The Lotus Sutra and Health Care Ethics
By Robert E. Florida
Professor of
florida@brandonu.ca
Contents
Buddhist Medical Ethical
Principles
Autonomy
Non-maleficence or Ahimsa
Justice
Compassion and Beneficence
Veracity
References to Medicine in the Lotus Sutra
Conclusion
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In the last several years there has been an increase in interest in the field
of Buddhist ethics, particularly health care ethics. In this paper I will
review the medical implications found in the Lotus Suutra. I will first discuss
some general ethical principles that apply in health care with reference to the
Lotus Suutra, and then go on to specific references in the sutra to medicine.
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Buddhist medical ethical principles
In traditional Buddhist societies, medical ethics, as a
systematic formulation of principles and their application to cases, has not
been a major concern. That is not to say that Buddhists have ever ignored
illness and health care. On the contrary, the metaphor of the Buddha as the
supreme physician, who cures the ills of the world and of the individual
sufferer, is ancient and major in the Dharma (1). Furthermore, caring for the
sick both within and without the monastic order has been understood as an
excellent way to manifest such primary virtues as compassion and friendship.
Nonetheless, it is only recently that there have been
attempts to work out systems of health care ethics in Buddhist
contexts (2). One of the latest and most ambitious is Buddhism and
Bioethics by Damien Keown (3). His general theoretical approach is based
mainly on Theravaada primary texts, and centres Buddhist ethics on three
"basic goods": life, knowledge (prajna), and friendship (4). These
three values inform the next lower level, the level of precepts or ethical
rules. Precepts in turn guide decision-making in specific ethical situations.
Respect for life (ahimsa), the first of the "basic
goods" according to Keown, is doubtless one of the pillars of Buddhist
ethics and generally pervades the Lotus Suutra. It is a key to Buddhist health
care ethics and will be discussed below. Knowledge (prajna) as the second
"basic good" or core principle of Buddhist ethics in Keown's analysis
is also very generally acknowledged as central in Buddhist thought. Prajna is
both the supreme paramita in the bodhisattva path and the culmination of
cultivation of mind in Theravaada traditions. It pervades the Lotus Suutra.
Prajna is often coupled with karuna (compassion) as summing up the Mahaayaana
or bodhisattva path. Together, artfully supporting one another, they lead the
practitioner to realise his or her Buddha nature. Upaaya (skilful means), a
fundamental theme which runs throughout the Lotus Suutra, can be understood as
identical to karuna.
Keown, however, takes friendship rather than
karuna/upaaya as the third "basic good" (5). Friendship as a Buddhist
ideal, he argues, is a complex bundle of rules, virtues, behaviours, and the
like which guide us in our relations with all other living creatures.
Friendship includes compassion (karuna) when appropriate, but much more as
well. Identifying friendship as a basic Buddhist good is one of the innovations
(a fruitful one in my view) in Keown's book. In the Lotus Suutra the qualities
of friendship that Keown describes are found in the relationships between the
various characters. For example, the parable of Devadatta in chapter twelve
shows the efficacy of friendship, which goes beyond one particular lifetime
into future incarnations to enable a very wicked man to realise his true
nature, his Buddhahood.
Other attempts to develop Buddhist health care ethical
theories are generally both less complete and more conventional than that of
Keown. One approach has been to try to fit Buddhist and other traditions' ideas
about health care into four principles: autonomy, beneficence/non-maleficence,
justice, and autonomy (6). These four principles have been very useful to many
Western theorists, which is not surprising as they are drawn from Western
philosophical, political, and medical sources. But do they apply well in the
Buddhist context (7)?
Dr. Pinit Ratanakul of
In Dr. Ratanakul's 1986 book Bioethics: an Introduction
to the Ethics of Medicine and Life Sciences, he takes fidelity to the medical
profession, autonomy, beneficence, non-maleficence and justice as the
"prima facie duties" that underlie bioethics (8). He does not develop
them from Buddhist texts, traditions, or arguments. Rather they come from the
Western philosophical and medical traditions.
