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[PD5-55] Buddhist Care for the Dying in Australian Society Diana Cousens Honorary Research Fellow, Monash University (Australia) In February this year I joined a convoy of 500 Vietnamese people in eleven buses for an all-day tour across Melbourne, visiting eight Buddhist temples that are large enough to accommodate 500 visitors in one sitting. All of these temples were built in the last ten to fifteen years, though some had predecessor temples that were older than that. The temples belonged to the Cambodian, Sri Lankan, Chinese, Vietnamese and Tibetan Buddhist traditions. The tour is an annual event that commemorates Vietnamese/Chinese New Year. The new year tour celebrates the strength of Buddhist identity in Melbourne and the cross-ethnic nature of that identity. In Australia, a new society, any tensions between different groups, for example, between the Cambodians and Vietnamese or the Tibetans and Chinese or the Mahayana and Theravada, is irrelevant. We are all Buddhists and that is enough. Such a non-sectarian approach to Buddhism is possible because most Buddhists in Australia are immigrants in a new country or newly converted Anglo-Australians. It is more important to find points of common interest and concern than to worry about lingering rivalries from centuries past. The establishment of Buddhist temples is the most visible sign of the recent establishment of the Dharma in a new land. Temples that are able to accommodate 500 visitors must cost well over a million Australian dollars, perhaps several million. The temples represent a major commitment from communities often largely composed of immigrants, many of whom are newly arrived. In the case of migrants from Indochina, most arrived less than 30 years ago as refugees. Temple building is admittedly very important, but the focus of my paper is on other, perhaps less obvious ways of ensuring that Buddhist religious practice is possible. As citizens of a country, we must engage with the rest of society – the courts, hospitals, prisons, schools, universities, the workplace – and there may be situations in these contexts that require the special characteristics of a Buddhist approach. There have been occasions of major disagreement between Buddhist practice and the norms set forth in Australian law. For example, in the Australian courts, people are given a choice of swearing to tell the truth on the Christian Bible or making an affirmation. In 2002 the State Government of Victoria undertook an “Inquiry into Oaths and Affirmations with Reference to the Multicultural Community.” Two other members of the Buddhist Council of Victoria and I appeared before the Inquiry as expert witnesses. Past practice in the courts had seen an uneven availability of the non-Christian affirmation. Some communities were able to swear on a holy book other than the Bible. During the Inquiry, the Islamic Council declared that it was inappropriate for Muslims to swear on the Korani and we contended that it would be preferable not to swear on a Buddhist book. The court room is a secular environment and in a Buddhist context religious oaths are usually done in conjunction with a religious practice. It seems that the attempt to find “holy book” alternative to the Bible has been undertaken to accommodate past court practice and the expectations of court officials. This expectation has been accommodated for the sake of simplicity and to avoid the need for justification and explanation. ii In our case, we contended Buddhists do not have a practice of swearing on statues or texts. iii Furthermore, there is no one Buddhist book that should be used in court, because Buddhist sacred texts vary both within and among Buddhist countries, not to mention complex issues of language. We proposed that the Buddhist oath should make reference to the commitment to refrain from lying, not to the Buddha. In a secular environment, we proposed that the Buddhist oath should be very simple. Our suggestion was, “In accordance with the Buddhist precept of truthful speech and mindful of the consequences of false speech, I (name), do solemnly, sincerely, and truly declare that I will tell the whole truth and nothing but the truth.” The Inquiry was also considering the proposition that the courts present only one non-religious oath for everyone. We contended that it would be more appropriate for different kinds of oaths to be made available to different kinds of people. For those who believe in God, for example, it is more evocative to include a reference to God. We were pleased to see that a recommendation of the Inquiry was that legally binding oaths be in accordance with different religious beliefs and practices, and that the court should make available a list of oaths which are considered acceptable.iv As Buddhists in Australia, we are given opportunities to look at and change customary practice in many contexts, such as in this case in the courtroom. Customary practice in any society is often invisible, because it is considered “normal.” Australia had a large Chinese Buddhist community during the gold rush in the mid-nineteenth century, but Buddhists had nearly disappeared until the influx of Asian migration that took place from the 1970s. The discovery of Buddhism by Anglo-Celtic Buddhists dates to about the same period. Therefore public institutions have largely been informed by a Christian, European, usually British, sensibility. Acceptance of the idea of Australia as a multicultural society – an idea that has gained momentum over the last 30 years – has provided an opportunity