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Do you support assisted dying? What is the Boddhist POV?
hermitwin
Veteran
Do you support assisted dying? What is the Boddhist POV?
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My mother went over to Switzerland to say goodbye.
When everything is exhausted I would consider it the best of a bad situation. I am not sure what else to offer?
now if there is an assisted suicide where it is not the person "pushing the button" but someone else, then that gets a bit more complicated.. but as always intention matters.
regardless of the vipaka of the actions there should be no judgement of the people involved nor guilt suffered needlessly.
I am also against life support and "extraordinary methods" to prolong a life, especially at the time of extreme premature births, and births with overwhelming physical and/or mental disabilities.
Some of you may know/remember that I was married once, my wife died at age 25(I was 27, 35 now) after a long battle with cancer. There came that time when I was given the decision, do I intubate or allow them to drug her until she dies. Well I knew that even if I intubated she would still die eventually, but I knew her wishes and I knew her families wishes, so I followed them and allowed them to intubate her.
she "lived" another 18 days as the tumors kept getting larger, suffocating her lungs, eventually even modern science could not keep her alive anymore and she died while intubated.
so for me personally, in a case like that, DNR, in a case where maybe I had an accident and I had a 20% or more chance of recovery, then sure intubate me.
I could go either way (all puns intended)
The social uneasiness with suicide is reflected in Buddhism when it, like other spiritual persuasions, proscribes killing. But practice encourages any serious student to see clearly the ways in which s/he is already a killer... this breath or this mouthful of cereal or this blade of grass might be the very thing that would preserve another life, a life unwittingly taken in whatever moment is considered.
And so -- short version -- I would prefer not to kill but have to acknowledge my participation in killing. And suicide is one form of killing.
But Buddhism also encourages responsibility. Each is responsible, like it or not, for his or her own life. And practice, in one sense, grows students into their own responsibilities. It may be fun or restful to praise this or blame that, but the fun and rest don't last. Why? Because each is responsible and there's no getting out of it. Practice builds the muscles that allow individuals to stop seeing their personal responsibilities as onerous.
And perhaps responsibility offers a better lens for suicide than some others. True, it may rip your heart out, as it has mine, to see a young person commit suicide. Or a beloved person. Or an elderly person. In the state where I live, Massachusetts, there used to be and may still be a law against committing suicide ... which, when you think it through, is ludicrous: What are you going to do -- prosecute a corpse? But the law reflects the social distaste or even horror at the act. But notice that the horror or distaste is generally aimed at someone else's actions ... actions which are their responsibility. The heart may ache and the principles or beliefs may shudder, but still ... whose life is it? Was it foolish or an over-reaction or a piece of selfishness ... still, whose life is it?
I'm not suggesting here that we simply brush off what may be a sense of tragedy or turn a cold shoulder to those in desperate times. I am suggesting that wishing someone well does not need to include blinding the eyes. If suicide is the choice, then suicide was the choice and the best anyone can hope is that the person involved was as responsible as possible when making the choice.
If any of that makes much sense....
I'm so sorry about your wife, Jayantha.
My father recovered fully, with the exception of occasionally forgetting a word and suggesting another to replace it. Lived another 20 years without assistance, traveled, freely associated with old friends, did just fine. My mother had to deal with a heart condition, which was not easy, but she lived another 20 years also, traveled internationally, would often come up and visit me, and lived almost the entire "extra" 20 years without assistance.
Just sayin'.
I still don't know how guilty I feel as she only kept going because of me. She had said that if it got into her brain, she would jump off a bridge but didn't because of the pain it would cause me. She still smiled in those last days but were they enough to offset the pain she was in?
I don't know.
There are cases in the Pali Canon where monks have committed suicide — whether due to an incurable illness and unbearable pain, aversion and disgust with the body, etc. — but it's seems that only those who are free from greed, hatred and delusion are entirely blameless in such actions, i.e., there's only fault when one "gives up this body and seizes another" (MN 144). When it comes to our practical day-to-day lives, however, we're not always capable of being as stoic as we may wish to be, and enduring all of the difficult circumstances that life has to throw at us isn't always possible.
