Describing anything as ‘Buddhist’, including in this case
law of the universe, and the acts that lead to bad karma,
a distinctively Buddhist bioethics, is fundamentally prob-
such as killing, stealing, lying, sexual misconduct and in-
lematic from both a historic and Buddhist point of view.
Historically, the Buddhist tradition has evolved in dozens
The problem with Buddhist ethics as natural law is that
of countries for 2500 years, with no one tradition having
the soteriological goal is one of liberating oneself from the
clear doctrinal authority over the others. Internally, even if
constraints of karmic causality to become an enlightened
a common Buddhist ethics was implicit in the practices of
being. The traditional anthropological explanation of this
the dozens of Buddhist cultures or the exegetics of their tra-
paradox has been to ascribe the natural law ethics of kammic
ditions, the core philosophical insight of Buddhism is that
reward and punishment to the laity and the nibbanic path
all things are empty of essential, authentic being, including
of escape from natural law to the monastics (King, 1964;
the Buddhist tradition. So, starting from the understanding
Spiro, 1972). More recent scholars (for instance, Keown,
that there is no authentic Buddhist bioethics to explicate,
1992; Unno, 1999) have challenged this dichotomy and ar-
and only a constellation of practices and ideas related to
gued that monastic ethics have always revolved far more
medicine and the body among Buddhists throughout his-
around the exchange of accumulated merits for alms than
tory, which may or may not be tied to core ideas of the
Buddhist tradition, we can interrogate the tradition for the
Nonetheless, the Buddhist ethical tradition does argue
lessons it may hold for contemporary bioethics.
for an escape from all mundane karmic constraints, and the illusions of material existence, to achieve a state of per-fect wisdom and compassion. Damien Keown, (1995) the
BUDDHIST ETHICS
leading Western scholar explicating Buddhist bioethics, calls this a ‘teleological virtue ethics’. As in Aristotelian
There is a vigorous debate among Buddhist scholars about
virtue ethics, Buddhists are to strive for the perfection of a
the correspondence of Buddhist ethics to the ethical tradi-
set of moral virtues and personality attributes as their prin-
tions of the West, and three traditions have the strongest
cipal end, and all moral behaviour fl ows from the struggle
resonances: natural law, virtue ethics and utilitarianism.
to perfect them. But unlike the Aristotelian tradition, the
The Western natural law tradition holds that morality is
ethical goal for Buddhists is teleological because they gen-
discernible in the nature of the world and the constitution
erally believe that a fi nal state of moral perfection can be
of human beings. In the Buddhist cosmogony all sentient
achieved. As virtue ethics, Buddhist ethics focuses on the
beings cycle through multiple rebirths, infl uenced by their
intentionality of action, whether actions stem from hatred,
past moral behaviour, karma. When the Buddhist properly
greed and ignorance, or insight and empathy.
understands the structure of mind, the effects of immoral
In the Mahayana tradition the being who embodies these
behaviour in creating suffering in this life and the next, and
virtues is the bodhisattva, who strives to relieve the suffer-
the importance of sila or moral discipline as the basis for
ing of all beings by the most skilful means (upaya) neces-
release from suffering, morality is the only rational choice.
sary. As the bodhisattva is supposed to be insightful enough
In this sense, Buddhist ethics are grounded in the natural
to understand when ordinarily immoral acts are necessary
Principles of Health Care Ethics,Second Edition Edited by R.E. Ashcroft, A. Dawson, H. Draper and J.R. McMillan 2007 John Wiley & Sons, Ltd
to alleviate suffering, and it is either willing to assume the
asserting that beliefs and practices that are shown to be
karmic consequences or is not subject to the karmic conse-
unscientifi c and not empirically supported should be set
quences of such acts, the consequentialist utilitarian tradi-
tion is also especially compatible with Buddhist ethics. The utilitarianism of J.S. Mill is most resonant with this interpre-tation of Buddhist ethics because Mill emphasized distinc-
NO-PERSONHOOD ETHICS AND
tions between coarse and fi ne states of mind, weighting the
REINCARNATION
contentment of the refi ned mind more heavily in the utility calculus than base pleasures. From a utilitarian approach,
A basic, and nearly unique, aspect of Buddhist philosophy
Buddhist moral precepts can be considered ‘rule utilitarian’
is its emphasis on the nonexistence of the self, anatta. Con-
general guides to action, but not deontological absolutes.
