In 1993 The Parliament of the World's Religions produced a declaration known as A Global Ethic which set out fundamental points of agreement on moral tissues between the religions of the world. However, the declaration did not deal explicitly with medical ethics. This article examines Buddhist and Christian perspectives on euthanasia and finds that in spite of their cultural and theological differences both oppose it for broadly similar reasons. Both traditions reject consequentialist patterns of justification and espouse a 'sanctity of (...) life' position which precludes the intentional destruction of human life by act or omission. (shrink)

Nagarjuna's Twelve Gate Treatise. Translated, with Introductory Essays, Comments and Notes by Hsueh-li Cheng.. D. Reidel, Dordrecht 1982. xv + 151 pp. D. fl. 85 $36.95.

Whether the law should permit voluntary euthanasia or physician-assisted suicide is one of the most vital questions facing all modern societies. Internationally, the main obstacle to legalisation has proved to be the objection that, even if they were morally acceptable in certain 'hard cases', voluntary euthanasia and physician-assisted suicide could not be effectively controlled; society would slide down a 'slippery slope' to the killing of patients who did not make a free and informed request, or for whom palliative care would (...) have offered an alternative. How cogent is this objection? This book provides the general reader with a lucid introduction to this central question in the debate, not least by reviewing the Dutch euthanasia experience. It will interest all in any country whether currently for or against legalisation, who wish to ensure that their opinions are better informed. (shrink)

Karma is a central feature of Buddhist ethics, but the question of its classification in terms of ethical theory has so far received little attention. Granting that karma is foundational to Buddhist ethics and arguing that what is fundamental to the Buddhist understanding of karma is the samsk?ric modification of the agent, this article relates the doctrine of karma as understood in Therav?da Buddhism to Western ethical concepts and challenges the casual consensus that treats Buddhist ethics as a variety of (...) consequentialism. The contrary argument, that Buddhist ethics is best understood in terms of virtue-mediated character transformation, is made dialectically through a critique of recent discussions of karma by Roy Perrett and Bruce Reichenbach and through an assessment of the plausibility of Philip Ivanhoe's concept of "character consequentialism.". (shrink)

John Finnis is a pre-eminent legal, moral and political philosopher. This volume contains over 25 essays by leading international scholars of philosophy and law who critically engage with issues at the heart of Finnis's work.

This is a study of the nature of time. In it, redeploying an argument first presented by McTaggart, the author argues that although time itself is real, tense is not. He accounts for the appearance of the reality of tense - our sense of the passage of time, and the fact that our experience occurs in the present - by showing how time is indispensable as a condition of action. Time itself is further analysed, and Dr Mellor gives answers to (...) most of the metaphysical questions it provokes, concerning the relation of time to space, the dissection of time, and its relation to change and causation. (shrink)

In this book the author considers data from both early and later schools of Buddhism in an attempt to provide an overall characterization of the structure of Buddhist ethics. The importance of ethics in the Buddha's teachings is widely acknowledged, but the pursuit of ethical ideals has up to now been widely held to be secondary to the attainment of knowledge. Drawing on the Aristotelian tradition of ethics the author argues against this intellectualization of Buddhism and in favour of a (...) new understanding of the tradition in terms of which ethics plays an absolutely central role. In the course of this reassessment many basic concepts such as karma, nirvana, and the Eightfold Path, are reviewed and presented in a fresh light. The book will be of interest to readers with a background in either Buddhist studies or comparative religious ethics. (shrink)

In the case of Ms B, the High Court ruled that as Ms B was a competent adult patient, her doctors acted unlawfully in overriding her refusal of life-preserving ventilation. This commentary considers whether this case supports the proposition that in English law the right to refuse treatment extends even to refusals which are clearly suicidal.

In April 2004 the Parliamentary Assembly of the Council of Europe debated a report from its Social, Health and Family Affairs Committee , which questioned the Council of Europe’s opposition to legalising euthanasia. This article exposes the Report’s flaws, not least its superficiality and selectivity.