But even though I don't see this as a black or white issue, the Buddha himself was pretty adamant about where he stood on these issues, and the willful termination of someone's life, no matter the motivation, isn't something he condoned. If we look at it from the Buddhist perspective, we can see that to kill, to assist in killing or to even speak in favor of killing violates the spirit of the first precept. For example, the Vinitavatthu, which documents various cases related to the major rules in the Vinaya and gives verdicts as to what penalty, if any, they entail, includes two explicit cases, one involving euthanasia and the other involving capital punishment: However, according to Ajahn Brahmavamso, the Samantapasadika, Buddhaghosa's commentary on the Vinaya, states that there's no offense for a bhikkhu who commits suicide themselves when done for the appropriate reasons, of which two are given: While these particular rules apply explicitly to monks, the first precept is the same for lay followers, so it's reasonable to assume that all Buddhists should refrain from such actions as much as possible, especially since the weight of such kamma is so heavy.
That being said, the precept itself is only a guideline for our protection, not a commandment that's written in stone, and there's no kind of Buddhist excommunication for breaking it. It's always up to the individual to weigh all the options and their potential consequences before performing any action; and in the end, sometimes our decisions depend more on what we feel than on what we're told is the 'right' or 'moral' thing to do. Moreover, I disagree with the commentarial tradition of Theravada in that I believe (as do most Mahayanists) that it's possible a person can assist another in dying out of compassion or other 'skillful' mental states.
Things like incurable illnesses that cause great amounts of pain can even be unbearable for arahants, let alone the average individual, and it's absurd to expect that everyone should live up to some sort of rigid and idealized standard of morality that's placed upon human existence or exhibit superhuman endurance for the sake of piety. Furthermore, it's my opinion that individuals should have the right to do what they want with their own bodies, regardless of other people's moral values.
In my mind, the ending of one's own life is a personal choice that's the individual's alone to make, and denying a person that choice is equivalent to torture. So, yes, I support assisted dying. When it comes to animals and invalids, however, I think it gets a bit more complicated since we effectively have to kill them in order to end their suffering and they have little choice in the matter.
The patient's comfort is the goal of care. The patient's dying from cancer are given an IV drip of morphine, dilaudid or fentanyl for pain, often along with a sedative. The drip is titrated upward based upon the symptoms of discomfort. At a certain point, the patient is unable to remain alert or even semi-conscious without unbearable pain. The way we determine pain in a completely sedated person is by their elevated heart rate and respirations. We titrate the drips until the heart and respiratory rate are within more normal limits. That's the idea, anyway, and more than not, it 'works'.
The medical term for what I do for my comfort care patient is called "terminal sedation", and I don't need to explain that one. Many nurses have a hard time 'being the one' to turn up the drip, what if the patient dies right after?
No one knows, really, it's not something you can morally imagine doing a control and test group, but it's likely the patient would live a week or two, instead of three or four days, without the 'terminal sedation'.
A patient had a catastrophic stroke and as a result was 'locked in'; alert (mostly), aware, cognition and emotion apparent because he could move his eyes to the left on command and the staff learned the patient's needs by watching his eye movement when they spoke with him.
He did not want to live in this state, and his family respected his wishes. When all the children and friends were finished saying good bye, the nurse gave him 10mg of IV Morphine and 4mg of Ativan (a sedative). The patient slipped into unconsciousness. The ventilator was turned off, and the patient was given 20mg of Morphine, and another 20 mg every fifteen minutes until his heart ceased beating.
My state doesn't have an assisted suicide law (except that it is illegal), and the hospital I work in is Catholic. The hospital would decline to participate even if it were legal here. But they euthanized the man who had the terrible stroke. I have turned up the drip on too many patients to count at this point. I have pushed drugs into them and feared 'this would be it', and every now and then, it was 'it'.