Interestingly enough, in a later journal article,
"Bioethics in
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Autonomy
Dr. Ratanakul describes autonomy as the ability of an
individual "to order, plan, and choose among the diverse human
potentialities, the pattern of their own lives, as long as it is consistent
with meeting the rightful claims of others upon them and the fulfilment of
their responsibilities as moral agents" (11). In traditional Buddhist
ethics, autonomy is not featured as a major category. The Buddhist emphasis on
the responsibility of each person for his or her own karma or moral character
implies something like this notion; however, there is something in the modern
Western insistence on autonomy that goes against the Buddhist grain. While Dr.
Ratanakul is careful not to fall into extremes, individualistic autonomy is
contrary to the central Buddhist insight of co-conditioned causality, which
insists on the interdependency of all beings. It is particularly at odds with
the bodhisattva ideal of sacrificing self for others that is at the heart of
the Lotus Suutra At any rate, we note that in his later formulation, autonomy
has dropped from Dr. Ratanakul's list of fundamental principles.
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Non-maleficence or ahimsa
Non-injury to living beings must, I think, be central to
any Buddhist medical ethical system. As Dr. Ratanakul put it, "In a
Buddhist society it is well known and accepted that a primary obligation is
non-injury to others" (12). Non-injury to life (ahimsa) applies to all
sentient life, but otherwise is the same as non-maleficence, which in the
Western world has usually referred only to human life, although this may be
slowly changing now. As mentioned earlier, Keown also identifies ahimsa as a
basic concept at the foundation of Buddhist bioethics. Obviously, it is very
powerful as a general principle in health care ethics and, as noted above,
pervades the Lotus Suutra.
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Justice
In his 1988 article Dr. Ratanakul identifies justice as a
basic Buddhist teaching and singles it out as one of the
fundamental principles on which to base a Buddhist
bioethical system for
This concept of justice is a modern Western one; compare
it to Gillon's formulation in Principles of Health Ethics where justice is
"often regarded as synonymous with fairness, and reasonably summarised as
the moral obligation to act on the basis of fair adjudication between competing
claims" (14). In practice, he continues, justice is based on the principle
of equality for all persons and is discussed under three headings:
"distributive justice" or fairness in the allocation of resources,
"rights-based justice" or respect for individuals' rights, and "legal
justice" or reliance on fair legal codes and procedures.
Traditional Buddhist sources have very little to say
about justice. Buddhaghosa, for example, a Theravaadin scholar of the fourth or
fifth century CE, who may be the greatest exegete that Buddhism has produced,
does not seem to mention justice at all in his masterpiece, the Visuddhimagga
(15). Tachibana, in his still valuable 1926 path-breaking book The Ethics of
Buddhism, attempts to formulate a comprehensive ethical system from the texts
of Theravaada Buddhism. In the early parts of his book, he stays very close to
the traditional terminology and formulations, and does not mention justice at
all. Then he changes his tack and decides to reformulate Buddhist ethics
according to modern categories. "This is firstly to make the moral ideas
of the Buddha clearer, and secondly to see how far a moral system designed
twenty-four centuries ago can appeal to the modern mind" (16).
Justice appears as a major category in his modern
reformulation, but he notes that it is not at all easy to find precise
equivalents from the Buddha's time to our own twentieth century for such basic
terms as justice, righteousness and impartiality (17). In effect, he seems to
admit that he was unable to show that justice is a fundamental ancient Buddhist
principle of social ethics. Nonetheless, recognising that justice is a keystone
for any ethical system which is to appeal to people shaped by modern Western
thought, he goes ahead in a very appealing but not quite convincing way to use
justice in his scheme of Buddhist ethics.
