[Buddha-l] Buddhist Bioethics

[curt]

Does the family cite specific Buddhist teachings as the basis for
their claim that "their Buddhist ethics" compel them to continue
in this fashion? If there are priests or monks that the family is in
contact with perhaps they could be consulted with to better understand
where they are coming from. If the family is relying on counsel that
they are receiving from people they see as religious authorities then
there is probably little chance of changing their minds. But perhaps
the family has simply gotten this idea into their heads, or maybe one
especially outspoken person in the family is insisting on this. In a
case like that, a Buddhist clergy person that the family trusts might
be able to persuade them to at least consider other options.

But in what sense is the patient suffering? If she is not only unconscious,
but will never regain consciousness I am unclear as to how it can be
said that she is suffering and even being tortured? In my opinion, and
this is not at all substantiated by any Buddhist teaching that I know of,
a good case could be made that what is happening to what used to be
her body no longer has any effect on her whatsoever - she is probably
"somewhere else" by now.

- Curt

John Chamberlin wrote:

> 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
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