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Cultural Awareness in Healthcare

Buddhism Dying

Buddhists believe that dying is part of an ongoing natural cycle and not an end to be scared of. Although the body will decay and dissolve, consciousness continues in some form, leading – unless Enlightenment has been gained – to a new being arising in dependence on the one who has died.

A Buddhist who knows that they are dying will probably wish to have their family and friends around them as much as possible, and may spend a lot of time sitting and meditating on what is about to happen. They will need as much peace and quiet as possible – if possible, it would be best to send the patient home. Friends and family may chant mantras and meditate with the patient, supporting them in their efforts to meet death in a mindful and aware state.

terminal illness

If an illness has advanced to the stage where no cure is possible, some Buddhists may consider life should be allowed to run its natural course; thus, pain relief, life support and other medical treatments may be refused. However, treatment will probably be accepted if it offers the hope of recovery, because it will prolong life and increase the chances of Enlightenment being attained in this lifetime.

For Buddhists, one of the greatest acts of kindness is to help a person attain a positive state of mind in preparation for death. As with all terminally ill patients, emotional and physical support should be given – pain relief (if requested), respect, compassion and time alone to contemplate their life and death, and to meditate. If patients have difficulty practising meditation owing to their state of health, assist them or arrange for a member of the Buddhist community to visit.

living wills

Situations may arise where a patient no longer has control over the course of their own death owing to unconsciousness or disability and a 'living will' may be created. It may be suggested that a living will relieves medical staff and family of the responsibility of making difficult decisions and allows a patient to die in peace. In some cases, it may be better to discuss this issue with family members, if present, rather than discussing the subject directly with the patient; alternatively, talk to the patient's priest or a member of their Buddhist community. However, in the case of Western Buddhists, frank communication about a patient's situation would normally be the most skilful and welcome course of action.

life support and resuscitation

Buddhists believe that death is inevitable and all part of the cycle of birth, death and rebirth. Thought may extend to the idea that life should be allowed to run its natural course and medical intervention, such as resuscitation, would interfere with this. Conversely, prolonging life to achieve the ultimate goal of Enlightenment may be the view taken.

talking to the family

It may be necessary to discuss with the family what the wishes of the patient would be should they become unconscious (see 'living wills'). If the family members are Buddhists, they should be asked if they would like some time and privacy for prayers and mantras.

prayer

At the moment of death, the state of mind is of great significance in Buddhist practice. Meditation and chanting of mantras by the patient, their family and friends will calm the mind in preparation for death, and may also be used as a form of pain relief

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