A review of current work in the field of Buddhist ethics
generally confirms the impression that justice is not a fundamental category of
understanding in Buddhist thought. First, in the 1991 book Buddhist Ethics and
Modern Society, a compendium of papers from a major international conference of
Buddhist scholars, justice is only mentioned in one passage, in the
contribution of Sulak Sivaraksa, the noted Buddhist reformer from
Both Gunapala Dharmasiri's Fundamentals of Buddhist
Ethics (19), which appeared in 1989, and Damien Keown's The Nature of Buddhist
Ethics (20), a 1992 title, fail to discuss the issue of justice as such
although there are indirect discussions of related issues. Two major books in
the field appeared in 1995. The first, Buddhism and Bioethics by Damien Keown,
is interesting for its complete lack of any discussion of justice (21). The
term itself, I believe, does not occur. Keown restricts his field of sources to
the Pali texts and thus does not draw upon historical or ethnographical
material. David Kalupahana, on the other hand, in his Ethics in Early Buddhism,
which mines the same sources as does Keown, devotes chapter fifteen to
"Law, Justice, and Morals" (22). There he argues that dhamma
(Sanskrit: dharma), which is one of the most fruitfully pregnant terms in
Buddhism, is the equivalent of "justice." At one level this is true,
but I think the equation is ultimately misleading, since "justice" in
the context of ancient
First is the more or less democratic order of monks, and
second is lay society for which a universal king, following the ancient Indian
model, whose job it is to turn the wheel of Dharma for the world, is offered as
the ideal ruler. Neither of these forms, in my opinion, has much to do with
justice as understood in contemporary Western countries such as
Kalupahana argues that both the polity of the monks and
the underlying basis for the universal wheel-turning monarch are consistent
with John Rawls' view of the foundations for achieving a just society (23). I
would agree with both Sulak and Kalupahana that there is indirect support for
ideas of social and individual justice in Pali text Buddhist traditions. Or
perhaps it would be better to say that there is no contradiction between
Buddhist traditional teachings and the modern Western concepts of justice.
Since Buddhism has been very successful in adapting itself to all sorts of
social realities, and since we seem to be in an era where Western social forms
are increasingly dominant, perhaps it will be the work of Buddhists in the
twenty-first century to synthesise Buddhadharma and justice.
Such a synthesis may well be different from the current
egalitarianism in Western theories, if not practices, of justice. I have not
found much evidence for egalitarian justice as a major theme in Buddhist
tradition. Consider, for example, the way that Buddhaghosa interpreted the
precept against taking life:
"Taking life" is then the will to kill anything
that one perceives as having life…insofar as the will finds expression in
bodily action or in speech….In the case of humans the killing is the more
blameworthy the more virtuous they are. Apart from that the extent of the
offence is proportionate to the intensity of the wish to kill. (24)The severity
of the offence is a function of the amount of virtue of the victim, hardly an
egalitarian concept.
Dharmasiri notes that although the Buddha rejected the
caste system and taught that all persons are equal in that they are subject to
the same moral law and in that every person is a potentially enlightened being
(25), he also taught that class society is inevitable. Classes do not have
equal rights and duties; rather they "should have reciprocal moral
relationships with each other" (26). Indeed, this seems to be the major
principle behind social relationships in traditional Buddhist countries and is
quite consistent with the teaching of the Lotus Suutra. The basic model is
paternalistic, as is very explicit in the case of the king, who, the Buddha
taught, should rule according to Dharma, "treating his subjects as parents
treat their own children" (27). Some of the parables of the Lotus Suutra,
such as the parable of the rich man and his sons in the burning house (chapter
three), the jewel in the gown (chapter eight), and the skilled physician
(chapter sixteen) spring to mind as powerful teachings in favour of patriarchy.
These ancient, traditional social teachings do, however,
strongly support the provision of adequate health care for all people, even all
living creatures, in society. The higher individuals in the reciprocal
relationships have a duty to be concerned for the welfare of those in their care,
and this most definitely includes health matters. For example, masters are
taught to give their servants help in times of sickness (28); and at the
highest level, the king's first duty to his subjects is to give them "help
when and where it is needed, i.e., a material or verbal or manual help"
(29).
In Buddhist political thought, the Dharmaraja (the king
who rules by righteousness or by Buddhist principles) or cakravartin
(literally, the wheel-turner, or the king who turns the wheel of righteousness)
is the ideal ruler (30). The royal precepts and virtues enumerated above are
drawn from that tradition. Asoka, an emperor in India who reigned in the third
century BCE, is the king revered today as the one who most nearly embodied the
Dharmaraja ideal, and he was very vigorous in promoting non-harming as a
principle of governance and as a way of life for his subjects. As well, he took
great interest in the physical welfare of his subjects and provided medical
herbs to be distributed free of charge to the people of his kingdom and also to
the animals (31).
