BUDDHIST BIOETHICS ON

EUTHANASIA PRACTICE

ANKUR BARUA

The Centre of Buddhist Studies, The University of Hong Kong,

Hong Kong

Corresponding address:
Dr. ANKUR BARUA
BLOCK – EE, No. – 80, Flat No. – 2A,
SALT LAKE CITY, SECTOR -2,
KOLKATA – 700 091
WEST BENGAL, INDIA
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Email: ankurbarua26@yahoo.com
 BUDDHIST BIOETHICS ON EUTHANASIA

PRACTICE

Abstract

According to Buddhism, life is made possible because of the continuous interaction

of all conditioning and conditioned factors. With no beginning and no end point, life

is considered to be a continuous process of an endless cycle. Death is considered as

an integral part of existence and is one phase of this endless cycle and cannot

terminate the cycle.

Euthanasia, popularly known as “Mercy Killing”, is the act of causing painless death

in order to end suffering. Though the concept of Euthanasia in India could be traced

back from Buddhist era, but Buddhism is opposed to Euthanasia essentially because

of its affirmative valuation of life. So, the doctor's aim would be to kill the pain and

not the patient.

Key words: Mercy Killing, Painless Death, Valuation of Life

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 BUDDHIST BIOETHICS ON EUTHANASIA

PRACTICE

Introduction

Euthanasia is the act of causing painless death in order to end suffering. It is

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popularly known as “Mercy Killing”. The concept of Euthanasia in India could be

traced back from Buddhist era. It was noted that once Buddha had been preaching

to the monks in the Mahavana in Vaisali regarding the defilement and filth of the

body. Buddha retired into seclusion for a fortnight. Unfortunately, during this time,

the monks, practicing philosophy and spirituality, developed disgust in sufferings of

life and loathing for their physical existence.

This urge became so intense that many felt death would be preferable to such a

repulsive existence. They found a willing assistant in form of Migalandika, an

unfaithful monk, who agreed to assist by killing the monks in return for their robes

and bowls. Migalandika started despatching his victims with a large sword, believing

that by killing the monks he was saving them from the sufferings of samsara. After

the first day’s killing spree, when he went to the river Vaggamuda to wash his

sword, he was seized with remorse. An Evil Spirit appeared before him from the

river and assured him that he was doing a noble service to the monks by helping

them to commit suicide. This encouraged him and he ended up killing a large

number of monks, up to sixty on a single day. When Buddha came out of His

fortnight's seclusion, He noticed the drop in numbers among the monks and

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enquired as to the cause. When He learned what had taken place, He proclaimed

this as the “third of the four most serious monastic offences.” This was the

prohibition on taking human life, and was announced as follows: “Whatever monk

should intentionally deprive a human being of life, or should look about to be his

knife-bringer, he is also one who is defeated and is no more in communion.”1,2 This

Precept prohibits murder even when the person being killed on request or provide

assistance in dying. This would seem to make it immoral for the Buddhists to have

any involvement in Euthanasia, either by requesting it or assisting in it. Both the

person who administers Euthanasia and the one who requests it would be in breach

of the Precepts.

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Various cases could be cited in which monks played a direct or indirect part in

causing death and had been reported during the Monastic Rule. Due to the

amputation of hands and feet, an individual became disabled. A person in this

condition would be unable to take care of himself and require constant attention

and care, including assistance with feeding. The family expressed the opinion that it

would be better if the man would die. This might be due to the reason that they

judged his quality of life to be so poor that he would be 'better off dead. Perhaps

their motive was simply to be free of the burden of providing the care and attention

he required. It may even have been a combination of these reasons. A monk, who

visited this person’s residence, took verbal consent from all his family members and

assisted in bringing about the death of this invalid person by prescribing a drink,

which proved fatal for him. The circumstances would suggest this was a case of

active Euthanasia, although it is not clear whether it was voluntary or not. The monk

who gave the advice was excommunicated.1,2

Another incident was concerned with an act of incitement to death, and related how

a group of wicked monks became enamoured of the wife of a layman. In order to

weaken his attachment to life the monks spoke to the husband of his virtues and

the pleasures, which would be his reward in heaven and provoked him to eat and

drink the wrong kind of food, who eventually succumbed to a fatal illness. When the

matter was reported to Buddha, He excommunicated the monks and expanded the

definition of the third serious monastic offence to include incitement to death:

