[Buddha-l] Buddhist Bioethics

[John Chamberlin]

Buddhist Bioethics:  If I might impose on the group on a matter of  
Buddhism and bioethics, I think it might be useful in helping us  
resolve a difficult bioethics case. I work as a clinical social  
worker on a palliative care team at a large community hospital in  
California. I’m also a member of the bioethics committee at this  
hospital and a practicing Buddhist. We currently have a case that has  
been referred to the committee by the attending physician. The  
patient is an 82 year old, Vietnamese female who is in a vegetative  
state as a consequence of several massive strokes. She’s on a  
ventilator and all the other life-prolonging technology that might be  
expected.  She’s been living at a nursing home for the past three  
years. In the opinion of the physicians attending the patient she has  
no chance at recovery, or even in recovering to any extent that might  
improve her quality of life.  This patient is on a feeding tube of  
course, and consistently aspirates her food causing pneumonia and  
frequent, repeated hospitalizations among other medical complications  
common to patients in vegetative states.

  The patient as well as her large, multi-generational family are  
Buddhist. The attending physician referred her to the committee,  
because the family continues to insist that all life-prolonging  
measures and hospitalizations be continued, despite the fact that the  
patient is slowly declining in health, and despite the fact that she  
will never regain consciousness. Repeated CT and MRI scans of her  
brain have shown terrible and irreparable brain damage as a result of  
her strokes. The attending physician’s ethics are compromised,  
because he must continue to provide futile care (as defined as  
medical care which has no chance in restoring the patient to any  
measure of health) at the dictates of the patient’s family, and the  
patient is suffering greatly as a consequence of the situation. The  
patient has no signed advance directive as to her own wishes, so the  
physician, by California state law, must follow the wishes of the  
next-of-ken.

The family continually sites that their Buddhist ethics prohibits  
withdrawing the patient from the life-prolonging technology. The  
family is aware that the patient is suffering and is essentially  
being tortured by her caregivers as her life continues to be  
prolonged by technology.

In my layman’s understanding of the Eightfold Path, behaving in ways  
that will directly cause the suffering of another being is to be  
avoided? I realize that this case is more complicated than this, but  
perhaps this is a good place to start. What is the stance of Orthodox  
Buddhist ethics in this case, and is there anything any one can add  
that might help us resolve this sad situation?

Thank you,

Jack Chamberlin