sequently, one of the most fundamental Buddhist contribu-
Some writers have also explored the compatibility of Bud-
tions to be made to contemporary medical ethics will be in
dhism with the ‘ethics of care’ articulated by Carol Gilligan
(1982). Gilligan argues that women are more likely to draw
The thrust of the no-self doctrine is complicated within
on compassion in their moral reasoning, whereas men are
the Buddhist tradition, however, by the doctrine of reincar-
more inclined to employ ethical principles. Gilligan’s work
nation. If there is no self, what reincarnates? The traditional
is very resonant for those who see Buddhism as a ‘situation
answer has been that the evolving constellation of mental
ethics’ relying on direct intuition and empathic sensitivity
substrates, the skandhas, causally encoded with karma,
for appropriate behaviour, as teachers in the Zen tradition
pass from one body to another but lack any anchor to an
often do (Curtin & Curtin, 1994).
unchanging soul, just as a causal chain connects a fl ame passed from one candle to another even though it cannot be said to be the same fl ame. (The fi ve skandhas are the body,
BUDDHISM AND MEDICINE
feelings, perceptions, will and consciousness.) Buddhist humanists and sceptics, most notably Stephen Batchelor
From the outset the Buddhist tradition presents itself as
(1997), have argued that the doctrine of reincarnation is not
a clinical diagnosis of the cause of human suffering, and
essential to Buddhist spiritual practice and that Buddhists
a prescription for its alleviation (Duncan et al, 1981; Soni,
have explicit doctrinal authorization to remain agnostic on
1976). The tradition does not set out divine commandments
reincarnation and on all beliefs without empirical support.
but simple statements about the dis-ease (dukkha) affl icting
Buddhist agnostics note that, in the context of Buddhism’s
human life, and the way the dis-ease can be treated. Although
rejection of Hindu beliefs in an eternal soul, the teach-
the emphasis is on a spiritual cure, Buddhism specifi cally re-
ing on no-self is actually a negation of the importance of
jects ascetic mortifi cation of the fl esh and accepts that medi-
cine is necessary for monks and laity. Although the monas-
Nonetheless, most Buddhists profess belief in reincarnation,
tic code forbad monks and nuns from practising medicine,
and belief in reincarnation shapes Buddhist practices and be-
they were instructed to provide medicine to one another and
liefs around abortion and dying. Interruption of the instan-
to keep it at hand (Keown, 1995). The use of medicine for a
tiation or transmigration of the reincarnating being, through
longer, healthier life is in no way seen as incompatible with
abortion or cadaveric organ transplantation, is therefore po-
spiritual practice, but rather is seen as an aid for it.
tentially as harmful, and has as weighty karmic implications,
Buddhism has blended with the medical traditions of
each country in which it has taken root. Zysk (1991) and Mitra (1985) discuss links between early Buddhism and the Indian medical tradition of ayurveda, and in China
ABORTION
and Tibet Buddhism mixed with traditional medicines and magic to create distinctive psycho-spiritual healing
Certainly abortion has been generally disapproved of in
practices and meditations. In the West, Buddhist-infl uenced
Buddhist culture on the grounds that it is a form of mur-
clinicians, such as Jon Kabat-Zinn and his Center for
der. Traditional Buddhist beliefs about the exact timing of
Mindfulness in Medicine, Healthcare and Society at the
the instantiation of the reincarnating being in the embryo
University of Massachusetts, are exploring the health
or foetus are not doctrinal, however, but drawn from latter
benefi ts of Buddhist meditation. The Dalai Lama, the
exiled monarch of the Tibetan kingdom and head of the
Some contemporary, and especially Western, Buddhist
Gelugpa sect of Tibetan Buddhism, has been distinctive
writers on abortion have argued for a more tolerant posi-
among religious leaders in embracing the application of
tion, on a number of grounds. First, if the moral status of
the scientifi c method to the spiritual experience and in
the embryo and foetus are contingent on the instantiation of
a sentient being, then current neurophysiological evidence
support the heart-death standard instead, but Keown em-
that suggests that sentience only emerges late in foetal devel-
braces the whole-brain argument that brain stem death
opment would validate abortion up to that point (Barnhart,
will quickly cause all other bodily functions to cease.) The
1998; Hughes, 1999). Keown (1999) argues against this
neocortical view, on the contrary, would apply to people in
point of view, emphasizing the moral importance of the
the ‘permanent vegetative state’ such as the Florida cause
creation of just the fi rst of the fi ve skandhas, the embry-
celebre Terri Schiavo. In Buddhism and Death: The Brain-
onic body. However, as Barnhart (1998). makes clear, the
Centered Criteria, John-Anderson Meyer (2005) argues
scriptures emphasize that a sentient being is created only
that the neocortical understanding of death is ‘most in con-
when all fi ve of the elements, including consciousness, are
formity with general Buddhist doctrine’.
