion as claimed by many people. Killing always brings bad karmic results both to the person who is killed and to the perpetrator.
When requested by patients to assist them to end their own lives Buddhism advises us instead of acting upon the request we should try to find different available means to ease their suffering according to the kind of suffering, physical, emotional or psychological, the patients are undergoing. Such is the way of genuine compassion.
Killing and letting-go
Prolonging death unnecessarily means prolonging suffering while "letting go", allowing death to come naturally, will lessen suffering as long as there is appropriate pain maintenance and total care of the patients and their families.
Animal life is valued because animals share with human beings many of the same qualities of suffering, pain, pleasure and conception. Other living beings which do not share human qualities such as plants, are not included in the precept.
Owing to his compassion and his conviction that privilege entails responsibility (the principle of noblesse oblige) the Buddhist usually considers it his duty to care for the well-being of all animals and at the same time is against the killing of animals as a sport or for luxury or for ritual sacrifice.
In Buddhist thought animal life is also sacred, but human life is considered more important. It is only a human being who has the direct path to nibbana. This is because of man's potentiality due to his central position in the universe.14
This position cannot be shared with other sentient beings including animals. Buddhism is well aware of the necessity of some animal experimentations to advance scientific knowledge that can help cure life-threatening diseases. Accordingly, this kind of animal experimentation is acceptable if there is no other way to attain such knowledge. Experimentation for cosmetics and minor disease are thus ruled out.
In the case of experimentation that has great benefit to mankind Buddhism asks us to carry it on in a way that is humane as much as possible. The animal must be provided with the best living conditions and made to feel the least pain.
The standard definition of death in Buddhist texts describes death as "the falling away, the passing away, the separation, the disappearance, the mortality of dying, the action of time, the breaking up of the aggregates, the laying down of the body."15 In this definition death is seen as the total dissolution of the five aggregates, the factors constituting the individual.
This may be explained by means of an analogy with a house-gate.
To one who is outside the house the gate is an entrance, whereas to the one inside the house it is an exit.
But for both of them it is the same gate. Similarly, the preceding state in the cause and effect process is called birth, whereas its following state is viewed as death, although both of them belong to the same single process.
It is through an understanding of death that we gain an understanding of life. Buddhists thus see the attempt made by people to define the meaning of life as an attempt to define the meaning of death.
A man who defines death as merely one event in the unbroken cause - and -effect continuum should be able to rid himself of anxiety and then could live life to the fullest conquering the vicissitudes of life.
This tragedy of death is magnified by the certainty of rebirth (again-arising) and the repetition of suffering and death (passing away) in samsara existence. That we are locked in the wheel of life and death is an indication of the fundamental emptiness of existence.
[The continuity and duration of life and death for each individual is incalculable, since if the collection of the bones of one person's repeated rebirth could be amassed, they would form a mountain of skeletons. This imprisonment in the round of existence, however, is neither arbitrary nor ordained by a huge power.
As an effect of his past deeds he is the product of the past. But as a cause he is a field of possibilities : he has the ability to gradually free himself from the past and to become whatever he wants to be.
Ways to cope with death
As a means of solving the predicament of death Buddhism has developed special systematic techniques of meditative methods, called moranasati and asubha bhavana, to enable us to face the fact of our death with equanimity and understanding and ultimately to attain nibbana, in which there is neither life nor death.
As a result he is moved towards liberating wisdom (vijja)16 that would free himself from the clutch of the illusory Ego and its selfish desires, particularly the lust for life (bhava tanha), the craving for sensual pleasure (kama tanha), and the craving for the immaterial sphere (vibhava tanha)17 and ultimately from the wheel of life and death.
The spiritual importance of dying
As we have seen it the discussion on the concept of life, Buddhism considers every moment in life of great importance, for it is the moment in which one constructs one's own destiny, More emphasis, however, is placed on the last moment in life, or the dying process, in which all the five aggregates of existence are disintegrating.
For in Buddhist thought in this last moment the last stage of consciousness (cuti vinana) of one's life is passing away to give place to a new stage of consciousness (patisanthi vinana), which will form another life by its new association with the new aggregates of existence.