“Should any monk intentionally deprive a human being of life or look about so as to

be his knife-bringer, or eulogise death, or incite [anyone] to death or who should

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deliberately and purposefully in various ways eulogise death or incite [anyone] to

death; he is also one who is defeated, he is not in communion”. 1,2

During his visit to India in the seventh century A.D., Ven. Xuan Zang (i.e. Huen-

tsang) reported that those who had become very old and felt that their goal of life

had been achieved & time of death was approaching or those who were afflicted by

an incurable disease, often consented to separate from this world and cast off

humanity, contemptuous of mortal existence and desired to be away from the ways

of the world. So their relatives and friends used to give them a farewell

entertainment with food and music before boarding them on a boat and rowed them

to the middle of the river Ganga where they drowned themselves, believing that

they would be reborn in Heaven. One out of ten often found it difficult to carry out

one’s contemptuous views. Rarely, one of them was seen not yet dead on the

shores of the river. 1,3,4

Modern Concept of Euthanasia

According to Webster’s Dictionary‚ Euthanasia is the "act of causing death

painlessly so to end suffering." Translated into Greek meaning "good death‚"

Euthanasia it is also known as “Mercy Killing”. In the context of medical treatment

we would define Euthanasia as: "the intentional killing of a patient or omission as

part of his medical care."1

There are two forms of Euthanasia: passive and active. 'Active' Euthanasia is the

deliberate killing of one person by an act, as for example, by lethal injection.

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‘Passive’ Euthanasia is the intentional or deliberate causing of death by an

omission, as for example, by not providing food or some other requisite for life. Each

of these modes of Euthanasia can take three forms: (1) voluntary, (ii) non-voluntary

and (iii) involuntary. 'Voluntary' Euthanasia involves the request by a legally

competent person that their life should be terminated. 'Non-voluntary' Euthanasia is

the killing of a non-competent patient. The removal of feeding tubes from comatose

patients is an example of non-voluntary Euthanasia. 'Involuntary' Euthanasia is the

intentional killing of a person against his will. 1

European countries like the Netherlands, Switzerland and Belgium allow physician-

assisted death in various incarnations. In Holland alone, about 2,000 people die

through assistance from their doctor each year. Dutch laws, like those in

Switzerland and Belgium, require that the patient clearly and insistently request

death. Oregon is the only state in US where physician-assisted suicide is legal. In

countries where Euthanasia is legal‚ the patient is required to prove that they are of

sound mind and have a legitimate reason to consider this form of death‚ such as a

terminal illness. If a person chooses to undergo Euthanasia it is his own choice and

others should not interfere.5

Some physicians believe that Euthanasia is immoral since the only reason people

choose to end their life is because of the pain and effective pain management can

be achieved with the help of modern medication. There has been a great
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improvement in hospice training and care‚ therefore Euthanasia is unnecessary.

There are also social considerations for Euthanasia other than suffering. People

might not want their loved ones to have to deal with the financial constraints due to

escalating medical bills that long time hospice can incur or see them drift further

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 5,6
and further away from reality even though they are still alive. To practice

Euthanasia in modern clinical set up, usually the sedative sodium thiopental

(anesthetic drug) is intravenously administered to induce a coma. Once it is certain

that the patient is in a deep coma, typically after some minutes, a muscle relaxant
5,6
is administered to stop the breathing and cause brain death.

Buddhist Attitude towards Life

The Buddhist perspective on life is explained in the theory of Dependent

Origination. According to this, life is nothing but a collection of events, where each

"event" or "happening" acts as the cause for the arising of the following event,

which then provokes another event. The preceding cause transmits its potential

force to the following effect. This concept is used to emphasize that life consists of

interwoven activities of causes and effects, referred to as the kamma process,

which is volitional activity whether mental, verbal or physical. The relationship

between cause and effect is that both the earlier and later phases are an integral

part of a single process with many psychophysical factors mutually conditioning one

another. Life is made possible because of the continuous interaction of these

conditioning and conditioned factors. With no beginning and no end point, life is

thus considered to be a continuous process of an endless cycle. Death is considered

as an integral part of existence and is one phase of this endless cycle and cannot

terminate the cycle. This conditioned existence is called samsara and represented
1,2
in Buddhist art by the Wheel of Life (bhavacakra).

