Buddhist Bioethics Buddhism and Medical Ethics: A Bibliographic IntroductionJames J. HughesMacLean Center for Clinical Medical EthicsDamien KeownGoldsmiths, University of London Published in the Journal of Buddhist Ethics, Volume Two, 1995ISSN 1076-9005BUDDHISM AND MEDICINE It has not gone unnoticed that the Buddhist aim of eliminatingsuffering coincides with the objectives of medicine (Duncan et al,1981; Soni, 1976). The Buddhist emphasis on compassion finds naturalexpression in the care of the sick, and according to the Vinayathe Buddha himself stated "Whoever, O monks, would nurse me, heshould nurse the sick" (Zysk, 1991:41). Buddhist clergy and laityhave been involved with the care of the sick for over two thousandyears. The Indian Buddhist emperor Asoka states in his second RockEdict that provision has been made everywhere in his kingdom formedical treatment for both men and animals, and that medicinal herbssuitable for both have been imported and planted. Birnbaum (1979) and Demieville (1985) provide good generalintroductions to Buddhism and medicine. Buddhism appears to haveplayed an important role in the evolution of traditional Indianmedicine (Zysk, 1991), and there are many parallels betweenBuddhist medicine, as recorded in the Pali canon, and Aayurveda(Mitra, 1985). There are short monographs by Haldar on thescientific (1977) and public heath aspects (1992) of medicine inthe Pali sources. It is likely that as Buddhism spread through Asiait would have interacted with indigenous medical traditionspromoting the cross-fertilization of ideas. Redmond (1992)discusses the relationship of Buddhism to medicine from Theravaadaand Mahaayaana perspectives and compares Buddhist and Daoistconcepts of disease. Discussions of Tibetan medicine may be foundin Clifford (1984), Dhonden (1986), and Rechung (1976), whileOhnuki-Tierney (1984) discusses illness and culture in contemporaryJapan. Buddhism's holistic understanding of human nature encourages apsychosomatic approach to the pathology of disease (Soni, 1976),something to which Western medicine is now increasingly attuned. Itmay also be suggested that the Buddhist philosophy of origination independence is both a fruitful diagnostic model and a philosophy whichencourages a preventive approach to healthcare. However, disquiet hasbeen voiced recently about how "natural" certain forms of traditionalBuddhist medicine are - notably the Tibetan "black pill" - somerecipes for which specify rhinoceros horn and bear-bile among theingredients (Leland, 1995).MEDICAL ETHICS Despite Buddhism's long association with the healing arts,little attention has been paid to the ethical issues which arisefrom the practice of medicine. A small number of monographs provideintroductions to the issues and dilemmas which arise in medicalpractice. These are Ratanakul (1986), Nakasone (1990) and Keown(1995), and these volumes should be consulted in conjunction with thesources listed under the specific subject-headings below. Alsorelevant is the unpublished Masters thesis by Shoyu Taniguchi (1987a).For general discussions in the periodical literature see Taniguchi(1987b), Mettanando (1991), and Ratanakul (1988; 1990). A usefuldiscussion of Buddhism in terms of the "four principles" approach tomedical ethics developed by Beauchamp and Childress (1989) is providedby Robert Florida (1994). The Encyclopedia of Bioethics contains articles on medicalethics in India (Jaqqi, 1987), Asia (Unschuld, 1987), and Japan in thenineteenth century (Kitagawa, 1987). Also on Japan see Umezawa (1988).On medical ethics in imperial China see Unschuld (1979) and onThailand Violette Lindbeck (1984) and Ratanakul (1988; 1990). The principal issues to be addressed in contemporary medicalethics may be summarised as moral personhood (the question of who isand who is not entitled to moral respect), abortion, embryoexperimentation, genetic engineering, consent to treatment, resourceallocation, defining death, organ transplantation, living wills, thepersistent vegetative state, and euthanasia. Little systematicattention has yet been directed to these subjects by Buddhistpractitioners or scholars, and some subjects have not been discussedat all from a Buddhist perspective. The arrangement of the topicsbelow is neither comprehensive nor final. It is inevitable there willbe overlap between the sections, and items which appear under onecategory may contain discussion of issues or principles which havebroader relevance. At this time, however, it seems useful to identify threegroups of issues and related literature. These concern: moralpersonhood, issues surrounding life at its beginning, and issuessurrounding life at its end. There is insufficient literature onresource-allocation, socio-economic issues, or other questions aboutgeneral medical practice to justify a category on those topics inthis review. There are signs, however, that a Buddhist perspective oncertain aspects of medical treatment is beginning to appear, forexample Epstein (1993) and Kabat-Zinn's (1990, 1994) integration ofBuddhist meditation into medical practice, and the growing literatureon Buddhism and social justice, such as