Even if the character of the new life is affected by the whole previous life, the nature of the last conscious state still contributes significantly to the quality of the ensuing one. If it is wholesome (kusala), this will produce a wholesome inauguration of the new life. Similarly, if it is unwholesome (akusala), the ensuing new life will be unwholesomely inaugurated.
Consequently, it is of great importance that special care should be given to enable the dying to die a "good death" i.e. a calm, and happy peaceful death which will occur only when the mind of the dying is clear and subtle, never be impaired by analgesics or sedatives.
In this respect Buddhism enriches the philosophy of the hospice movement, devoted to the full physical, psychological, social and special care of the dying, and reaffirms the significance of the dignity and importance of death and the need for spiritual care.
Buddhism also teaches that removing one's thought focused on the pain of death can be done through specific meditations, which are usually mastered only after years of practice. By using these specific meditations one can transform oneself into a state of painlessness.
Without his long and arduous effort no one can ever reach the stage. As this power is available to very few, the question of withholding pain-killing drugs and sedatives from those who have not made such preparation is a serious one.
Buddhism can serve as a resource for the on-going discussion of bioethical issues which have arisen with new scientific knowledge and new circumstances of modern life. The Buddhist "middle way" ethic, based on the concept of interdependence, for example, is an alternative between the two extreme positions on abortion i.e. the pro-abortion view and its opposite.
Similarly, the Buddhist emphasis on intention as the important ingredient in ethical decision is useful for our reflection on bioethical issues in the gray areas where ethical water becomes muddy and where one has to choose between the two evils. The Buddhist understanding of death as a process and not an event is another example. It supports the total brain death approach which prohibits the premature removal of organs for transplantation.
Moreover, the Buddhist death-accepting attitude and the great spiritual importance it gives to the dying process can significantly contribute to the discussion on euthanasia and the care for the dying.
The "letting-go-of-life" view is on alternative between act-utilitarian approach where the end justifies the means and the apposing deontological position.
But since all the bioethical issues that have been under discussion today are the questions and challenges which Buddhism has not encountered before, Buddhism has to reflect on its traditional understanding in a new way to meet new circumstances.
Living tradition has always done this in different times and places. That is why they could still remain alive today. Such adaptation is necessary and does not violate the teaching because Buddhism itself teaches us not to cling to any belief and practice, but to direct our attention to reality and what will release suffering from human kind.
2. These factors are ignorance (avijja), volitions or Kamma formations (sanskaras), consciousness (vinnana), the six faculties-the five senses plus mind-(ayatana)-, contact (phassa), feeling (vedana), craving (tanha), clinging (upadana), becoming (bhava), again-becoming (jati), decay (jara), disease (phayadhi), death (norana), grief (domanassa), lamentation (parideva), suffering (dukkha).
3. The term samsara refers to the round of life and death in which the whole range of sentient beings, from the tiniest insect to man, is believed to exist. Only the human being, however, has the potential to terminate this endless cycle. Sec also notes No.5 and No.14.
5. There are various meanings of nibbana found in different contexts in Buddhist texts. In the paper the term is used to mean the unconditioned state of consciousness in which there is the ceasing of the "I" (Ego), lust, hatred and delusion, the three principal forms of evil in Buddhism. This state is not caused, not originated.
There are two kinds of nibbana " sa-upatisesa nibbana-nibbana without the disintegration of all the five aggregates of existence, and anu-patisesanibbana-nibbana without any element of life remaining.
6. Buddhism in Translations by Henry Clarke Warren (N.Y. : Atheneum, 1968), p. 150.
In this case the three groups are called rupa, cetasika (conditioning factors of consciousness) and citta (state of consciousness). The five aggregates are also arranged in two groups : (i) rupa (ii) nama (the other four aggregates).
8. Suffering constitutes an essential part of Buddhism. All its teaching is primarily focused on this unpleasant fact of experience. "This 1 do teach," declared the Buddha, "suffering and the cessation of suffering" (The Book of the Kindred Sayings, Vol. III, trans. F.L. Woodward. London : Luzac and Co., Ltd. 1954. p. 157).
