World Religions: Buddhism

Basic Facts:

• Buddhism is based on the teachings of Siddhartha Gautama, the Buddha, who lived in India in the 6th century BCE

• Legend has it that the sight of an ill person, an old man, and a dead body led this former Hindu prince on a spiritual search to explain the cause of suffering and find a means to its cessation


• As Buddhism spread from India to China, Japan, Tibet, and other Asian countries wide variances in belief and rituals developed

• More than 250 million people worldwide are Buddhists

Buddhism - Traditional Beliefs

• The Four Noble Truths and the Eightfold Path
• Buddhist View of the Self
• Nirvana
• Death in the Buddhist Tradition

Buddhism - Spiritual Practices
Buddhism - Actions Before and After Death
Buddhism - Implications for Hospice/Palliative Care
References

Buddhism - Traditional Beliefs

The Four Noble Truths and the Eightfold Path

• The Four Noble Truths and the Eightfold Path proclaimed by the Buddha upon his enlightenment are the foundation for Buddhist belief and practice

• They put forth the impermanence and interdependence of all reality and an ethic that respects the dignity and worth of each living being

• Buddhists celebrate the birth, enlightenment, proclamation of the dhamma (teachings), and death of Gautama but most sects do not consider the Buddha to be a god

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Buddhist View of the Self

• Buddhists believe that the self or soul is only a temporary composite of matter, sensations, perceptions, mental formation, and consciousness that dissolve at the time of death, although some stream of consciousness undergoes reincarnation

• Through spiritual practice a person is freed from the illusion of a permanent self, attachment to any mental or material state of being, and desire for pleasure

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Nirvana

• The ultimate goal is enlightenment, or nirvana, a state of consciousness that may be attained during life and primarily through one’s own efforts, though it may take many lifetimes to reach

• Pure Land Buddhists, distinct from the Theravada tradition, believe that nirvana is an actual heaven or paradise entered into through faith in Amitabha Buddha or Guan-yin, the goddess of compassion

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Death in the Buddhist Tradition

• Meditation upon decaying bodies has long been employed by Buddhist monks as a means to comprehend the changeable nature of reality, to conquer the fear of dying, and to experience the dissolution of ego

• Death is also a prominent theme in Buddhist scripture (The Heart of Perfect Wisdom Sutra) and popular tales

Story

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Buddhism - Spiritual Practices

• The primary goal is to help the practitioner achieve a clear, calm state of mind and penetrate the true nature of reality. These include:

• Meditation
• Breathing exercises
• Chanting
• Study of scripture
• Mindfulness
• Prostrations
• Concentration on mandalas or other sacred images

• Skillful, good, compassionate deeds are the result of a pure mind and produce merit in the next life; lying, stealing, killing, sexual impropriety, and other harmful or selfish actions increase suffering

• The Eightfold Path is the means to liberation from suffering and the foundation for an ethical life

• Right views
• Intent
• Speech
• Conduct
• Livelihood
• Effort
• Mindfulness
• Concentration

• Veneration of monks, reverence for ancestors, and devotional rites are also practiced to accumulate merit

• The belief in the interconnection of all living beings promotes vegetarian diets and non-violence

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Buddhism - Actions Before and After Death

• Actions before death

• The state of a person’s mind as death approaches/at the time of death is of critical importance


• All efforts are made to relieve the dying person’s agitation, anxiety, fear, and attachment


• The family, relatives, friends, and monks will repeat mantras and chant certain sutras (teachings of the Buddha) believed to help calm the mind and strengthen knowledge of the true nature of reality


• Those accompanying the dying person should refrain from any display of emotions or behavior that will disturb this state of mind


• Mahayana Buddhists may focus their thoughts on the Pure Land or repeat the name of Amida Buddha to ensure their liberation


• The Tibetan Book of the Dead proscribes elaborate rituals to guide the dying person and later the corpse through the transition from life to rebirth, a state known as bardo

• Actions after death

• Many Buddhists believe that the life force or consciousness remains in and around the corpse for hours after the last breath is taken to as long as several days


• No embalming is necessary; cremation or burial conducted by lay persons or monk


• Funeral service may include:
• The wearing of white by the family
• Burning of incense
• Picture of the deceased
• Offering of fruit and flowers
• Chanting and extolling the virtues of the deceased


• Chanting and meditating for the deceased is continued after cremation, often for 49 days, to help the soul on its journey from one state to the next and to comfort the bereaved


• The mental and emotional state of the bereaved influence the state of the soul of the deceased and its rebirth. Except where cultural norms dictate specific behaviors, often along gender lines, excessive expression of grief is avoided


• Anniversary observed at 49 days and 100 days


• Buddhist All Soul’s Day observed in many temples in the month of August


• Many families erect altars in the home with picture of the loved one
• Conduct regular rituals on behalf of the deceased

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Buddhism - Implications for Hospice/Palliative Care

• The primary goal of hospice/palliative care to relieve suffering and facilitate a good death fits well with a Buddhist framework of meaning, unless medical staff focus solely on the relief of physical pain

• The relief of spiritual suffering and concern for the mental state of the dying patient needs to be fully integrated into a plan of care

• Pain management may be impeded by the dying person’s spiritual preference for full awareness

• Contrarily, controlling pain, anxiety, and terminal restlessness through medications may be the means to ensure a calm mental state at the time of death and reassure family of the future well-being of the deceased’s spirit

• Telling the patient about their life-threatening illness allows for mental and spiritual preparation

• Spiritual practices may be more easily accommodated when palliative care is provided in the home

• However, if the patient is in the hospital setting, every effort should be made to respect central spiritual practices of meditation, chanting, and the overriding need for a calm, undisturbed mental state for the dying person in their last few days and hours


• Not touching the body for several hours after the last breath is taken is easily accommodated in the patient’s home by instructing the family to wait to contact the hospice program


• In the hospital, medical staff need to be educated that from the perspective of the Buddhist family, the person is not really dead until this time period has elapsed, even if vital signs indicate otherwise


• The patient may correctly be regarded as alive, (a paying patient necessarily occupying a bed and room), when considered from within this framework of understanding

Example

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References

UNIPAC,. Hospice/Palliative Care Training for Physicians: A Self-Study Program, UNIPAC TWO: Alleviating Psychological and Spiritual Pain in the Terminally Ill, pp. pp. 98-100. Porter Storey, M.D, and Carol F. Knight Ed.M. (authors) (Gainesville, Florida: American Academy of Hospice and Palliative Medicine, 1997)

Kramer, Kenneth. The Sacred Art of Dying: How World Religions Understand Death, (New York: Paulist Press, 1988), pp.43-80

National Conference for Community and Justice, 1999 Interfaith Calendar, (Chicago, IL, 1998)

Truitner, Ken and Nga, “Death and Dying in Buddhism,” pp. 125-136 In Ethnic Variations in Dying, Death, and Grief, edited by Donald P. Irish, Kathleen F. Lundquist, Vivian Jenkins Nelsen (Washington, D.C.: Taylor & Francis, 1993)

Dennis Ryan, “Death: Eastern Perspectives,” in K. Doka (ed) Death and Spirituality, pp. 75-92, (Amityville, New York: Baywood Publishing Company, Inc., 1993)

Chogyam Trungpa, translator, The Tibetan Book of the Dead (Boulder, Colorado: Shambala Press, 1975)

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