I am anguished for the family, but you know, I can feel the patient too, after. Sort of. It feels like bursting light, relief, and I just stand there and touch them and feel so relieved for them, and not that I'd say it in most situations, so glad for them, because it's over.
So I guess I have helped a lot of people die, cloaked under the auspices of "comfort care" and "terminal sedation". I feel like I do something very, very important and valuable. I take regularly scheduled vacations every two months too, I learned the hard way about that. It's necessary, and important, and sometimes beautiful in that crazy spiritual way. I do not love my job. I do not love being a nurse. I have deep reverence for the role I end up fulfilling, but that's about it.
Gassho
I think it was mountains who said that he has known of many occasions in hospitals where practitioners will give a fatal dose to really terminally ill people.
But I want to be present in my death as an awareness practice. (easy to say at 36)
People like you, who do what you do.... you are the true courageous ones. The true heroes. Your post brought tears to my eyes. I too worked in the medical field, only I was not as courageous or heroic as you. I couldn't deal with the sorrow and grief of the family and friends; being constantly bombarded with (excruciating) emotional turmoil. Palms together in respect Hamsaka.... ((( and a hug, too )))
When you are paying that's a personal choice. When society is paying that's a social choice. I expect a lot of attention on this over the next couple years. If a person earns 1 million $s in their lifetime and costs 5 million to keep alive for an extra ten years, that is a hardship. If everyone does that, that is a disaster. We will be talking about quality of life years versus cost of care. Letting people die will become the norm and I suspect society will look down on the few greedy rich who want to pay to keep themselves alive at their own expense-because they can-while others can't. Personally I plan a DNR because my life is great but no so important that I want to put others to great expense.
If anyone hasn't seen it, I highly recommend watching The Sea Inside, based on the life (and death) of Ramon Sampedro Camean:
[LINK]
here's more, turn on captions for english subs.
True enough. When you have private care and you are paying the decisions you make often wipe out your estate and leave your heirs with nothing. That is a choice and with private insurance you can pay a higher premium or get catastrophic only insurance and
leave your heirs less. With socialized medicine the choice is no longer in your hands.
Funny-with insurance you don't pay so there is less reason to be healthy and live clean. But, on the other hand society might just let you go and there is nothing you can do about it. One thing is for sure: just letting old people die is a lot cheaper and is a good place to look for savings. I'm 66 so I am not being callous. But true is true.
You see we have socialized medicine here in Canada. Of course that does not mean it is free. I pay a monthly premium. And it certainly isn't the best. Wait times are ridiculous.
But I buried both parents under this system, so I'm wondering how your statement relates to my experience. Actually I should say that we put them down under this system, because that's how it seemed to me at the time.
Thanks.
There ain't no such thing as a free lunch. "free" medicine is paid by someone somewhere and in my travels abroad in the last 10 years I've heard many stories like @robots from various countries. No system is perfect, but I'd much rather have more freedom in the hands of doctors and myself, then from government bureaucrats.
We pick our own doctors. Although part of the problem with the wait times is a lack of specialists and equipment, which is probably due to budgetary constraints that you don't get in a private system. So in reality for most people choosing a specialist isn't possible.
When our daughter was born the luck of the draw had it that there was a real asshole of an obstetrician on duty. It was his way or the highway. I'm not sure what we could have done to have some control over that situation.
There was no bureaucratic interference in the care of my parents at the end. There was some talk about how we would go about putting them down with drugs, due to certain laws we have about euthanasia.
But that was discussed quite openly with the doctors.
since I don't want this to turn political, I'll let you respond then I won't respond back. I try to stay way from politics on this forum but it's hard for humans to give up views , I guess if we were all advanced dhamma practitioners we wouldn't even be on a forum to express views haha.
Translation: I don't want people who have never been able to afford dental care to now be able to afford it and be able to have it, since it may inconvenience me.
If that ain't being selfish, I don't know what is.
So, yes, when it is needed, I support assisted dying.