to change customary practice. There have been some significant occasions when the law, Australian customary practice and Buddhist sensibilities have been at odds. The most startling of these occasions arose in 1993 as a result of the death of a Tibetan Sakyapa lama, Gyalsay Rinpoche, in Canberra, Australia’s capital city. On the night before his death, he gave a Medicine Buddha empowerment. Prior to that, he had complained of a severe headache for several weeks. During the night a blood vessel burst in his brain and he died of a stroke. In the morning he was found dead in his bed by his students. There were no other Tibetan lamas in Canberra at that moment. The students were shocked and, feeling at a loss, called the ambulance in the hope that he might be revived. They also contacted the head of the Sakya tradition, His Holiness Sakya Trizin. His Holiness’ advice was that the body should not be moved, that certain prayers should be performed in the presence of the deceased, and that an autopsy should be avoided. Meanwhile the ambulance arrived and the students notified the police that they wished to complete the prayers before the body was taken away. The police showed some patience and negotiated the removal of the body with the students. After a few hours, two lamas came from Sydney and performed further prayers in front of Gyalsay Rinpoche’s body at the morgue. The lamas reassured the students that Rinpoche had died of a “wind stroke,” and that his consciousness had left the body straight away. Therefore, they said, it would not be disruptive to perform an autopsy, even thought the head of the Sakya tradition had said it was preferable to avoid an autopsy. The students met with the Attorney General, the coroner, the doctor scheduled to perform the autopsy, representatives from the Office of Tibet, and Rinpoche’s own doctor. The law required an autopsy but it could be limited to Rinpoche’s head. The Attorney General also said the law could be changed. Later that day he announced that an inquiry would be held into the ACT Coroner’s Act. The body was embalmed, with students performing Buddhist prayers in the funeral parlor during the embalming. The body was then flown back to Rinpoche’s monastery in India for burial.v This episode came as a shock to the whole Australian Buddhist community. We had no preparation for the death of a lama. Australian law and customary practice did not favor a Buddhist point of view or Tibetan cultural expectations. The key Buddhist concerns were not to move the body, to provide an opportunity for religious practice, and to avoid an autopsy. Other concerns were that primacy be given to the preferences of Buddhist spiritual leaders, such as the head of the Sakya tradition and the lamas who came from Sydney. Australian law gives rights to family members, whereas from a Tibetan Buddhist perspective the responsibility for ensuring appropriate practice lies with religious authorities. In the case of the death of a Buddhist monk or a nun who has left the household life, family members may be fairly peripheral in the scheme of things. There is a parallel in Australia, in that exceptions are given to Aboriginal and Torres Strait Islanders, among whom custom and tradition may also give responsibility to a person outside the family. Another consideration is that many Australians also have spiritual beliefs which are not shared by their family members. The Inquiry into the Coroner’s Act resulted in amendments that reflect some of these concerns that were put into effect in 1997. In determining whether the coroner should order an autopsy or the removal of a body, the statute now reads that the Coroner may “have regard to the desirability of minimising the causing of distress or offence to persons who, because of their cultural attitudes or spiritual beliefs, could reasonably be expected to be distressed or offended.”vi This is a big step forward, but an awareness of the importance of spiritual authority for Buddhists at the time of death remains unlegislated. My discussions with friends in Canberra who played a part in managing the death of Gyalsay Tulku and changing the law there, and my role on the Buddhist Council of Victoria, inspired me to develop a small publication that would assist Buddhists at the time of death.vii The result of this was the booklet, Buddhist Care for the Dying. Because of Australia’s multi-ethnic Buddhist community – reflected in the many kinds of large temples already mentioned – it seemed a good idea to ask the major Buddhist communities for advice about appropriate procedures at the time of death. I formulated a simple questionnaire that asked the following questions: In your tradition, when a person knows they are going to die, is there any particular method of preparation that will help them? In your tradition, what are good things to do around or for a dying person? What are things to avoid doing around a dying person? Are there any particular rituals, ceremonies, or procedures that dying people must do or have done for them before they die? Can you please tell us any particular prayers or mantras that a dying person should repeat or have repeated in his or her presence? Is it helpful or disruptive to the dying person to have relatives present at the time of death? Is there any particular way that the body should be handled or treated after death? (Such as a period of not touching it or not touching particular parts of the body?) Is it acceptable in your tradition to have an autopsy conducted if there is some uncertainty as to the cause of death? Is it acceptable to use parts of the body