The latter half of the twentieth century witnessed a growing interest in Buddhism, and it continues to capture the imagination of many in the West who see it as either an alternative or a supplement to their own religious beliefs. Numerous introductory books have appeared in recent years to cater to this growing interest, but almost none devotes attention to the specifically ethical dimensions of the tradition. For various complex cultural and historical reasons, ethics has not received as much attention (...) in traditional Buddhist thought as it has in the West. Written by Damien Keown, one of the few experts worldwide who specializes in the area, Buddhist Ethics illustrates how Buddhism might approach a range of contemporary morals ranging from abortion to euthanasia, sexuality to cloning, and even war and economics. (shrink)

Organ donation after a circulatory determination of death is possible in selected patients where consent is given to support donation and the patient has been legally declared dead by two doctors. The National Health Act (61 of 2003) and regulations provide strict controls for the certification of death and the donation of organs and tissues after death. Although the National Health Act expressly recognises that brain death is death, it does not prescribe the medical standards of testing for the determination (...) of brain death (neurological determination of death), circulatory death (circulatory determination of death) or for determination of death based on somatic criteria. However, in all cases of organ donation, including after circulatory death, the National Health Act mandates that two doctors certify the death, with one doctor possessing more than 5 years of experience. Additionally, both doctors must be independent from the transplant team. The standard for such determination, as for brain death, aligns with accepted medical standards. The Critical Care Society of Southern Africa has published South African (SA) Guidelines on Death Determination that outline rigorous standards for death determination in hospital settings by either a neurological or circulatory method. Legislation and the Health Professions Council of SA’s (HPCSA) professional guidance direct clinicians on obtaining informed consent for donation either from the patient or in cases of incapacity from their surrogate decision maker. Collectively, the legislation, regulations and professional guidelines in SA provide a robust ethical framework that supports organ donation after circulatory death. (shrink)

Issues such as abortion, embryo research and euthanasia have been discussed exhaustively from the standpoint of Western philosophy and religion, but so far the voice of Buddhism has been little heard in the debate. Although widely respected for its benevolent and humanistic values, Buddhism has not so far shown how its ethical principles can be applied in a consistent manner to contemporary moral dilemmas. Drawing on both ancient and modern sources, this book sets out the basis of a Buddhist response (...) to the major ethical questions posed by modern medicine. (shrink)

Article 3.4 of EC directive 89/381 requires member states to take "all necessary measures to promote Community self-sufficiency in human blood or human plasma" and, for this purpose, to "encourage the voluntary unpaid donation of blood and plasma". This paper presents an ethical case in support of the policy of voluntary, unpaid donation.

When two Christian prelates as internationally prominent as Desmond Tutu and George Carey call for the legalization of euthanasia and physician-assisted suicide, their arguments merit close consideration. This article sets out and evaluates their arguments. It concludes that the prelates rehearse the superficial case regularly advanced by euthanasia campaigners and fail adequately to engage with the arguments, both principled and practical, against legalization.

Philip Reed’s interesting and welcome comparison of the expressivist case against, on the one hand, prenatal testing and abortion and, on the other, physician-assisted suicide and voluntary active euthanasia, indicates the relevance of the expressivist case against the latter and its resilience to criticisms of the expressivist case against the former. Advocates of PAS/VAE commonly argue that they should be lawful out of respect for autonomy: everyone has the right to choose a physician-hastened death if they meet specified conditions such (...) as ‘terminal illness’ or ‘unbearable suffering’. The focus on autonomy is distracting, for the real work of justifying PAS/VAE is done by the argument that life with the conditions specified is not ‘worth living’. Legalisation endorses, and expresses, the judgement that it is reasonable for people with those conditions to think their lives no longer worth living and obtain medical help to end them. Were the justification to respect autonomy, why limit the choice? It is small wonder, in light of the discriminatory nature of such a judgement, that disability groups have been outspoken opponents of legalisation. As society’s ‘canaries in the coalmine’ they have warned of the …. (shrink)

Several contributions in the book show how these principles apply to contemporary problems and moral issues.

