August 2015
By Jamuna Rangachari
Hamlet’s classic dilemma is echoed in the debate governing the practice of euthanasia or mercy killing. Jamuna Rangachari casts a spiritual perspective on the vexed issue
The death of Aruna Shanbhag on May 18, 2015, in a hospital in Mumbai, after living in a vegetative state for 40 years, has triggered the debate on euthanasia once again in India. Before we examine this, we need to first understand what euthanasia is. Since euthanasia is about death, before we address it, we must understand what death, the only common destination we all have, really is.
Death – the common factor
Death is actually a natural process. Sri Sri Ravi Shankar points this out when he says, “Death is not something to be feared. It should neither be accellerated nor delayed but must be treated as a natural process. Thus it would be considered acceptable to remove life support in the case of a terminally ill person with the consent of all involved.”
In many ancient civilisations, including India, voluntary death was accepted. The Mahabharata refers to the Pandavas and Draupadi giving up their kingdom and embarking on mahaprasthana (the great departure) to meet death. Similarly, the concepts of samadhi and nirvana form part of the Indian heritage which recognise the right of an individual to leave his current body.
Sri Sri Ravi Shankar says, “Passive euthanasia was practised by the ancients, a prime example being Bhishmacharya choosing the time of his death. Ayurveda says that if the treatment cannot provide a person a quality life then it is better to give no treatment other than palliative measures.”
When the Buddha was asked about the morality of committing suicide or what we now call euthanasia, he did not criticise it. He emphasised, however, that only the uncraving mind would be able to move on towards nirvana, and emphasised only the state of the mind while deciding to terminate life.
Buddhism sees death as not the end of life, but simply a transition; suicide is therefore no escape from anything. In the early sangha (community of followers of the Buddha), suicide was in principle condemned as an inappropriate action. However, the early Buddhist texts include many cases of suicide which the Buddha himself accepted or condoned. For instance, his disciples, Vakkali and Channa, committed voluntary suicide in the face of painful and irreversible sickness. It is significant, however, that the Buddha’s acceptance was not based on the fact that they were in terminal states, but rather that their minds were selfless and enlightened at the moments of their passing.
Sallekhana is the Jain way of making death a time for contemplation and celebration, and not mourning. Every creature instinctively knows the time of its death. For instance, a tiger, when it knows that it is going to die, lies down quietly and refuses to eat. Sallekhana is a brave way to die, it is an embracing of the inevitable, instead of trying to run away from it.
Similarly, Prayopavesa, or fasting to death, is an acceptable way for a Hindu to end their life in certain circumstances. Like Sallekhana, Prayopavesa is very different from what most people mean by suicide. It is non-violent and uses natural means; it is used when the right time for this life to end approaches. Unlike the suddenness of suicide, prayopavesa is a gradual process, giving ample time for the patient to prepare himself and those around him for his death. While suicide is often associated with feelings of frustration, depression, or anger, prayopavesa is associated with feelings of serenity.
Some examples
Vinoba Bhave, who has been called the spiritual heir of Mahatma Gandhi chose to pass away voluntarily. He had done a lot of social work in his life, including that of the bhoodan movement that encouraged rich people to donate land to the poor. Declaring that he had completed his mission in the current life, he died on 15 November 1982, in Wardha after refusing food and medicine for a few days.
The mother of Satish Kumar, the editor of Resurgence magazine, performed sallekhana after living to a ripe old age. He has said, ‘After receiving permission from her guru, she went to all her relatives and asked their forgiveness. There was an air of festivity in our home as she began fasting. First she gave up food, and then water. After a few days, she died peacefully.”
Satguru Sivaya Subramuniyaswami, a Hindu leader born in California, took his own life by prayopavesa in November 2001. After finding that he had untreatable intestinal cancer, the Satguru meditated for several days and then announced that he would accept pain-killing treatment only and would undertake prayopavesa – taking water, but no food. He died on the 32nd day of his self-imposed fast.
These deliberate and dignified exits, chosen from a place of awareness and often even knowledge that one’s time had come, cannot compare with the emotionally loaded decisions that we call euthanesia, which are driven by unbearable physical or emotional pain. While no one can condemn another for choosing to end his or her suffering, instead of prolonging it beyond their capacity, there is the question of karma. Should we void the karma that has brought on this physical or mental condition by braving the pain and allowing death to occur naturally, or carry it over to another lifetime, by choosing to make a premature exit?
An article titled, Karma and Reincarnation on the website, www.himalayanacademy.com says:
“When a person is put on long-term life support, he must be left on it until some natural biological or environmental event brings death. If he is killed through euthanasia, this again further disturbs the timing of the death. As a result, the timing of future births would be drastically altered.
“Euthanasia, the wilful destruction of a physical body, is a very serious karma. This applies to all cases including someone experiencing long-term, intolerable pain. Even such difficult life experiences must be allowed to resolve themselves naturally. Dying may be painful, but death itself is not. All those involved (directly or indirectly) in euthanasia will proportionately take on the remaining prarabdha karma of the dying person. And the euthanasia participants will, to the degree contributed, face a similar karmic situation in this or a future life.”
At the same time, no one can deny the dying person or his family the choice of refusing aggressive methods such as the use of the ventilator. Doctors allow patients or their families to make this decision which is admissible by the law of this land.
Patients who cannot express
How does the question of euthanasia stand in the case of patients who are unable to make a decision themselves? People like Aruna Shanbhag, for instance?
Sohrab is clear that in such a case, it behoves the caregiver to do the best that they can till the soul decides to move on.
Knowing that her mother had deliberately chosen this condition for growth brought deep peace for Suma, who had been anguished at the suffering her mother was enduring. Her mother passed away a few weeks after this soul communication, and Suma experienced this as a completion.
Living will
Many caregivers find it hard to choose between life and death for their dear ones. In this scenario, it is a good idea to discuss this eventuality with one’s family and state one’s preference.
Sohrab states that his mother has told all of them that if she were not in a state to communicate, they should not put her on ventilator, but let her stay at home and pass away. If and when her time comes, Sohrab and his siblings are clear that they shall indeed honour her wishes.
This reminds me of the recent movie, Piku, in which the aged father tells his daughter that he does not wish to be put on ventilators, but to die at home. He does indeed die at home in accordance with his wishes.
The last thought
We must know that however ill we are physically, our mind and soul are still intact. The only way to elevate ourselves is to make the thought positive and hence, our soul pure. Sri Sri Ravi Shankar states, “There is something called ‘Ichaa Maran’. It does not matter how your life has been throughout but the last thought is very important. “
I remember how Suma used to play music for her mother round the clock. As a result, her mother looked peaceful and calm, despite her physical limitations. One can only surmise that her last thought would have been positive.
As far as Aruna Shanbhag is concerned, we do not know what she must have thought of at the last moment. We do know, however, that the nurses had taken good care of her and hence, I for one, feel she must have given a silent thanksgiving prayer to them before moving on to her next life.
In sum, the subject of euthanasia is complex and multi-pronged. While the spiritual and religiously sanctioned exits are governed by motivation and the consciousness of the person, respect for life and the role of karma compel us to proceed very carefully in this matter.
What would I choose? I would choose to brave the pain and go through the situation in the hope of voiding my karma. I would choose to move on naturally at the time that my soul decides.
Bio: Jamuna Rangachari is a writer who has authored three books for children, and compiled and interpreted Teaching Stories-I and II for Life Positive.
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