for organ donation? What is your preferred method of disposal of the body? What is the most beneficial thing to do for a person after they have died? The answers to these questions from members of different Theravada groups overlapped, so a separate Theravada section was compiled. Among the Mahayana respondents, who were Japanese, Chinese, Tibetan, and Vietnamese, we found a wide range of responses. It seemed advisable to respect the differences and include each of these answers separately. The sponsor of the publication was the Yung Yang Temple, a Taiwanese Chinese temple in Narre Warren. The temple’s abbot suggested that the Chinese and Vietnamese sections of the booklet be translated into those languages. At a fairly late stage in the booklet’s development, the chair of the Buddhist Council of Victoria and I visited the chair of the Victorian Multicultural Commission who agreed to fund 2000 copies of the booklet and distribute it to every ward in every hospital, prison, medical teaching establishment, and welfare office in the state of Victoria. The largest cemetery in Victoria, the Necropolis, distributed 250 booklets to all the funeral directors in metropolitan Melbourne. The Necropolis is simultaneously developing a large Chinese Buddhist section of the cemetery, with landscaping done in accordance with Feng Shui principles. So the question may be asked: How does the advice in the booklet differ from Australian customary practice? In what sense will it change behavior in a hospital? How will it help caregivers of Buddhists who may not be Buddhist or who may have a vague family affiliation with Buddhism without much depth of understanding? An implicit assumption in all the advice offered is that the dying person is preparing for the next life. There is a shared emphasis among all respondents about the importance of maintaining a peaceful environment, of not fighting or crying, of creating a spiritual atmosphere through the repetition of mantras, prayers, or guided visualizations. The Vietnamese interviewee, Ven. Thich Phuoc Tan, counseled that the time approaching death was a time to repent, purify the mind, and affirm the practice of going for refuge in the Triple Gem. He advised playing tapes of chanting and placing an image of the Buddha in front of the dying person. The Chinese recommended doing good deeds on behalf of the dying person and transfering the merit. These recommendations represent a rather complex process of preparation, in contrast perhaps to a medical emphasis on minimizing pain. Most Buddhists in Australia are ethnically Vietnamese or Chinese. To another question, the Chinese interviewee said that a dying person should not be resuscitated and should not be moved for eight to ten hours after death. Both of these recommendations differ from ordinary hospital practice. The booklet emphasises the assistance that can be given by a monk or a nun. It poses the question: Is it helpful or disruptive to the dying person to have relatives present at the time of death? This question does not assume the primacy of family relations and answers to the question varied. The Tibetans answered, “At the point of death, seeing relatives may be upsetting.” The Vietnamese answered more indirectly, “Do not do anything that may cause anger to arise.” Theravadin Buddhists advised that the person should be consulted on this point ahead of time, but, in any case, family members should not upset the dying person. As a practitioner of Tibetan Buddhism, my understanding is that organ donation is something to be avoided, because pain may be experienced even after clinical death. I was surprised to find, however, that most Buddhist traditions are not disquieted over the prospect of organ donation. The Tibetan informant simply offered, “No comment.” Perhaps this was a skillful answer, since there is great deal of debate about this topic and reasons can be given to support both sides of the question. The Chinese answer was more precise, “Normally organ donation happens as soon as the person passes away or is just about to pass away, so unless the person has a very strong will to overcome the physical pain, it is suggested to avoid organ donation.” However, responses from the Theravadin, Vietnamese, and Japanese communities all endorsed organ donation, assuming the donor agrees. I wonder whether organ donation would be acceptable to those who are concerned about the possibility of pain after brain death if the person was anaesthetized, since normally there is no perception of the body under anaesthesia However, normal medical practice would not assume a need for anaesthesia in the case of a person determined to be clinically dead. All the Buddhists consulted treated the issue of autopsy as a matter for the law, with one proviso from the Tibetan informant – “[It] does not matter once the person is definitely dead.” – and one from the Chinese informant – “It should be avoided in the first eight to ten hours after death.” The issue of determining the time of death is perhaps key to refining this debate. The Tibetan point of view is that a person is not really dead until the body begins to decompose, which is evident when the body begins to smell. Another idea implicit in the booklet is that a deceased person still has significant needs. This does not accord with Australian customary practice; even the reformed ACT Coroner’s Act was primarily concerned with minimizing distress to survivors.viii All of the advisors for the booklet recommended that some form of meritorious activity be performed on behalf of the deceased after death. Theravadins recommended