[Buddha-l] Buddhist Bioethics

[jkirk]

I sympathize with this predicament, as I know of another similar case. The 
mother of a Chinese woman friend had a similar stroke and is in a nursing 
home in coma.  I don't know the latest medical review, but it seems that she 
is not going to recover from the coma, and/or if she did her life would not 
be much of a life, she might not even have all her marbles. Her daughter is 
not a Buddhist, sheis even an theist, but she's strongly governed by 
Confucian ethics of filial piety, and so she will not ask the medical staff 
to remove the tubes and oxygen tank. She will just continue to pay for her 
mother's care.

In S.E.Asia (Vietnam in this case) as in China, both Buddhism and Confucian 
ethics are strong within the kin groups. S.E.Asians often say that "we are 
Buddhists" but what they don't say is that they are also Confucianists. Even 
if they are not aware of it, it's a strong part of the cultural ethics. 
Thus, the hospital has a double whammy of culture to deal with.

My guess is that even if some Buddhist construction could be found to allay 
their dread of allowing the patient to die, the shame engendered by filial 
piety would prevent it as an ethical resort. For everyone's sake I hope a 
way out can be found. Perhaps something helpful could be found in discourses 
on Confucian ethics.

Best wishes,
Joanna Kirkpatrick
================================


----- Original Message ----- 
From: "John Chamberlin" <jchamberl at cox.net>
To: <buddha-l at mailman.swcp.com>
Sent: Saturday, August 20, 2005 6:10 AM
Subject: [Buddha-l] Buddhist Bioethics


> 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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