It seems that justice in the egalitarian sense does not
have a firm base in Buddhist traditional thought. Perhaps a sounder Buddhist
case for an equitable distribution of health services could be built on the
foundations of karuna (compassion), a fundamental virtue for all Buddhists,
friendship as a "basic good" (borrowing from Keown), and on the
noblesse oblige expected of the ideal Buddhist monarch, all of which seem to be
consistent with the teachings of the Lotus Suutra. All three of these entail
helping the poor: karuna and friendship as primary virtues should motivate
individuals, whether commoners or royal, and the state should manifest the
ideals of the Dharmaraja, the king who rules according to the teachings of the
Buddha (32).
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Compassion and beneficence
Compassion is one of the most fundamental Buddhist
categories, so fundamental that the entirety of the tradition can be described
as compassion (karuna) and wisdom (prajna) working together. It is important to
keep in mind that the two are linked and one without the other is dangerous.
For example, a person who is not wise may cause enormous problems by witlessly
attempting to be compassionate, and a person who has penetrating insight
without compassion is very dangerous indeed.
In order to help one attain this balance, to make sure
that the practitioner develops skilful means (upaaya), certain sublime states
of mind are cultivated in Buddhism. There are four of these taught by all schools
of Buddhists and recognised as necessary for living a moral life, generating
kusala karma, or skilful deeds, rather than the opposite. The four are loving
kindness for all sentient beings, compassion for the unhappiness of others,
sympathetic joy for the happiness and good fortune of others, and equanimity
(33). On the level of practice, the Lotus Suutra could be interpreted as no
less than an extended sermon on how to live the transcendental bodhisattva path
by using skilful means compassionately, thus embodying the four sublime states
just detailed. Were a nation to be governed according to these impulses, its
health care system would be a most excellent manifestation of Buddhist
beneficence.
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Veracity
The fourth principle which Dr. Ratanakul sees as
essential in Buddhist biomedical ethics is veracity, which he firmly bases on
another of the five basic moral precepts: "I undertake to observe the rule
to abstain from false speech." In applying this precept to medical ethics,
he concludes that one must always tell the complete truth to the patient.
Failure to disclose the truth is generally, he argues, due to denial and fear
on part of medical personnel. If the patient does not know all the facts of his
or her condition, then his or her "strength, will-power, and
endurance" (34) will be compromised. Buddhists know that life is hard and
full of suffering and have always taught that these truths must be dealt with
frankly and openly. Hiding from the unpleasant side of things is not part of
the Buddhist way.
This insistence on veracity fits in very well with the
current doctrine in Western medicine that the patient as an autonomous moral
agent has a responsibility for his or her own health and care. However, in the
Mahaayaana tradition, there is rather different approach to the issue of
veracity. In chapter sixteen of the Lotus Suutra, there is a parable where the
Buddha compares himself to a skilful physician. All his sons have foolishly
taken some powerful, poisonous medicine. Those who are most deranged by the
poison refuse to take the antidote which he has quickly prepared. Therefore, he
deceives them by feigning his own death, thereby shocking them back into their
right minds so that they will take the remedy. Lord Buddha rhetorically asks
the assembly, "Is there any man who can say that this good physician is
guilty of the sin of wilfully false speech, or is there not?" And they
reply: "There is not, O World-Honored One" (35). In his discussion of
the Lotus Suutra in his recent book of readings, Buddhism in Practice, Donald
Lopez demurs from the judgement of the assembly. He argues that "the claim
to legitimacy of the earlier tradition is usurped by the Mahaayaana through the
explanation that what the Buddha had taught before was in fact a lie"
(36), albeit a compassionately motivated lie. Too strong by far (37), but it
does point to an interesting question: is it not possible for the doctrine of
skilful means, in less than skilful hands, to lead in a direction away from the
Dharma? The parables of the Lotus Suutra are taught as examples of upaaya or
skilful means. It would seem that deception on the level of relative truth is
quite justified as long as it advances the cause of absolute truth and, as in
the story of the skilful physician, is beneficent. Of course, if a deception
led to harm of sentient beings, it would be unskilful rather than skilful.
Thus, in Mahaayaana thought at least, a case could be made for the health care
team withholding the truth or even deceiving a patient if such withholding or
deception was thought for good reason to be therapeutic.