Some Buddhists reject even the whole brain defi nition of
Moreover, insofar as Buddhism is similar to a utilitarian
death, and resist any organ transplantation, on the grounds
ethics towards general happiness, or an ethics of care, or an
that tampering with the corpse in the critical days after
ethics of virtuous intent, then the immorality of the abortive
death may interfere with the transmigration of the skand-
act of violence can be outweighed by the intentions of the
has to their rebirth. The Japanese only adopted brain death
mother and the greater suffering that it may prevent to
standards after a protracted debate, with resistance partly
mother, potential child and society. The Dalai Lama has ar-
due to Buddho-Confucian veneration of ancestors (Lock
gued, for instance, that although abortion is generally inap-
and Honde, 1990; Lock, 2001). Other Buddhists have de-
propriate, it may be permissible in cases of severely handi-
fended organ transplantation on the grounds that it is the fi -
capped foetuses that may suffer in life; ‘the main factor is
nal compassionate act (Lecso, 1991; Tsomo, 1993) and even
motivation’ (quoted in Tsomo, 1998). Additional consider-
a means to acquire merit for a better rebirth (Hongladarom,
ations would be the degree to which the mother had become
pregnant and aborted carelessly, without suffi cient attention to the gravity of the act (Tworkow, 1992). Depending on Buddhists’ beliefs about the importance of consciousness to
SUICIDE, EUTHANASIA AND THE GOOD
the moral status of the embryo and foetus, the intentional-
ity of the actor and the consequences of the action, some Buddhists will therefore come to different conclusions on
Buddhism has been seen by many Westerners to be indiffer-
derivative issues such as the use of embryos in cloning and
ent to death, or even to nihilistically valorize suicide. This
stem cell research (Schlieter, 2004).
misconception is perpetuated by images of self-immolating
Much attention has also been paid to the Japanese
Vietnamese monks and disgraced samurai committing sep-
Buddhist tatari rituals for aborted foetuses (mizuko) which
puku (ritual suicide). Some scriptures even appear to show
acknowledge and expiate the mother’s karmic debt (Lafl eur,
the Buddha condoning the suicide of enlightened monks
1992). For some Western Buddhists the ritual for aborted
foetuses is a way to acknowledge the moral weight of the
Buddhist meditation does include many contemplations
choice while accepting its occasional appropriateness
of the inevitability of death and the stages of the decompo-
sition of the corpse. There are also many stories of Buddhist monks, and the Buddha himself, accepting their deaths with equanimity and even humour. But, in fact, Buddhist scrip-
BRAIN DEATH AND ORGAN
ture and tradition, like most religions, holds that suicide and
TRANSPLANTATION
euthanasia are forms of murder. As with abortion, however, consequentialist and compassion-based moral reasoning
The debate about the importance of consciousness for moral
may legitimate suicide and euthanasia on the grounds that
standing also shapes Buddhist approaches to brain death,
they alleviate suffering and permit a ‘good death’.
the permanent vegetative state and organ transplantation.
The ‘good death’ is especially important for the Buddhist
Keown (1995). argues, for instance, that Buddhists should
who believes that their state of mind at death will be partly
adopt the ‘whole brain’ theory of brain death, which re-
determinative of the quality of rebirth they achieve in the
quires evidence that all brain function, including brain
next life. This view is expressed in the Tibetan tradition
stem activity, has ceased, rather than the ‘neocortical’
through the bardo meditations which are chanted for the
view that only the irreversible cessation of conscious-
dying and dead to remind them of the 49 days of diffi cult
ness should be adequate for declaring death and remov-
visions they will traverse as they transition to their next life.
ing life support. Keown cites Buddhist scriptural sources
Consequently, Buddhists may prefer to be as awake and
that imply that death only occurs when vitality, heat and
aware at the moment of death as possible, even if they must
consciousness have all left the body. (This would seem to
endure pain (Levine, 2000). On the contrary, appropriately
calibrated pain medication can allow for greater focus during
CONTRACEPTION, SEXUALITY, GENETIC
terminal care, and there is no necessary reason for a Buddhist
ENGINEERING AND REPRODUCTIVE
to embrace pain when it can be medicated (Anderson, 1992).
