I must preface this post by saying I do not know all that much about Buddhism.  In recent years, I have been spending time learning what I can about pre-Qin Chinese thought, a historical period well before Buddhism entered China.  So, I offer the ideas below in the hopes that any readers who understand or practice Buddhism might comment and correct me if I am wrong.

    This story was on the front page of today’s Boston Globe:

After Buddhist dies, legal battle continues

Kin, hospital  split on when  death occurs

The family of 72-year-old Cho Fook Cheng of Brookline knew there was no chance that he would ever wake  up again.

Last week, doctors declared Cheng, a grandfather
of seven who suffered cardiac arrest the day after Thanksgiving,
brain-dead and said it was time to remove him from the ventilators and
intravenous medicines keeping his organs functioning.

But the
family refused to let doctors take Cheng off the life-support system
because his heart was still beating. They said their belief as
Buddhists was that Cheng’s beating heart meant his spirit and
consciousness was not ready to move on. Taking him off life support,
they said, would be the same as killing him.

The Chengs hired a
lawyer and obtained a restraining order against the hospital; Beth
Israel Deaconness Medical Center Friday took Cho Cheng’s wife, Joyce,
and his son, Henry, to court to get an order allowing doctors to remove
life-support systems.

    First, let me say that I have every sympathy with the Chengs.  I know well just how difficult it is to face the death of a loved one, and how agonizing end of life decisions can be.  Their desire to keep their father alive is completely understandable.  The story continues: ultimately the Chengs agreed to cut back his medications and he died.  The legal battle goes on, however, as the Chengs are bringing actions (not well specified in the article) against the hospital.

     What baffles me is the invocation of Buddhist principles here.  Further on in the story we have this:

One complication is that there are different Buddhist understandings
of death, said John J. Makransky, a professor of Buddhism at Boston
College.

"Tibetan Buddhism is the one that is the most renowned
for the understanding of death," he said. "Within the Tibetan Buddhist
system, there are different levels of consciousness, levels that may
not be measured by scientific methods. Even if someone is brain-dead,
there may be a level of consciousness communicated by the heart
beating. Even if there is no measurable activity in the brain, there
still could be consciousness."

While Buddhism is not a
centralized religion, all Buddhists believe in rebirth, said Makransky,
when consciousness becomes associated with another life after it leaves
that body. For such a spiritual achievement, a peaceful state of mind
in death is important to the Chengs in their Taiwanese form of
Buddhism, Jing Tao Chung, Unitt said.

    As I suggested before, I have no good basis upon which to judge these assertions, though it is certainly reasonable to expect that there are diverse Buddhist positions on these kinds of questions.  And, again, I do not doubt the Chengs sincerity.  But, in this case, the "beating heart" and the "consciousness" of Mr. Cheng were the result of "artificial" means of life support.  It would seem, to me, that it was reasonable to turn off the ventilator and stop his medications, even in terms of Buddhist understandings.

    I would imagine that, for Buddhists (and here is where I could be getting onto thin ice), a "natural death" would be one that did not depend upon IVs and ventilators.  This, of course, would not preclude Buddhists from pursing "extraordinary" or "heroic" care.  Rather, it would presumably mean that withdrawing such measures would be acceptable under the kinds of circumstances the Chengs faced.  After all, discontinuing artificial means would bring an individual closer to his or her "natural" state and that is when a determination of consciousness would be possible.

    My own views are now colored by Taoism and Confucianism.  In this case, Taoists – or, I should say, Taoists who are influenced by Chuang Tzu’s notions about the end of life – would accept the withdrawal of extraordinary measures.  Confucians might disagree, wanting to make sure, as the Cheng’s were trying to do, that the honor and dignity of the family member were respected.  Again, in this case, given the imminent deterioration of Mr. Cheng’s body, I think Confucians might also agree that the time was right to turn off the ventilator. 

      Of course, for any particular case, these sorts of general theoretical understandings might be very hard to apply.  The Chengs were trying to make sure their father was respected – and we all must respect that.

    But, I wonder if they were acting more on Confucian impulses than Buddhist tenets. 

    I look forward to comments from readers who might add to these considerations.