This preoccupation with suffering has made many outside observers frequently regard Buddhism as a pessimistic religion. Such misunderstanding arises from their looking at suffering apart from the context of the Four Noble Truths (i.e. the fact of suffering, the causes of suffering, the cessation of differing, and the Eightfold Nobel Path which leads to the cessation of suffering).
The Buddhist approach to suffering emphasizes a sense of realism and certainly discourages any attempt to brood over suffering and be agonized by it. It would be more appropriate to describe Buddhism not as "pessimistic" but as "realistic" for it begins with the fact of experience.
10. In Buddhist texts it is stated that for an act of killing to be complete and kammically potent (i.e. producing unwholesome effect) five conditions must be observed : (i) the knowledge that the being is a living being,
(iii) the intent or resolution to kill, (v) the act of killing by appropriate means, (v) the resulting death. Is the absence of any one of these conditions, the act would not constitute killing even though death should follow, and will not entail any evil effect on the doer.
11. Bodhisatttava is a term that refers to the one who is a Buddha-to-be. It is believed that prior to becoming a Buddha, Gotama the Buddha was bodhisattava in 550 previous lives practicing all kinds of perfection (e.g. Perfection of Wisdom, Perfection of Compassion, Perfection of Vigor). The stories of the Buddha's previous lives are collected in Jatakas Stories.
The Buddha was said to give approval to suicide of a monk named Godhika who, after attaining the state of spiritual release through meditation six times in succession and then falling away from it, committed suicide the seventh time he attained it, in order not to fall away from it again (Samuvutta-Nikaya I, pp.120f).
13. Vegetarianism is one of the main controversial issues among Buddhists today. Many devout Buddhists are vegetarian and some do not wear silk because they do not want to have the lives of the silkworms on their conscience.
Similarly, there is no rule or injunction is the teaching of Buddhism that a Buddhist should live wholly or even principally an vegetables. Whether or not meat is eastern is purely an individual concern.
In relation to animals, only man can experience both joy and suffering without being addicted to any of these experiences, and thus has the potential to transcend them and to free himself from the round of existence. In addition, man can have unhealthy and healthy volition, whereas animals usually tend to have unhealthy more than healthy volitions.
It is therefore extremely difficult for animals to free themselves from samsara existence. Animals can be helped through being associated with human beings, especially if the humans are spiritually advanced.
15. Buddhism in Translations by Henry Clarke Warren (N.Y.: Atheneum, 1963), p.202.
16. Wisdom (vijja) means knowledge of the true nature of the world and human existence-impermanence, insubstantiality and suffering. This knowledge as opposite to ignorance (avijja) has within itself a power to free a person from ego-absorption.
Through knowledge the "I (Ego) falls, and with the fall of the "I" fall also ego-desires. The transformation of ignorance to knowledge is synonymous with the act by which the "I" is dissolved. The eradication of the "I" is at the same time the termination of the cycle of life and death.
"By the dissolving away of that attachment (to the "I"), the life impulse (the will-to-live) is dissolved; by the dissolution of the life-impulse, being (the five aggregates of existence) is dissolved; by the dissolution of being, birth is dissolved; by the dissolution of birth are dissolved old age and death, woe, distress, sorrow, grief and despair." (quoted by Paul Dahlke in Buddhist Essays, New Delhi : Swarn Printing Press, 1978, p. 182).
First there is the Plane of Desire, in which are included earth-bound deities, the world of human beings, and various worlds inhabited by spirits, infernal beings. Next to it comes the Plane of (Subtle) From, the world of the deities which, though dissociated from "matter", is bound up with spiritual forms, Finally, the Formless Plane, inhabited by deities of the highest order of all (called arupa-bhrama), representing various dimensions of pure but still mundane consciousness.
Even this Plane is subject to impermanence and a part of the Wheel of Life and Death, though the duration of life is much longer than in the other Planes. For a detailed description of the Buddhist cosmology see The Three Worlds of King Ruang; translated from the Thai Trai Bhuum Phra Ruang, by Frank and Mani Raynolds (Chicago University Press, 1983).