Nineteen ninety-six saw the publication of a major Dutch survey into euthanasia in the Netherlands. This paper outlines the main statistical findings of this survey and considers whether it shows that voluntary euthanasia is under effective control in the Netherlands. The paper concludes that although there has been some improvement in compliance with procedural requirements, the practice of voluntary euthanasia remains beyond effective control.

During the past four decades, the Netherlands played a leading role in the debate about euthanasia and assisted suicide. Despite the claim that other countries would soon follow the Dutch legalization of euthanasia, only Belgium and the American state of Oregon did. In many countries, intense discussions took place. This article discusses some major contributions to the discussion about euthanasia and assisted suicide as written by Nigel Biggar, Arthur J. Dyck, Neil M. Gorsuch, and John Keown. They share a (...) concern that legalization will undermine a society's respect for the inviolability and sanctity of life. Moreover, the Report of the House of Lords Select Committee on the Assisted Dying for the Terminally Ill Bill is analyzed. All studies use ethical, theological, philosophical, and legal sources. All these documents include references to experiences from the Netherlands. In addition, two recent Dutch documents are analyzed which advocate further liberalization of the Dutch euthanasia practice, so as to include infants and elderly people "suffering from life". (shrink)

_Action Dharma_ charts the emergence of a new chapter in an ancient faith - the rise of social service and political activism in Buddhist Asia and the West. Fourteen new essays treat the historical origins, global range, teachings and practices, and leaders and organizations that make up the latest turning of the Dharma. Environmentalism and peace walks through the minefields of Southeast Asia, the future of the 'untouchables' of Japan, and outreach to minorities and inmates of the criminal justice system (...) in the West are some of the challenging topics considered. (shrink)

In an earlier article in this journal, I advanced five ethical arguments in favour of a voluntary, unpaid system of blood donation. In his reply to my article, Hugh McLachlan criticised one of those arguments, namely, the argument that an unpaid system promotes altruism and social solidarity. In this reply to Dr. McLachlan, I maintain that his criticism is misguided, and that he appears unclear not only about my own argument, but also about his own.

A Survey of Vinaya Literature. Charles S. Prebish. The Dharma Lamp Series 1, Jin Luen Publishing House, Taipei 1994. 157 pp. No price given.

Medical ethics in Buddhism involves essentially the application of the wider principles of religious ethics to problems in a more specialized field. The “Four Principles” approach can be only partially successful in the context of Buddhism. This chapter considers Buddhist view on substantive biomedical issues. The topics discussed include abortion, death and dying, brain death and organ donation, and cloning. Buddhism has had a particular interest in the analysis of stem cell research, psychology and neuroscience. Caution must be exercised when (...) drawing conclusions about Buddhist perspectives on bioethics, as there is a risk of inadvertently superimposing Western categories on the discussion. The doctrine of karma and the belief in rebirth make Buddhism distinctive from an ethical perspective, and it is also renowned for its emphasis on benevolence and compassion and a scrupulous respect for living beings. (shrink)

_Buddhist Studies from India to America_ covers four important areas of Buddhist Studies: Vinaya Studies and Ethics, the history of Buddhist schools, Western Buddhism, and Inter-religious dialogue. These are the main areas which Charles S. Prebish has either inaugurated or helped to define; and his academic career as a leading, international scholar, and his significant professional achievements are celebrated within this volume. The geographical and historical scope of the essays in this collection range from ancient India to modern America, and (...) includes contributions by well-known international scholars. The contributors discuss a variety of academic disciplines including philosophy, psychology, history, feminism, and sociology. It will appeal to scholars whose interests embrace either ancient or modern aspects of the Buddhist tradition. (shrink)

Difficult Beginnings. Three Works on the Bodhisattva Path. Candragomin. Translated, with commentary by Mark Tatz. Shambhala, Boston and London 1985. $22.50. 121 pp.

Development of Buddhist Ethics. G.S.P. Misra. Munshiram Manoharlal, Delhi 1984. xii + 184 pp, appendix, bibliography and index. Rs. 80.

Fundamentals of Buddhist Ethics. Gunapala Dharmasiri. The Buddhist Research Society, Singapore 1986. 185pp.