TECHNOLOGY
There is a growing literature on Buddhist approaches to end-of-life care and counselling exploring these issues from Ti-
Buddhism is decidedly indifferent to whether people have
betan (Rinpoche, 1994; Sachs, 1998), Zen (Kapleau, 1989;
children or not. Buddhist laity are enjoined to avoid sexual
Levine, 1982) and Vipassana (Smith, 1998) perspectives.
misconduct, but not to be fruitful and multiply. Buddhist
Beyond death, emerging technologies suggest that mem-
monks were forbidden to perform weddings or bless ba-
ories and consciousness may eventually be transferred to
bies, although they eventually developed ceremonies that
new bodies or to computers. As technological reincarnation
functionally do both. In the last fi fty years Buddhist coun-
becomes a possibility, the Buddhist understanding of the
tries like Sri Lanka, Japan and Thailand have aggressively
transmigration of our illusory, personal identity will be-
embraced contraception, and their birth rates are among
come even more relevant (Hughes, 2004). Indeed the Dalai
the lowest in Asia, to the consternation of some Buddhist
Lama has opined that human consciousness could be in-
stantiated in a suffi ciently advanced computer (quoted in
More fundamentally, Buddhism rejects any notion of
a ‘natural’ and inviolate human body or procreative act which needs protection from ‘artifi cial’ contraception, genetic engineering or reproductive technologies (Loy,
SPECIESISM AND THE HUMANE TREATMENT
2003). The important questions from Buddhist ethics
OF ANIMALS
are the intentions of the would-be (non)parents, and the consequences of their actions. Concerns about children not
Buddhist doctrine holds that animals are part of the
knowing who they ‘really are’, when they are products of
reincarnate chain of being, being potentially both former
artifi cial reproduction or cloning, are foreign to Buddhism
and future human beings, and moral subjects whose
which does not recognize an ‘authentic self’ to begin with
behaviour accrues karma. Many of the Jataka tales, about
the Buddha’s previous lives, concern his lives as a coura-
This tolerance of the ‘unnatural’ extends to homosexuals
geous and self-sacrifi cing animal; for instance as a deer
and the transgendered. Although homosexuality, as sex
that convinces a king to stop his hunt. The murder of ani-
outside of marriage, has always been seen as a violation of
mals is therefore karmically unskilful, and Buddhists have
the precept against sexual misconduct, it is seen as no worse
considered vegetarianism praiseworthy, opposed hunting
than heterosexual misconduct. Although the monastic code
and animal sacrifi ce, and frowned on butchery and leather-
bars the ordination of gay men and eunuchs, the Buddha
working as inappropriate occupations. The monastic code
permitted some transgendered males to ordain and live
allows monks to eat meat that is offered as alms but not to
with nuns and transgendered females to ordain and live
drink water that might contain living creatures. The Cak-
with monks (Jackson, 1998). Thailand has an active and
kavattisihanada Sutta says that the righteous ruler will pro-
tolerated gay and transgender subculture, and it is an in-
vide for wild beasts and birds. The most famous example of
ternational centre for transgender surgery (Jackson, 1998).
a Buddhist code of humane animal treatment are the edicts
Gay and transgender people are welcome in the Sri Lankan
of the fi rst Buddhist emperor, Asoka, which include numer-
and Thai armies. Male homosexuality was common among
ous decrees that various species not be hunted and that their
the Buddhist warrior caste samurai and monastic culture of
habitats should be protected. In India and China, Buddhists
Japan (Jñanavira, 2005), and gay and transgender images
released captive animals as a means of acquiring merit.
