MINISTERING TO THE SICK AND THE TERMINALLY ILL
by
Lily de Silva
Bodhi Leaves No. 132
Copyright 1994 Lily de Silva
BUDDHIST PUBLICATION SOCIETY
KANDY SRI LANKA
* * *
DharmaNet Edition 1995
Transcribed directly from BPS Pagemaker files
Formatting: John Bullitt
This electronic edition is offered for free distribution
via DharmaNet by arrangement with the publisher.
DharmaNet International
P.O. Box 4951, Berkeley CA 94704-4951
* * * * * * * *
MINISTERING TO THE SICK AND THE TERMINALLY ILL
"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 sanna//) 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
//Papancasudani// (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 BPS 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 upon request
with an enclosure of U.S. $1.00 or its equivalent to cover air mail
postage.
Write to:
The Hony. Secretary
BUDDHIST PUBLICATION SOCIETY
P.O. Box 61
54, Sangharaja Mawatha
Kandy Sri Lanka
or
The Barre Center for Buddhist Studies
Lockwood Road
Barre, MA 01005 USA
Tel: (508) 355-2347
* * * * * * * *
DISTRIBUTION AGREEMENT
~~~~~~~~~~~~~~~~~~~~~~
TITLE OF WORK: Ministering to the Sick and Terminally Ill (Bodhi Leaves
#132)
FILENAME: BODHI132.ZIP
AUTHOR: Lily de Silva
AUTHOR'S ADDRESS: c/o Buddhist Publication Society
PUBLISHER'S ADDRESS: Buddhist Publication Society
P.O. Box 61
54, Sangharaja Mawatha
Kandy, Sri Lanka
COPYRIGHT HOLDER: Lily de Silva (1994)
DATE OF PUBLICATION: 1994
RIGHTS AND RESTRICTIONS: See paragraph below.
DATE OF DHARMANET DISTRIBUTION: August 1995
ORIGIN SITE: Access to Insight BBS, Pepperell MA * (508) 433-5847 (96:903/1)
The copyright holder retains all rights to this work and hereby grants
electronic distribution rights to DharmaNet International. This work may
be freely copied and redistributed electronically, provided that the file
contents (including this Agreement) are not altered in any way and that it
is distributed at no cost to the recipient. You may make printed copies of
this work for your personal use; further distribution of printed copies
requires permission from the copyright holder. If this work is used by a
teacher in a class, or is quoted in a review, the publisher shall be
notified of such use. See the title page of this work for any additional
rights and restrictions that may apply.
It is the spirit of dana, freely offered generosity, which has kept the
entire Buddhist tradition alive for more than 2,500 years. If you find
this work of value, please consider sending a donation to the author or
publisher, so that these works may continue to be made available. May your
generosity contribute to the happiness of all beings everywhere.
DharmaNet International, P.O. Box 4951, Berkeley, CA 94704-4951
[end]
Return to The Skeptic Tank's main Index page.
The views and opinions stated within this web page are those of the
author or authors which wrote them and may not reflect the views and
opinions of the ISP or account user which hosts the web page. The
opinions may or may not be those of the Chairman of The Skeptic Tank.