This sort of paternalism is no longer stylish in the West
and many current health care ethicists reject it, including Dr. Ratanakul, who
writes, "The practice of paternalism in regard to truth-telling is
therefore unacceptable to Buddhism" (38). Although his argument for
veracity on medical, general ethical, and Buddhist grounds is strong, it
nonetheless seems to me that his conclusion is overstated, especially in regard
to the Mahaayaana. Medical paternalism may be justifiable in traditional
Buddhist societies, which accept that society is to be governed by ancient
hierarchical principles enshrined in the texts and traditions of Buddhism. It
certainly is the current practice in
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References to medicine in the Lotus Suutra
(1) Parable of the skilful physician
This parable, which occurs in chapter sixteen, is perhaps
the most relevant and important passage in the Lotus Suutra in regard to the
practice of medicine.It has been discussed above.
(2) Parable of the medicinal herbs
Chapter five consists of a lovely parable about how
beneficent waters nourish all plants without discrimination, whether they are
tiny medicinal herbs or awe-inspiring giant trees. In the Chinese version of
the text, the one which is influential in the Far Eastern Buddhist communities,
there does not seem to be anything in this chapter that applies to medicine or
medical ethics. The Sanskrit version (translated by Hurwitz and Kern) ends with
a lengthy parable that is interesting in this regard. In this parable a man who
has been blind from birth relies on his own experience to deny that there are
any shapes at all in the world to be seen. A compassionate and supremely
skilful physician takes pity on this man and collects and prepares four
wondrous herbs which restore the man's sight. Seeing heavenly bodies for the
first time, he now claims to be all-seeing and to have attained perfect
extinction. Wise seers quickly correct him and point out how ignorant he
actually remains.
This parable makes use of the classical metaphor of the
Buddha as the supremely skilled physician. It could be taken as a practical
example for all Buddhists, who should emulate his compassion by applying their efforts
and skills to treating the ill. It is also making one of the primary points of
the Lotus Suutra, that those who follow the lesser of the three vehicles need
to be reminded that they are a long way indeed from the ultimate goal.
(3) Bodhisattva-mahasattva Medicine King
The bodhisattva Medicine King (Bhaisajya-raja) occurs in
several places in the Lotus Suutra. These passages seem to foreshadow the
celestial Medicine Buddha (Bhaisajya-guru), who became very important in the
Buddhist traditions of the
Chapter ten on the Teacher of the Law begins with the
Lord Buddha addressing the assembly through the bodhisattva Medicine King, but
I find no medical references at all in the chapter. Similarly chapter thirteen
on Holding Firm begins by mentioning bodhisattva Medicine King as part of the
audience, but has nothing in it about medicine. Some of the Buddha's previous
existences are covered in chapter twenty-three, a very interesting chapter in
which the bodhisattva offers his entire body, his arms, and his fingers out of
reverence as fire offerings, a practice which was frequently emulated up until
recent times (41). Near the end of chapter twenty-three there is a
reference to the medical efficacy of the Lotus Suutra: anyone who hears it will
be cured of sickness, old age, and death.
In the Dharani chapter, chapter twenty-six, the
bodhisattva Medicine King offers a dharani for the protection of those who
preach the Lotus Suutra. The spell has no medical references. However, in the
same chapter, a horde of female demons offer a dharani that protects men,
women, boys, and girls against all manners of demonic beings and against all
manners of fevers. The final mention in passing of the bodhisattva Medicine
King, along with his brother Medicine Superior, is in chapter twenty-seven
dedicated to these two bodhisattvas' father. There are no medical references.
In summary, it appears that the passages about the
bodhisattva Medicine King, rather surprisingly, tell us little about the
practice of medicine or of medical ethics.
(4) Medical benefits to those who revere the Lotus Sutra
and medical penalties to those who do not respect it
Both chapter fourteen on bodhisattva practices and
chapter eighteen on the benefits of joyous response to the Lotus Suutra detail
the health benefits which accrue to those who have joy and faith in the Suutra
itself. As noted earlier, chapter twenty-three mentions similar wonderful
effects.
On the other hand, those who slander or disparage the
Lotus Suutra have much to lose. In chapter three there is a passage that says
that anyone who speaks badly of the teachings shall be afflicted with all sorts
of congenital deformities and illnesses. Furthermore, he or she will be unable
to heal anyone else, and any medical attention he or she receives will exacerbate
the condition treated. At the very end of the Lotus Suutra—perhaps the
placement of this passage is a sign of its importance—terrible medical
results are promised for those who disparage believers of the Suutra.