Jones (1989) and Sizemore andSwearer (1993).MORAL PERSONHOOD Personhood is both a central problem for Buddhist ethics andWestern medical ethics, and consequently a very promising area for adialogue between the two. The problem for Buddhist ethics has alwaysbeen why should people act ethically if there is no act, no actor andno consequences of action (Collins, 1982). If there is no self orother, how can there be karmic consequences, responsibility, loyalty,or even compassion? Theravaadin scholars continue to be divided overwhether Buddhism suggests different ethics for those who persist in theillusion of self (kammic ethics) and for those who would transcendthe illusion of self (nibbanic ethics). The paradoxical unity ofcompassionate ethics and nihilistic insight into selflessness has beenthe central koan of Mahaayaana Buddhism. Tantra and Zen suggest thatthe person who sees that there is no "I" is beyond good and evil. For bioethics, struggles over abortion, animal rights and braindeath have brought personhood to the forefront (Nelkin, 1983).Opponents of abortion and euthanasia, and advocates for the disabledand animals, on the other hand, assert that mere humanness or merelybeing alive should bestow a "right to life." But most bioethicistsbelieve that human beings and animals take on ethical significance tothe extent that they are "persons." Some, such as Tooley (1984),would set a standard which would exclude almost all animals, newborns,and the severely retarded or demented. When they specify which elementsof sentience and neurological integrity create the illusion ofpersonhood, Western bioethicists begin to sound remarkably Buddhistic:"the awareness of the difference between self and other; the abilityto be conscious of oneself over time; the ability to engage inpurposive actions" (see, for instance, Fletcher, 1979). At the same time, Western bioethicists have become increasinglytroubled by questions about the autonomy, continuity and authenticityof the self. Do anti-depressants create an inauthentic self, or is theself more authentic when its cheerful? Is one respecting a patient'sautonomy by respecting the treatment preferences they expressed whenhealthy, or those they express in the throes of illness? Is it everpossible for a patient to give truly free and informed consent totreatment? The most radical challenge to Western ethics of self-determination came in 1984 with the publication of British philosopherDerek Parfit's Reasons and Persons. In this meticulously argued tome,Parfit rejects the existence of continuous selves and concludesthat an individual is as discontinuous from itself at some latertime as it is from other individuals. Consequently, working for thefuture welfare of all beings is the same as working for one's ownfuture welfare, since there will be no "I" to benefit in thefuture. Bioethicists are only now incorporating Parfit's argument. Forinstance, researchers find that is impossible to accurately anticipateone's state of mind when one is sick or dying, much less when one isunconscious, undercutting the assumption of continuous personhoodundergirding "living wills." From a Buddhist/Parfitian perspective, the search for "real"preferences, central to the identity of the person, is a pointlessone. With this acknowledgement, it is less troubling to place ourtrust in our family and friends to make decisions for our futureselves (Kuczewski, 1994). More to the point, a Buddhist/Parfitianwould encourage citizens to look beyond their personal preferencesin dying, which may be to "die with dignity" but may also be to useas many resources as possible to stave off death, and insteadparticipate in creating a health care system that served the needsof everyone in society. Another area of potential dialogue is in the efforts to gobeyond Cartesian (and Hindu etc.) mind-body dualism in defining lifeand death. Over the last twenty years the West has slowly acceptedthat a "person" is dead if their brain is destroyed, even if the bodycontinues to function. Yet it still troubles many Westerners andBuddhists to declare the permanently unconscious "dead," believingthat this is an example of inappropriate mind-body dualism. OtherWesterners and Buddhists believe that only a "neocortical" definitionof death recognizes the centrality of consciousness and personhood inethics (Gervais, 1986). More challenging, some Western ethicists havebegun to discuss the status of personhood as future technologies makepossible the continuity of personality from one body to another (More,1994). When medical technology offers reincarnation, Buddhistbioethics will certainly flourish.ABORTION Buddhism, like all religious and secular philosophies, focuseson two central questions concerning abortion: (a) when does theembryo or fetus acquire the property which makes termination ofpregnancy "killing"?; and (b) is termination of a pregnancy, beforeor after this point, ever justifiable? While there was a minority tradition in classical Hinduembryology that held that incarnation does not occur till as late asthe seventh month (Lipner, 1989), most Buddhist commentators haveadopted classical Hindu teachings