that donations be made to monks and charities in the name of the deceased and all the Mahayanists recommended 49 days of prayers and additional practices, such as observing a vegetarian diet, giving donations to charity and religious groups, releasing animals, and planting trees. A unique idea was offered by the Japanese informant, who explained that wealthy people hold memorial services with their family and a Buddhist priest annually or every five years, for up to 50 years. He also commented: It looks like these ceremonies are for the deceased, but in fact they are for the people who have survived. If all the family and people who are connected to the person come together and have a dinner together than it means that everything is going well and peace is maintained. A memorial brings the past and the present together and gives a chance for some reflection. If there has been a misfortune then people can come together and be reconciled. It reduces the karma of the deceased person.ix Gathering for memorial services is considered beneficial to both the deceased and their survivors. The bulk of the advice in the booklet is very practical. I avoided any emphasis on the esoteric dimensions of Buddhist practice. The booklet is aimed at caregivers, not practitioners in retreat. Serious practitioners know that the time of death may provide an unparalleled opportunity for meditation on the nature of mind, since many of the distractions and confusion of bodily experience are absent. However, most Buddhists are not highly advanced meditators. In a society that does not discuss death freely, openly, or often, it is perhaps useful to begin the discussion on a practical level. One of the aims of the booklet is to begin the conversation, to face this most difficult issue, and to ask how can we do things better. When the booklet was launched, one of the speakers was Dr Ian Gawler, who also wrote the foreword to the booklet. He talked about the death of his mother when he was a teenager, and said that if anyone wanted to write a book about how to handle death badly, they could just follow what happened in his family. The loss was not discussed and everybody was just expected to get over it. The booklet does not talk about how to manage grief and loss, but perhaps by learning to provide better care for the dying, those who remain behind will not be haunted by anxieties about all the things they should have done but didn’t. A large proportion of people born in Australia are born to parents from other countries. Many of these people do not remember traditional cultural practices related to dying because, as the second generation, they have assimilated into the mainstream. And those of us who have become Buddhist by choice are still very much in the process of learning. A week after the booklet was launched, Daniel Andrews, the MP who launched it, announced in Parliament: “This valuable resource is an important recognition that in order to treat someone with dignity, we need to understand and respect that which is of value to them. The booklet will help us meet that important challenge.” He described the booklet as a “valuable resource in the provision of culturally appropriate health_care in Victoria.”x Perhaps another way of seeing all this is that bringing the Dharma to the West requires many strategies. The Buddhist Council of Victoria recently joined with the Buddhist Councils of New South Wales and Queensland to establish the Federation of Australian Buddhist Councils (FABC). The establishment of this Federation is a way of creating a national umbrella body that can represent Buddhist interests to the Federal Government, though thus far the FABC has not received that level of recognition. Surprisingly, one of the first things Buddhists need in order to be officially recognized as a religion in Australia is a wedding ceremony, so one of the first actions of the FABC was to create a wedding ceremony. Perhaps marriage is not one of Buddhism’s defining features, but in order to fit into the Australian cultural understanding of what constitutes a religion, such a ceremony is required. Buddhism in Australia is at a very early stage and we still have a long way to go. Buddhists need beautiful temples, inspirational stupas, impressive art work, translations, and collections of texts. We need facilities to seriously study our various scriptures, so that we can have an enlightened and educated understanding of the Dharma. We need opportunities for meditation and retreat. We also need to work together with other Buddhists and with established institutions in the larger society to find ways to include Buddhist understandings and reform institutions and practices which do not meet Buddhist needs. NOTES i Victorian Parliament Law Reform Committee, Inquiry into Oaths and Affirmations with Reference to the Multicultural Community (Melbourne, Government Printer, 2002), pp. 81-83. ii Ibid., p. 83. iii Ibid., p. 81. iv Ibid., p. xx. v Ann Pickering, “Respecting Spiritual and Cultural Beliefs About Death – An Australian Buddhist Case Study,” a talk delivered to the Conference on Human Rights, Faith, and Culture, hosted by the Association for Baha’i Studies in Canberra, Australia, November 7-8, 1998. vi The Coroners Act, ACT, Section 28. quoted in Ibid., p. 6. vii Cousens, Di, Editor, Buddhist Care for the Dying, published by the Buddhist Council of Victoria, Footscray West, 2004. viii Pickering, “Respecting Spiritual and Cultural Beliefs About Death,” p. 6. ix Cousens, op cit., p.18. x Victorian Hansard, March 3, 2004.
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