Death
Having discussed the concept of life and suffering in Buddhism let us now turn to the related concept of death. As already discussed, death is an essential part of the human predicament. It is one of the conditioned and conditioning factors of the cycle of causes and effects (samsara) in which human beings exist. It is also shown that death is one of the central causes of the suffering of human existence.
Brain death and organ transplantation
Buddhism defines death in terms of the concepts of impermanence (anicca) and insubstantiality (anatta). The standard definition of death in Buddhist texts describes death as "the falling away, the passing away, the separation, the disappearance, the mortality of dying, the action of time, the breaking up of the aggregates, the laying down of the body."15 In this definition death is seen as the total dissolution of the five aggregates, the factors constituting the individual.
This Buddhist view of death is congruent with the concept of total brain death in the present discussion. The ceasing of the functioning of the high cortex does not constitute "death" in Buddhism. By recognizing that dying is a process and not an event such a total brain death view allows for a window of opportunity for the taking of organs for transplantation. It also provides protection against the pre-mature removal of organs. The ceasing of the functioning of the high cortex alone is only the death of the cortex and not of all other vital organs
The relationship between death and life
As the manifestation of the impermanence of life, death is not a one-time event but occurs at every moment of life. Since the aggregates are in a state of constant flux, birth (seen as arising) and death (seen as passing away) are always present in juxtaposition to each other. These momentary lives and deaths are one phase of the cycle. From another perspective death is nothing but the arising of the new state in place of the preceding one. This may be explained by means of an analogy with a house-gate. To one who is outside the house the gate is an entrance, whereas to the one inside the house it is an exit. But for both of them it is the same gate. Similarly, the preceding state in the cause and effect process is called birth, whereas its following state is viewed as death, although both of them belong to the same single process.
Hence in its analysis of the nature of existence Buddhism also places emphasis on the reality of death. It is through an understanding of death that we gain an understanding of life. Buddhists thus see the attempt made by people to define the meaning of life as an attempt to define the meaning of death. A man who defines death as merely one event in the unbroken cause - and -effect continuum should be able to rid himself of anxiety and then could live life to the fullest conquering the vicissitudes of life. But this is impossible without the full realization that life and death are two inseparable aspects of one entity.
The wheel of life and death
Buddhism agrees with the generally negative view that death is the fearful and disastrous culmination of an existence already marred by sorrow and suffering. This tragedy of death is magnified by the certainty of rebirth (again-arising) and the repetition of suffering and death (passing away) in samsara existence. That we are locked in the wheel of life and death is an indication of the fundamental emptiness of existence. The continuity and duration of life and death for each individual is incalculable, since if the collection of the bones of one person's repeated rebirth could be amassed, they would form a mountain of skeletons. This imprisonment in the round of existence, however, is neither arbitrary nor ordained by a huge power. It is rather the result of one's own deeds (kamma), good or bad. Through his deeds each person weaves his own web of fate. It is therefore in the power of each individual to either remain in the endless cycle or to escape from it. For in this cycle he is both cause and effect, the entire act or deed on the one hand, and, on the other hand, the consequence of the act. As an effect of his past deeds he is the product of the past. But as a cause he is a field of possibilities : he has the ability to gradually free himself from the past and to become whatever he wants to be.
Ways to cope with death
Buddhism places death at the heart of the human predicament while also recognizing it as the primary solution to this predicament. This religion has maintained that one cannot find liberation from the human predicament by denying death but only by confronting it. Therefore Buddhism does not condone a melancholic reaction to the death of those dear to us. What is necessary when death occurs is that we understand its meaning and cope with it in a realistic and intelligent manner.
As a means of solving the predicament of death Buddhism has developed special systematic techniques of meditative methods, called moranasati and asubha bhavana, to enable us to face the fact of our death with equanimity and understanding and ultimately to attain mibbana, in which there is neither life nor death. These meditations are concerned with concentration on the idea of death (moranasati) and actual observation of decomposing corpses (asubha bhavana). Through progressive stages of confronting and comprehending death the meditator is led towards control and freedom. The meditations give him an increased sense of non-attachment towards himself and the world as well as more control over his own mental development. In addition, these meditations further the process of freedom or liberation by revealing the impermanent and substantial nature of existence. As a result he is moved towards liberating wisdom (vijja)16 that would free himself from the clutch of the illusory Ego and its selfish desires, particularly the lust for life (bhava tanha), the craving for sensual pleasure (kama tanha), and the craving for the immaterial sphere (vibhava tanha)17 and ultimately from the wheel of life and death.
The spiritual importance of dying
As we have seen it the discussion on the concept of life, Buddhism considers every moment in life of great importance, for it is the moment in which one constructs one's own destiny, More emphasis, however, is placed on the last moment in life, or the dying process, in which all the five aggregates of existence are disintegrating. For in Buddhist thought in this last moment the last stage of consciousness (cuti vinana) of one's life is passing away to give place to a new stage of consciousness (patisanthi vinana), which will form another life by its new association with the new aggregates of existence. Even if the character of the new life is affected by the whole previous life, the nature of the last conscious state still contributes significantly to the quality of the ensuing one. If it is wholesome (kusala), this will produce a wholesome inauguration of the new life. Similarly, if it is unwholesome (akusala), the ensuing new life will be unwholesomely inaugurated.
Consequently, it is of great importance that special care should be given to enable the dying to die a "good death" i.e. a calm, and happy peaceful death which will occur only when the mind of the dying is clear and subtle, never be impaired by analgesics or sedatives. Impairment by drugs would affect the consciousness of the dying person and make it impossible to fill his mind with wholesome and happy thought.
In this respect Buddhism enriches the philosophy of the hospice movement, devoted to the full physical, psychological, social and special care of the dying, and reaffirms the significance of the dignity and importance of death and the need for spiritual care. Buddhism also teaches that removing one's thought focused on the pain of death can be done through specific meditations, which are usually mastered only after years of practice. By using these specific meditations one can transform oneself into a state of painlessness. In order to reach this understanding one has to be prepared to devote oneself to the study and the practice of meditation. Without his long and arduous effort no one can ever reach the stage. As this power is available to very few, the question of withholding pain-killing drugs and sedatives from those who have not made such preparation is a serious one.
Concluding Remarks
Buddhism can serve as a resource for the on-going discussion of bioethical issues which have arisen with new scientific knowledge and new circumstances of modern life. The Buddhist "middle way" ethic, based on the concept of interdependence, for example, is an alternative between the two extreme positions on abortion i.e. the pro-abortion view and its opposite. Similarly, the Buddhist emphasis on intention as the important ingredient in ethical decision is useful for our reflection on bioethical issues in the gray areas where ethical water becomes muddy and where one has to choose between the two evils. The Buddhist understanding of death as a process and not an event is another example. It supports the total brain death approach which prohibits the premature removal of organs for transplantation. Moreover, the Buddhist death-accepting attitude and the great spiritual importance it gives to the dying process can significantly contribute to the discussion on euthanasia and the care for the dying. This Buddhist approach to dying also implies the right to die (i.e. to let death comes naturally without fruitless treatment) of a person when there is no hope for recovery. The "letting-go-of-life" view is on alternative between act-utilitarian approach where the end justifies the means and the apposing deontological position. But since all the bioethical issues that have been under discussion today are the questions and challenges which Buddhism has not encountered before, Buddhism has to reflect on its traditional understanding in a new way to meet new circ