are pervasive in contemporary Japanese culture. The larg-
Although the Buddhist tradition is clearly less anthropo-
est sect of Japanese Buddhism, the Jodo Shinshu, performs
centric than the Abrahamic faiths, in which only human be-
ings are ensouled, Buddhist rulers only rarely advocated an ‘animal rights’ legal code forbidding the killing of animals, which would be consistent with a belief in the full equality of
BRAIN SCIENCE, PSYCHOPHARMACOLOGY
human and animal life (Waldau, 2002). Vegetarianism was
AND THE MYTH OF THE AUTHENTIC SELF
seen as an extreme form of asceticism in the Tibetan tradi-tion, and the Dalai Lama like most Tibetan monks eats meat,
Brain science and psychology have eroded the idea of an
although he counsels that those who can should become veg-
autonomous, continuous and authentic self, in ways quite
etarian. Nonetheless, some Buddhists are beginning to argue
compatible with Buddhist psychology. Bioethics is just begin-
that Buddhism should adopt a more consistent vegan and ani-
ning to grapple with the implications. Do anti-depressants,
stimulants or pain medications create an inauthentic self, or
a more authentic self? How can we respect patient auton-
principles of medical ethics articulated in the classic work
omy when preferences change in illness and pain, and from
of Beauchamp and Childress (1983) – autonomy, nonma-
moment to moment? Within Western philosophy Derek
lefi cence, benefi cence and justice. Florida concludes that
Parfi t’s (1984) Reasons and Persons posed the most radi-
Buddhist ethics, being centrally concerned with compas-
cal challenge by arguing, parallel to Buddhism, that per-
sion, is strongly compatible with the nonmalefi cence and be-
sonal identity is only statistically related over time. After
nefi cence principles, but that there is no Buddhist doctrinal
a certain point we share as much with all future people as
basis for an egalitarian social order or the defence of indi-
we do with our future selves. This Parfi tian/Buddhist view
vidual liberty. Although Buddhism, like all the world’s an-
may, for instance, legitimate the delegation of health care
cient faiths, developed before the European Enlightenment
decision-making for the incapacitated to family, friends and
and has only recently entered into dialogue with democratic
society (Kuczewski, 1994), and support a general regard for
and humanist ideas, Florida appears unaware of an extensive
social welfare over individual self-interest.
literature on the implicit egalitarianism and individualism
Buddhist meditation teachers, and most famously
the Dalai Lama, have embraced the emerging fi eld of
A classic work that explicates the latent, revolution-
neurotheology, which explores the neurophysiology of the
ary egalitarianism of early Buddhism is the The Buddha
meditative experience. Some Buddhist neuroscientists, such
by Trevor Ling (1973). Ling points to the radical demo-
as James Austin in Zen and the Brain, have explored the
cratic structure of the Buddhist monastic order and ideals
many neurophysiological bases for meditative experience
of Buddhist governance and to the many dialogues of the
(Austin, 1999). The collection Zig, Zag, Zen: Buddhism
Buddha which disparage the Hindu caste system and the
and Psychedelics (Badiner, 2002) documents how many
emerging monarchism and mercantilism of his time, which
Western Buddhists found their way to Buddhism through
together suggest a Buddhist strategy for liberal and egali-
the use of psychedelic drugs, which many still consider pos-
tarian social reform. The Buddha’s story of the origin of
governance is of a social contract between citizens and
But anti-depressants in particular pose a challenge for
their chosen rulers to protect public order, similar to the
Buddhists (Chambers, 2001), since the beginning of the
Hobbesian view. One of the obligations of the righteous
Buddhist path is embracing the fundamental unhappiness of
Buddhist king is to ensure that citizens do not fall into pov-
life (dukkha), whereas the idea of ‘happy pills’ would sug-
erty, from which all other social ills are said to fl ow. In In-
gest a short-circuiting of spiritual growth. In other words, is
ner Revolution Tibetan Buddhist scholar Robert Thurman
Prozac cheating? Most Western Buddhist psychologists have
(1999) argues that the social welfare measures enacted by
articulated the view that there should be a distinction between
the Buddhist Asokan monarchy prefi gured modern social
the fundamental dissatisfactoriness of ego-bound life, which
democracy. In the twentieth century Buddhists have devel-
is present for the depressed and happy alike, and the immo-
oped these strains into Buddhist-socialist syncretism, most
bilizing depression of the chemically unbalanced mind. For
notably the Buddhist socialism of U Nu in Burma (Sarki-
people with clinical depression anti-depressant therapy is a
syanz, 1965) and Bandaranaike in Sri Lanka, the Dhammic
necessary adjunct to spiritual growth, returning their capac-
socialism of Bhikkhu Buddhadasa (Buddhadasa, 1986), the
ity for compassion, mindfulness and energy (Hooper, 1999).