Blindness, deformity, or leprosy will be their fate for generation after
generation.(5) Bodhisattva practices
Chapter fourteen details appropriate activities for one
who is cultivating the bodhisattva path, and chapter twenty-five is a
marvellous account of how a bodhisattva of great attainment, namely
Avalokitesvara, is able to help anyone who calls on him in a time of need. I
find it interesting and somewhat surprising that medical matters are completely
absent from both sets of practices. However, in the introductory chapter,
bodhisattvas are commended for offering hundreds of different kinds of
medicines to the Buddha and his monks.
(6) Inquiries about the health of the Lord Buddha
The appearance of the jewelled stupa in the sky in chapter eleven and the
emergence from the earth of an astounding number of bodhisattvas in chapter
fifteen are examples of the very exalted nature of buddhas in the Mahaayaana.
It is a little jolting to find similar simple inquiries about the health and
vigour of the World-Honoured One:
Is the World-Honoured One at ease,
With few ailments and few troubles?
In instructing the all the living beings,
Is he free from weariness? (42)
It is very strange to me that one so inconceivably splendid could possibly
be ill or weary, and thus these well-meaning inquiries seem out of place.
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Conclusion
In the study of ethics in the West there is widespread
agreement, perhaps an emerging consensus, that certain
principles—autonomy, beneficence, non-malfeasance, and
justice—apply prima facie to health care issues. Not all of these four
principles fit into a Buddhist framework. Two of them, however, do fit well.
Non-malfeasance and the Buddhist principle of ahimsa (non-harming) appear to be
practically identical. Furthermore, karuna (compassion), which perhaps is the central
ethical principle of the Buddhist tradition, is very similar indeed to
beneficence. Autonomy is also important in Buddhist practice, but, as argued
above, is not central, and there are important differences both in theory and
in application to health care from the way it is understood in the West.Justice
seems to be the sticking point. Egalitarian justice is not part of traditional
Buddhism, although justice in health care can be approached using other
Buddhist ideas and practices. As noted in the introduction, Buddhism has a
wonderful flexibility, enabling it to adapt to and to learn from new
situations. It is noteworthy, I think, that converts to Buddhism in the Western
world, eastern Buddhists who have settled in the West, and those like Dr. Ratanakul
who have been influenced by Western thought, are tending to make justice a
central Buddhist value (43).
"Cease to do evil, learn to do good, cleanse your
own heart," the catch phrase which is popularly used to sum up the essence
of Buddhism, suggests how important non-malfeasance, beneficence, and
self-reliance or moral autonomy are in Buddhist thought. All three are aspects
of karuna (compassion) and upaaya (skilful means), the qualities necessary to
function well in the world as a Buddhist. These relative qualities must, of
course, work in conjunction with prajna (wisdom), insight into absolute truth.
To be true to the Buddhist tradition, any theoretical system of health care
ethics must be based on wisdom and compassion, and all applications should manifest
skilful means. The underlying principles of the Lotus Suutra are consistent
with these, and the parables and references to medical matters offer some
specific guidance. At the present, with the tremendous changes and challenges
taking place in the heath care field, Buddhist thought, by applying wisdom,
compassion, and skilful means to both theory and practice, can make a
tremendous contribution to bioethics.
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Editions of the Lotus Suutra consulted
Bunno, H., W. E. Soothill, et al., trans. The Threefold Lotus Sutra.
Kern, H., trans. SadDharma–Pundarika, or the Lotus of the True Law.
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Notes:
