Buddhism stems from the teachings of the Buddha Mahatma Gautama Shakyamuni who lived in Northern India around 500 BCE.* Buddha is not worshipped as a god but revered as an inspiration of how people can transform their lives. There are various Buddhist traditions. The ancient civilisations of India and China were profoundly affected by Buddhism and today it remains deeply fluential in Sri Lanka, Burma, Thailand, Korea, Japan and the countries of the Himalayas; as well in areas of India settled by Tibetans in exile.
The Buddha's words were transmitted orally through his followers and later formulated into teachings which Buddhists call the Dharma. These teachings were eventually written down and transmitted to anyone who wished to hear them. Buddhism encourages its followers to develop wisdom and to have compassion towards all forms of life. The Buddhist path involves meditation, practice and study leading to 'Enlightenment'. This path is eightfold and defined as:
There are five basic precepts and these are:
Shortly before his death at the age of 80, the Buddha brought together a group of his followers and founded a religious order — the Sangha — which has remained both the guardian and the embodiment of his teachings to this day.
These three aspects — the Buddha, the Dharma and the Sangha — are known to all Buddhists as the Three Refuges or the Three Jewels. For a sincere Buddhist they point to the practical path of spiritual awakening.
*Before the common era. This is often referred to as BC (before Christ)
Most Buddhists have a positive attitude towards healthcare staff and are willing to seek medical help and advice when sick. Buddhists generally are willing to take any medicine that helps. Some Buddhists will be wary, and will wish to know the effects of any drug that alters their emotional state or clarity of mind, because of the fifth precept. However, the idea of the fifth precept is to prevent people carrying out harmful acts while intoxicated, so they usually accept prescribed medication that may be intoxicating but also heals or reduces suffering. Nevertheless, some Buddhists may favour alternative health remedies or may be reluctant to accept sedating medication.
Most Buddhists practise meditation, and it may be helpful to offer access to a quiet area for this, or to allow chanting of prayers or sacred texts.
Many Buddhists are vegetarian or vegan, due to the first precept and respect for other sentient beings. Some may follow a precept that involves eating only one main meal a day. This is usually eaten before midday. However, some Buddhists are non-vegetarian as the Buddha asked his monks to eat whatever they received.
If their health allows, some Buddhists fast on new moon and full moon days and on specific festival days such as Buddha's birthday, his death day, his enlightenment, his first sermon and others. Some Buddhists may also eat only one main meal a day (see diet).
Washing and toilet present no unusual problems for Buddhists.
The manner of consideration for the dying will depend on the Buddhist group. If you need specific guidance about a patient's particular school of Buddhism, or want to arrange counselling from a fellow Buddhist practitioner, then you should find out from the patient or family which specific form or school of Buddhism the patient practises. You can then seek out local contact details.
The most important consideration relates to the patient's state of mind at the time of death, for this wilI influence how they experience the intermediate or 'bardo' states and thereafter the character of rebirth. Nearing the time of death, the state of mind should ideally be one of peace, so the patient may wish to meditate and ask for a quiet place. They may wish for a Buddha figure close by and may use a candle or incense stick. Some may ask for counselling from a fellow Buddhist, with recitation of prayers or sacred texts.
Some Buddhists may express a strong wish to die at home rather than in hospital. If possible this should be granted. Healthcare staff should discuss in full the practical implications of this decision with the patient and relatives if terminal illness is diagnosed.
After death, in many schools of Buddhism there is no ritual requirement and normal hospital procedures are accepted. However, some Buddhists hold strong views about how the body should be treated after death. It would be helpful to ask about such views before death occurs, to avoid unnecessary distress to relatives and friends.
After death, the main Buddhist tradition is for the family to request prayers from the sangha (usually a monk, lama, nun, priest or order member) of the appropriate school of Buddhism and perform certain actions and dedicate them to the dead person. Particularly for practitioners of Vajrayana Buddhism — most commonly in Britain, Tibetan Buddhism — an experienced Buddhist practitioner may perform the special Buddhist practice of Powa or ejection of consciousness.
Some patients and relatives may object to a post mortem due to the belief that the mind may stay in the body for some time after the heart has stopped, and interfering with internal organs may undermine the optimal dissolution of consciousness; therefore the body should not be moved for 72 hours.
Buddhists can dispose of a dead body by any of the four elements (earth, air, fire and water) whichever is appropriate to the country and people. Traditions vary as there are different schools of thought. However, most Buddhists are cremated and the body should be disposed of within three to seven days.
The most important consideration relates to the patient's state of mind at the time of death, for this wilI influence how they experience the intermediate or'bardo'states and thereafter the character of rebirth. Nearing the time of death, the state of mind should ideally be one of peace, so the patient may wish to meditate and ask for a quiet place. They may wish for a Buddha figure close by and may use a candle or incense stick. Some may ask for counselling from a fellow Buddhist, with recitation of prayers or sacred texts.
There are no unusual customs surrounding the birth of a child. Although in some countries they may ask for the umbilical cord to be salted and placed in an earthern jar.
There is no established doctrine about family planning for Buddhists, although they are generally reluctant to tamper with the natural development of life. A Buddhist may accept all methods of family planning, but with different degrees of reluctance. The worst of all is abortion or'killing a human to be'. This is seen to be harming a living sentient being. Pills and condoms are much more acceptable, though many prefer condoms. Generally all Buddhist traditions condemn abortion and euthanasia.
There are no religious objections to blood transfusions, but attitudes amongst Buddhists to organ transplants vary. Many will have no religious objections, since helping others is fundamental to Buddhist belief — and all consider organ donation during life an act of compassion. However, some Buddhists may decline to offer organ donation after death because they believe the mind may stay in the body for some time after the heart has stopped (see death customs).