Buddhist feminist movement (Gross, 1992), and the myriad
Just as Buddhists have generally accepted stimulants such as
ongoing activities of the ‘engaged Buddhism’ movement
tea as helpful in maintaining mindfulness during meditation,
(Kotler, 2005; Queen, 1996, 2000). Whether social de-
this approach would presumably also apply to other drugs
mocracy is validated by doctrinal and historical Buddhism,
that enhance capacities for empathy or attention, such as
there is clearly a stronger case for universal health care
stimulant medications for attention-defi cit disorder.
provision in Buddhism than for a system based on unequal
Conversely, Buddhists are enjoined to avoid mind-
altering substances that interfere with spiritual growth,
The case for a Buddhist ‘human rights’ doctrine is more
such as alcohol, narcotics and opiates, and warned that
complicated, however, because Buddhism”s fi rst move is
absorption into blissful states is a spiritual dead-end. If and
the deconstruction of the autonomous individual on which
when true ‘happy pills’ are available, these would be more
the Western rights tradition is based. Like contemporary
socialist (Sen, 1999), feminist (Binion, 1995; Sherwin, 1998) and communitarian (Glendon, 1993) critics of the Lockeian autonomous individual, a Buddhist approach to
HEALTH CARE ACCESS AND HUMAN RIGHTS
human rights emphasizes the embeddedness of the elusive individual in a web of interconnectedness, and that human
Richard Florida (1994) has explored the compatibil-
rights are not immutable laws of nature but social norms that
ity of Buddhist ethics with the four ‘Georgetown mantra’
encourage respect and compassion. The key Buddhist idea
here is ‘co-dependent origination’ (paticcasamuppada);
Duncan AS, Dunstan GR, Welbourn RB. Buddhism. Dictionary of
all people and things come into their (temporary, illusory)
Medical Ethics. London: Darton, Longman and Todd, 1981.
existence through their relations with other (temporary, il-
Falls E, Skeel JD, Edinger W. The Koan of cloning: a Buddhist per-
lusory) people and things (Traer, 1988). Although monks
spective on the ethics of human cloning technology. Second Opin 1999; 1: 44–56. http://www.parkridgecenter.org/Page169.html
lived under numerous strict codes of conduct, they were
Florida RE. Buddhism and the four principles. In: Gillon R, Lloyd
self-chosen to the degree that monks were allowed to form
A, eds. Principles of Health Care Ethics. Chichester: John
new communities if doctrinal disagreements emerged. The
Wiley & Sons, 1994; pp. 105–16.
laity was enjoined to acquire merit through fulfi lling the
Gethin R. Can killing a living being ever be an act of compassion?
reciprocal obligations of parent and child, husband and wife
The analysis of the act of killing in the Abhidhamma and Pali
and employer and worker, but there is no model for these
commentaries. J Buddhist Ethics 2004; 11: 168–202.
moral codes to be enforced by law, as in Islamic Sharia.
Gilligan C. In a Different Voice: Psychological Theory and Wom-
Despite this emphasis on social embeddedness over
en’s Development. Harvard University Press, 1982.
liberal individualism, the soteriological goal, individual
Glendon MA. Rights Talk: The Impoverishment of Political Dis-
enlightenment, is not found through fulfi lling social
course. Simon and Schuster, 1993.
Gross, R. Buddhism After Patriarchy: A Feminist History, Analy-
obligations but through letting go of social ties. This rejec-
sis, and Reconstruction of Buddhism. SUNY Press, 1992
tion of obligations to family and the state brought Buddhism
Gyatso HH. Dalai Lama Tenzin. Our Faith in Science. New
into confl ict with more authoritarian cultures, especially the
York Times, November 12, 2005. http://www.iht.com/arti-
Indian caste system, the Chinese Confucian veneration of
family and imperial Shintoism in Japan. Buddhist doctrine,
Hayward JW, Varela F. Gentle Bridges: Conversations with the Da-
with its pacifi sm and suggested but not mandated codes of
lai Lama on the Sciences of the Mind. Boston: Shambhala, 1992.
