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Cultural Awareness in Healthcare

Buddhists: Issues For Buddhist Healthcare Staff

working on holidays

On festival days, Buddhist healthcare staff may, as lay people, observe the practice followed by monks and nuns in Theravadin monasteries where one daily meal is eaten before midday. This should not interfere with the working day, although some staff may choose to spend festivals celebrating with the Buddhist community (the Sangha).

meditation

An individual's meditation schedule is flexible, and should not have any effects on the working day.

determining the moment of death

Tibetan Buddhism explains the process of death in eight clear stages. At the fourth stage, breathing stops (when the air element dissolves), but death has not yet occurred as the consciousness still exists for up to three days. There are signs indicating that this has happened: heat is no longer emitted from the heart, the body begins to emit an odour and a small amount of fluid leaves the sexual organ or nostrils. The body should not be moved until the consciousness has left the body. Individual Buddhists will have their own views as to whether they wish to treat non-Buddhist patients in this way.

organ donation

Organ donation is still a subject under some debate, but it may be possible to discuss organ donation with the family of the deceased without causing offence. Possibly, harvesting organs would disturb the process of dissolution that takes place after death, and would be considered undesirable.

However, the good karma that a person would gain by helping someone else to live after their own death may offset the perceived dangers of disturbing their body too quickly. Although most Western Buddhists now consider organ donation to be a good thing, some healthcare workers may have concerns about it.

termination of pregnancy

The termination of a pregnancy is believed to be unethical by many Buddhists, who generally consider that a foetus is alive from the moment of conception, or at least within several days. 'Aliveness' occurs when three conditions are present – sperm, egg and consciousness – and life is seen as beginning from the time that they join together. Most Buddhists would consider the decision to have an abortion a very serious one.

If testing reveals that a foetus will be born with Down's syndrome, for example, some Buddhists may believe that the condition has arisen from the karmic actions in a previous life, and that the individual should be born to undertake the consequences of those actions.

However, this position is considerably softened in Western Buddhism. Here, termination would still be seen as an unethical action, but may in some circumstances be less unskilful than, for example, allowing a woman to die during pregnancy. Cases may have to be examined on their individual merits, and it is worth consulting a Buddhist priest if this situation arises.

As a student doctor (or nurse), a Buddhist may refuse to be involved in the termination of a pregnancy. Buddhist doctors are unlikely to enter into a speciality that involved termination; however, if they do, they may again refuse to terminate a life.

post-mortem

Technically, Buddhists should not have any issues with carrying out a post-mortem because the fleshy shell of a person is not held in great reverence once their consciousness has departed it. However, as some Buddhists believe that it takes at least three days for the consciousness to leave a body and that no disturbance or movement should take place during that time, a quick post-mortem could endanger this process.

Thus, whether a post-mortem can be performed by a Buddhist on a Buddhist might depend on whether the body had been at rest for up to three days. If a Buddhist mortician, pathologist or student doctor believes that they are unable to perform post-mortems on bodies that have not been at rest long enough for the consciousness to have departed, then this may become an issue in some cases.

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