How to Meditate: a practical guide. Kathleen McDonald. Wisdom Publications, London 1985. 221 pp. including Appendix and Glossary. £4.95.

Images of Eternity. Concepts of God in Five Religious Traditions. Keith Ward. Oneworld Publications Ltd., Oxford and New York 1993. viii, 197 pp. £8.95.

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Into the Jaws of Yama, Lord of Death: Buddhism, Bioethics, and DeathDamien KeownInto the Jaws of Yama, Lord of Death: Buddhism, Bioethics, and Death. By Karma Lekshe Tsomo. Albany: State University of New York Press, 2006. Pp. 270.An anecdote recounted in this work gives an insight into the present state of Buddhist bioethics. The author relates how she asked the spiritual director of a Tibetan centre in Honolulu (...) whether he thought it was a good idea to donate one’s organs at the time of death. He immediately replied in the affirmative. When asked if the removal of the organs would disturb the dying process, he responded that it would be okay since the doctors could “wait for a few days.” On being informed that the organs had to be removed immediately to save the life of the recipient he “expressed alarm” and changed his mind, advising that for an ordinary Buddhist practitioner organ donation might not be advisable after all (p. 160).The fact that Tibetan lamas are giving ethical advice on organ donation without even a layman’s knowledge of the medical procedures involved suggests that Buddhist teachers have a lot to learn about adapting traditional teachings to modern contexts. If the problem were simply that many lack scientific knowledge, this could probably be resolved in the short to medium term. The deeper problem, however, is that Buddhism as a tradition lacks the ethical infrastructure needed to address moral dilemmas, particularly those of the complex kind presented by contemporary scientific and medical developments. Despite their undoubted acumen in certain branches of philosophy (notably metaphysics), Buddhist thinkers of the past have consistently failed to probe the moral foundations of their teachings or to establish a theoretical foundation in terms of which moral dilemmas can be analyzed. Not a single treatise on moral philosophy was produced by any of the classical scholars cited in this volume as authorities. Not surprisingly, the legacy of this neglect is that the voice of Buddhism has been almost completely silent with respect to the kinds of ethical issues addressed in this book.The present work commendably seeks to remedy this absence of information on Buddhist bioethics. This is only the second book ever to attempt such a task, the first being my Buddhism and Bioethics, published over ten years ago in 1996 (reissued by Palgrave in 2002). In the intervening period there have been many scientific [End Page 157] advances, such as cloning and genetic engineering, both of which receive attention in the volume under review. While my own approach sought to build bridges by translating Buddhist concepts into the vocabulary of contemporary bioethics, the present volume holds more tightly to the traditional teachings of Tibetan Buddhism. Accordingly, while the concepts and terminology used will be familiar to those inside the tradition, I am not sure to what extent it will facilitate dialogue with bioethicists and clinicians, for whom the colorful and somewhat medieval facets of these teachings may at times seem esoteric.Before discussing the ethical issues further, it should be pointed out that less than half of the book (chapters 8–11) is devoted directly to bioethics. The first seven chapters are for the most part an account of topics in Mahayana philosophy (such as no-self, dependent origination, and emptiness) and descriptions of the beliefs and practices of Tibetan Buddhism surrounding death. These include meditational practices relating to death and the notion of the post-mortem intermediate state (bardo). Somewhat oddly, chapter 5, titled “Foundations of Buddhist Ethics,” has almost nothing to say about ethics: after a short but potentially interesting section titled “Buddhist Definitions of Life and Death,” it veers off into a lengthy summary of Madhyamaka, Vijnanavada, and Tathagatagarbha doctrines.Tibetan teachings about death have been summarized in numerous popular volumes in recent years, and it is unclear why such an extended treatment of them is presented again here. The opening sentence of chapter 8 suggests this was necessary to “set the stage for an exploration of bioethical issues from Buddhist points of view,” but the bulk of this material has little connection with bioethics. In particular, it is not clear how it is... (shrink)

Meditation on Emptiness. Jeffrey Hopkins. Wisdom Publications, London 1983. 1017pp. £17.95.