conduct, is more consistent with the respect for individual
Hongladarom S. Organ Transplantation and Death Crite-
freedom of choice, thought and action than traditions based
ria: Theravada Buddhist Perspective and Thai Cultural
Hooper J. Prozac and Enlightened Mind. Tricycle 1999; Summer. Hughes J. Buddhism and abortion: a western approach. In: Keown REFERENCES
D. Buddhism and Abortion, Macmillan. http://www.change-surfer.com/Bud/Abortion.html.
Aitken R. The Mind of Clover: Essays on Zen Buddhist Ethics. San
Hughes J. The Death of Death. In: Machado C, Shewmon DA, eds.
Brain Death and Disorders of Consciousness. Kluwer, 2004; pp.
Anderson P. Good death: mercy, deliverance, and the nature of suf-
79–88. http://ieet.org/index.php/IEET/articles/hughesdeath/.
fering. Tricycle 1992; 2(2): 36–42.
Jackson PA. Male homosexuality and transgenderism in the Thai
Austin J. Zen and the Brain: Toward an Understanding of Medita-
Buddhist tradition. In: Winston L, ed. Queer Dharma: Voices of tion and Consciousness. MIT Press, 1999. Gay Buddhists. Gay Sunshine Press, 1998.
Badiner, AH, ed. Zig, Zag, Zen: Buddhism and Psychedelics. San
Jñanavira D. Homosexuality in the Japanese Buddhist tradition.
Western Buddhist Review 2005; 3. http://www.westernbuddhis-
Barnhart MG. Buddhism and the morality of abortion. J Buddhist Ethics 1998; 5: 276–97.
Kapleau P. The Wheel of Life and Death. New York: Doubleday,
Batchelor, S. Buddhism Without Beliefs: A Contemporary Guide to Awakening. New York: Riverhead, 1997.
Keown D. The Nature of Buddhist Ethics. New York: St. Martin’s
Beauchamp TL, Childress JF. Principles of Biomedical Ethics,
2nd edition. Oxford University Press, 1983.
Keown D. Buddhism and Bioethics. London: Macmillan/New
*Becker CB. Buddhist views of suicide and euthanasia, Philosophy East and West 1990;40(4): 543–55.
Keown D. Buddhism and suicide – the case of Channa. J Buddhist
Binion G. Human rights: a feminist perspective. Human Rights QEthics 1996; 3: 8–31.
1995; 17(3): 509–26.
Keown D. Buddhism and abortion: is there a middle way? In:
Buddhadasa B. In: Swearer DK, translator and ed. Dhammic So-
Keown D, ed. Buddhism and Abortion. Macmillan, 1999. cialism. Bangkok: Thai Inter Religious Commission for Devel-
King W. In the Hope of Nibbana. La Salle: Open Court, 1964.
Kotler A, ed. Engaged Buddhist Reader. Parallax Press, 2005.
*Chaicharoen P, Ratanakul P. Letting-go or killing: Thai Buddhist
Kuczewski MG. Whose will is it anyway? A discussion of advance
perspectives on euthanasia. Eubios J Asian Int Bioethics 1998;
directives, personal identity and consensus in medical ethics.
8: 37–40. Bioethics 1994; 8(1): 27–48.
Chambers T. Should the Buddha have taken Prozac? Religious im-
LaFleur W. Liquid Life: Abortion and Buddhism in Japan. New
plications of SSRIs. Park Ridge Center Bull 2001; 19.
Curtin P, Curtin D. Mothering: moral cultivation in Buddhist and
Lecso PA. The Bodhisattva ideal and organ transplantation. J Re-
feminist ethics. Philos East West 1994; 44(1): 1–18. ligion Health 1991; 30(1): 35–41.
Levine S. Who Dies? An Investigation of Conscious Living and
Sachs R. Perfect Endings: A Conscious Approach to Dying and Conscious Dying. Doubelday, 1982. Death. Healing Arts Press, 1998.
Ling, Trevor. 1973. The Buddha: Buddhist Civilization in India &
Sarkisyanz E. Buddhist Backgrounds of the Burmese Revolution.
