The Lancet
Vol.347 No.9001
1996.03.02
Pp. 601-602
Copyright by Lancet Ltd.
"A doctor who administers euthanasia is acting as a `knife-bringer'
and thereby doing something which is explicitly prohibited by
Buddhist precepts." At first sight there is seemingly nothing new
with such a statement: euthanasia is explicitly declared illicit yet
again. On reflection, however, there is a difference from western
bioethics. In Buddhism, it is assumed that an individual life may
manifest itself in different forms at different times - there is
rebirth and reincarnation. This assumption has far-reaching
consequences. When, according to Buddhist tradition, does a new life
start and when does it end? The answer is of great importance for
the way that one deals with the dilemmas concerning abortion, embryo
research, and fertility control on the one hand and with persistent
vegetative state and euthanasia on the other. All of this - and much
more - is discussed in detail in the second chapter ("at the
beginning of life") and in the third ("at the end of life").
But Keown begins with a lucid exposition of Buddhist ethics and of
the role of ethics in Buddhism. The basis for the author's approach
to the bioethical issues is the principle that "Karmic life must
never be destroyed intentionally re-gardless of the quality of
motivation behind the act or the good consequences which may be
thought to flow from it".
Deeper understanding of the Buddhist tradition might also be of help
in defining concepts, for example the definition of euthanasia.
Whereas the author makes use of the following definition: "the
intentional killing of a patient by act or omission as part of his
medical care", another is in use in the Netherlands: "the
intentional taking of the life of a person upon his or her explicit
request by someone other than the person concerned". What has
Buddhist tradition to tell us about the role of the intentions of
the doctor and what about the autonomy and volition of the patient
involved? Could it give us a better understanding of what is
fundamental?
Buddhism and Bioethics represents a gallant effort to introduce a
general readership in the complex matter of biomedical ethics looked
at from a Buddhist perspective. Keown was faced with many
difficulties: western biomedical dilemmas had to be put in eastern,
Buddhist, terms and - at least equally important - he had to break
new ground because only a few studies of Buddhist ethics on the
beginning and end of life are available. This text makes an
important contribution to the transcultural study of biomedical
ethics.