1. Raoul Birnbaum, The Healing Buddha (Boulder: Shambhala,
1979). Return to text
2. The Journal of Buddhist Ethics, vol. 3 (1996), has six
papers from the 1995 American
3. Damien Keown, Buddhism and Bioethics (New York: St. Martin's Press,
1995). Return to text
4. Ibid., pp. 43ff. Return to text
5. Ibid., pp. 51ff. Return to text
6. Raanan Gillon, ed., Principles of Health Care Ethics
(Chichester: Wiley, 1994). This very large book attempts to apply the four
principles across the board around the world with varying success. For a good
discussion of the four principles see the editor's introductory essay,
"Medical Ethics and the Four Principles." Return to text
7. What follows in the remainder of this section is based
upon my paper "Buddhism and the Four Principles" in Gillon,
Principles, pp. 105–116. Return to text8. P. Ratanakul, Bioethics: an
Introduction to the Ethics of Medicine and Life Sciences (Bangkok : Mahidol
University, 1986), p. 86. Return to text
9. P. Ratanakul, "Bioethics in
11. Ratanakul, "Bioethics: an Introduction," pp.
83–84. Return to text12. Ibid., p. 54. Return to text
13. Ratanakul, "Bioethics in
14. Gillon, "Medical Ethics," Principles, p. xxv. Return to
text
15. Buddhaghosa, The Path of Purification
(Visuddhimagga), 2 vols. (Berkeley and London, 1976), Lamotte, Histoire du
Buddhisme Indien, vol. 1, (Louvain: Universit du Louvain, 1976), pp.
25ff., and several other basic source books yielded nothing on justice as an
early Buddhist concern. Similarly,
17. Ibid., pp. 264–265; see A. L. Basham, The
Wonder that was India (New York : Grove Press, 1959), pp. 114–117 and
passim, for an indication of how very different the ancient Indian concept of
justice is from the current Western notion. Return to text18. Sulak
Sivaraksa, "Buddhist Ethics and Modern Politics: A Theravada
Viewpoint," Buddhist Ethics and Modern Society: An International
Symposium, ed. Charles Wei-hsun Fu and Sandra A. Wawrytko (New York: Greenwood
Press, 1991), pp. 163–64. Return to text19. Gunapala Dharmasiri,
Fundamentals of Buddhist Ethics (Antioch, California: Golden Leave, 1989).
Return to text
20. Damien Keown, The Nature of Buddhist Ethics (New York: St. Martin's
Press, 1992). Return to text
21. Damien Keown, Buddhism and Bioethics. Return to text
22. David J. Kalupahana, Ethics in Early Buddhism (Honolulu: University of
Hawai'i Press, 1995). Return to text
23. Kalupahana, Ethics, p. 125. Return to text
24. E. Conze, trans. Buddhist Scriptures (Harmondsworth: Penguin, 1959),
pp. 70–71. Return to text25. Dharmasiri, Fundamentals, p. 62.
Return to text
26. Ibid., p. 61. Return to text
27. S. B. Indr, "The King in Buddhist Tradition," Buddhism in
Thai Life, p. 61. Return to text
28. Phra Dhammadhajamuni, Outline of Buddhism, 2nd. ed. (
29. Ibid., p. 53. Return to text
30. S. J. Tambiah, World Conqueror and World Renouncer: a
Study of Buddhism and Polity in
31. Basham, Wonder, pp. 53–57, 500. Return
to text32. It seems to me from my time in
33. S. Taniguchi, A Study of Biomedical Ethics from a
Buddhist Perspective (
35. L. Hurvitz, trans., Scripture of the Lotus Blossom of
the Fine Dharma (New York: Columbia University Press, 1976), p. 240.
Return to text
36. Donald S. Lopez, Buddhism in Practice (Princeton, New
Jersey: Princeton University Press, 1995), p. 29. Return to text
37. Nikayo Niwano, A Guide to the Threefold Lotus Sutra
(Tokyo: Kosei, 1981), pp. 110ff., provides a good corrective to Lopez's
position. Return to text
38. P. Ratanakul, "Bioethics in
39. E. Ohnuki-Tierney, Illness and Culture in
Contemporary
41. Lopez, Practice, chapter 36; Paul Williams, Mahayana
Buddhism: The Doctrinal Foundations. (London and New York: Routledge, 1989),
pp. 154–155. In the introductory chapter to the Lotus Suutra it is noted
with approval that bodhisattvas give their own flesh, hands, and feet as
offerings. Return to text42. Bunno Kato, W.E. Soothill, et al., trans.,
The Threefold Lotus Sutra (Tokyo, New York: Kosei, Weatherhill, 1975), p. 239.
Return to text
43. F. Eppsteiner and D. Maloney, eds. The Path of
Compassion: Contemporary Writings on Engaged Buddhism (Berkeley, California and
Buffalo, New York: Buddhist Peace Fellowship and White Pine Press, 1985). This
book is a good introduction to this phenomenon. Return to text.
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