Lock M, Honde C. Reaching consensus about death: heart trans-
Schlieter J. Some observations on Buddhist thoughts on human
plants and cultural identity in Japan. In: Weisz G, ed. Social Sci-
cloning. In: Roetz H. (Hg.), ed. Cross-Cultural Issues in Bio-ence Perspectives on Medical Ethics. New York: Kluwer, 1990;
ethics – The Example of Human Cloning. Amsterdam: Rodopi,
Lock M. Twice Dead: Organ Transplants and the Reinvention of
Sen A. Development as Freedom. Oxford: Oxford University
Death. University of California Press, 2001.
Loy DR. Remaking the world, or remaking ourselves? buddhist re-
Sherwin S. et al., eds. The Politics of Women’s Health: Exploring
fl ections on technology. In: Hershock P, Stepaniants M, Ames R,
Agency and Autonomy. Philadelphia: Temple University Press,
eds. Technology and Cultural Values: On the Edge of the Third Millennium. Honolulu: University of Hawaii, 2003; pp.176–87.
Smith R. Lessons from the Dying. Wisdom Publications, 1998.
http://ccbs.ntu.edu.tw/FULLTEXT/JR-MISC/101792.htm
Soni RL. Buddhism in relation to the profession of medicine. In:
*Mettanando B. Buddhist ethics in the practice of medicine. In: Fu
Millard DW, ed. Religion and Medicine, Vol. 3. London: SCM
CW, Wawrytko SA. Buddhist Ethics and Modern Society: An International Symposium. New York: Greenwood Press, 1991;
Spiro M. Buddhism and Society. New York: Harper Paperbacks,
Meyer, J-AL. Buddhism and death: the brain-centered criteria. J
Thurman R. Inner Revolution: Life, Liberty, and the Pursuit of Buddhist Ethics 2005; 12: 1–24. Real Happiness. Riverhead Books, 1999.
Mitra J. A Critical Appraisal of Ayurvedic Materials in Buddhist
Traer R. Buddhist affi rmations of human rights. Buddhist Chris-Literature (with special reference to Tripitaka). Varanasi: The
tian Stud 1988; 8: 13–9.
Tsomo KL. Opportunity or obstacle: Buddhist views of organ do-
Parfi t D. Reasons and Persons. Oxford: Oxford University Press,
nation. Tricycle 1993; Summer: 30–5.
Tsomo KL. Pro-life, pro-choice: Buddhism and reproductive eth-
Phelps N. The Great Compassion: Buddhism and Animal Rights.
ics. Feminism Nonviolence Stud 1998; Fall: 1998. http://www.
*Pryor FL. A Buddhist economic system–in practice. Am J Econ
Tworkov H. Anti-abortion/pro-choice: taking both sides. TricycleSoc 1991; 50(1): 17–33.
1992; Spring: 60–9,
Queen C, ed. Engaged Buddhism: Buddhist Liberation Movements
Unno MT. Questions in the making – review essay on Zen Bud-
dhist ethics in the context of Buddhist and comparative ethics. J
Queen C. Engaged Buddhism in the West. Wisdom Publications,
Religious Ethics 1999; 27(3): 509–36.
Waldau P. The Specter of Speciesism: Buddhist and Chris-
*Ratanakul P. Bioethics: An Introduction to the Ethics of Medicine tian Views of Animals. Oxford: Oxford University Press,
and Life Sciences. Bangkok: Mahidol University, 1986.
Rinpoche S. The Tibetan book of living and dying: a spiritual clas-
Zysk, KG. Asceticism and Healing in Ancient India: Medicine
sic from one of the foremost interpreters of Tibetan Buddhism to
in the Buddhist Monastery. Oxford: Oxford University Press,
the West. San Francisco: Harper, 1994. Author Query
Q1: Please include reference Levine (2000) in the reference list. Q2: Please provide publisher’s location in References- ‘Keown D. (1999)’, ‘Lock M. (2001)’, ‘Sachs R.’, ‘Levine S.’,
‘Austine J.’, ‘Beauchamp TL’, ‘Thurman R.’, ‘Gross R.’, ‘Queen C (1996)’, ‘Queen C. (2000)’ ‘Kotler A’, ‘Sherwin S.’, ‘Glendon MA’.
Q3: Please provide names of all editors in Reference ‘Sherwin S.’Q4: Please provide the citations of References marked with ‘*’. Q5: Reference number, not consistant, please check.