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Buddhist Bioethics on Euthanasia Practice

The concept of Euthanasia to cause death and end a precious human life is quite

opposite to the concept of non-injury to life as mentioned in the Digha-Nikaya of Pali

Canon. The Buddha’s profound appreciation for the universal existence of suffering

had evoked a great compassionate response (karuna) and loving kindness (metta)

for all living beings. The very first percept among the Five Precepts (pañca sila),

which form the minimum code of ethics for all the followers of Buddhism, involves

abstention from injury to life. It is explained as casting aside of all forms of weapons

and being conscientious about depriving a living being of life and promotes the

cultivation of compassion and sympathy for all living beings. Buddhism also

tirelessly advocates the virtues of non-greed, non-hatred and non-delusion in all

human pursuits. Though the practice of Euthanasia is never encouraged according

to the ethical aspect from the Buddhist perspective, but still it remains a debatable

issue of whether to practice Euthanasia with restrictions and proper judgement on

accounts of socio-economical considerations in real-life situations.1,2,3

Buddhist Hospice Care

According to Buddhism, life is a result of the continuous interaction of conditioning

and conditioned factors and a continuous process of an endless cycle. On the other

hand, Death is considered as an integral part of existence and is one phase of this

endless cycle and cannot terminate the cycle. The Buddhist practice of compassion

and wisdom, a willingness to serve, tolerance, a duty to do no harm, and the

significance of death in the eternal process of rebirth, shares a commonality with

hospice discourse.1,2,3

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Some Buddhist organizations are providing hospice-at-home service, with expert

nursing, counselling and palliative care. Apart from this, they are also providing the

individual and family counselling, as well as bereavement counselling and mental

support to cope with worries in times of crisis.6

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Conclusion

Modern arguments in favour of Euthanasia emphasize the principle of autonomy,

the right of an individual to choose life or death for him or herself. However, this

issue is no longer one of individual rights because doctor is not simply an

instrument of the patient's will. The doctor himself must also concur with the

patient's reasons for seeking Euthanasia before the person administers it. Doctors

must also use their own professional judgment about what is clinically and ethically

right in a given case. Where patients in terminal illness are in great pain it may be

necessary to administer drugs and other medication to relieve pain. The doctor's

aim here, however, would be to kill the pain and not the patient. 5,6 Buddhism is

opposed to Euthanasia essentially because of its affirmative valuation of life. To

value death above life is to deny that life is a basic good. From the perspective of

Buddhist ethics, the ultimate aim of Buddhism is to overcome death. Any choice in
1,2
favour of death is a rejection of this vision of human good.

References

1. Keown, D. 1995. Buddhism & Bio-Ethics. London: MacMillan:168-73.

2. Vinaya-Pitaka, iii, pp.68 ff.; Samantapasadika, ii, pp. 399 ff.

3. Si-Yu-Ki. 1969. Buddhist Records of the Western World. Delhi: Oriental Books

Reprint Corporation Book Publishers:86-7.

4. Watters, T., Davids, T.W.R., Bushell, S.W., ed., 1961. On Yuan Chwan’s Travel

in India (A.D. 629-645). Delhi: Munshi Ram Monohar Lal: 174-5.

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5. Burdette, A.M., Hill, T.D., Benjamin, M.E. 2005. Religion and Attitudes toward

Physician-Assisted Suicide and Terminal Palliative Care. Journal for the

Scientific Study of Religion 44(1):79-93.

6. Werth, Jr., James, L., Blevins, D., Toussaint, K.L., Durham, M.R. 2002. The

influence of cultural diversity on end-of-life care and decisions. The American

Behavioural Scientist 46(2):204-219.

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