that the transmigration ofconsciousness occurs at conception, and therefore that all abortionincurs the karmic burden of killing. Before modern embryology,however, in both Buddhist countries and the West, ideas aboutconception were scientifically inaccurate, and often associated thebeginning of life with events in the third or fourth month ofpregnancy (for a discussion of traditional Tibetan embryology, seeDhonden, 1980 and Lecso,1987). Another problem in early Buddhists' embryology is theirassumption that the transmigration of consciousness is sudden ratherthan gradual. Based on the findings of modern neuro-embryologyBuddhists today might maintain that the fetus does not fully embodyall five skandhas and the illusion of personhood until afterbirth; this is the argument developed by most Western ethicists todefend abortion (Tooley, 1984; Flower, 1985; Bennett, 1989). If thefetus is not yet a fully embodied person, then the karmicconsequences of abortion would be even less than the killingof animals, which Buddhism teaches do have moral status. Thisneurological interpretation of the skandhas may be moreconsistent with Western Buddhism, which often sees the doctrine ofrebirth as peripheral or interprets rebirth metaphorically ratherthan literally (Batchelor, 1992; King, 1994). The second question is whether abortion always generates badkarma, or in Western terms, is it ever "justified." This relates tothe debate about whether Buddhist ethics are absolutist, utilitarianor "virtuist," i.e. seeing the good in the development of personalqualities. The absolutist would hold that bad karma is incurred fromany act of murder, whatever the justifications. The utilitarian wouldargue that murder can be a compassionate act with positivekarmic consequences, taking into account factors such as the healthof the fetus or mother, the population crisis, and the readiness ofthe parents to raise a child. A virtue-oriented Buddhist would argue that the attitude andmotivations of the pregnant woman and her collaborators woulddetermine the ethics of an abortion. Along this line, Tworkov(1992) argues that the karmic skilfulness of an abortion isrelated to whether the person became pregnant and made her decisionto abort without serious mindfulness. From this perspective,aborting a fetus conceived without an effort at contraception wouldbe more karmically significant than an abortion necessitated inspite of contraception. The much discussed Japanese tolerance for, and ritualization of,abortion appears to combine both utilitarian and virtue approaches.The Japanese believe that abortion is a "sorrowful necessity," andBuddhist temples sell rituals and statues intended to representparents' apologies to the aborted, and wishes for a more propitiousrebirth. The Japanese have reached these accommodationsconsensually, with little debate, and without discussion of therights of women or the unborn (LaFleur, 1990, 1992). The Theravaadin commentator Buddhaghosa appears to have combinedall three views. He held that killing produces karma jointly throughthe mental effort and intensity of the desire to kill, and the virtueof the victim (Florida, 1991). Since killing big animals requiredmore effort, and was therefore worse than killing small animals, thekarma of feticide would be less than murder of adults, and less inearlier stages of pregnancy. On the other hand, for Buddhaghosa, thekarma of feticide would be greater than that of killing villains inself-defence. Buddhists have thus far given little thought to the thirdimportant question, the connection between morality and law,specifically how, and on what grounds, the state should regulateabortion. Some Buddhists have adopted the stance of many moderates inthe West: abortion is murder of a person, but women should have thatchoice (for instance, Imamura, 1984 and Lecso, 1987). Since mostBuddhists have no problem with laws to discourage and punish murderin general, implicit in this position is that murder is eitherjustifiable when it conflicts with bodily autonomy or, since fewBuddhists would imprison butchers, that fetuses are closer in statusto animals. Clearly there is much room for clarification of therelationship between religious ethics and law in pluralisticsocieties. Some scholars (such as Ling, 1969, and LaFleur, 1992) havelooked beyond the strictly ethical concerns with abortion to examinethe cultural aspects of the question. From thisperspective it is sometimes pointed out that Buddhism is not"pro-natalist," i.e. does not hold that reproduction is a religiousduty - quite the reverse in fact - and does not advocate "familyvalues," at least in the sense that Confucianism did. Buddhistskepticism about family and reproduction was a central cause ofConfucian and Shinto persecution. The Sinhalese embrace ofcontraception and abortion was so enthusiastic in the 1960s, comparedto Sri Lanka's Muslims, Catholics and Hindus, that racialist monksbegan to argue that Buddhists had an obligation to"race-religion-nation" to reproduce.DEATH, DYING AND EUTHANASIA The themes of impermanence, decay and death are omnipresent inBuddhist literature. In many Asian cultures Buddhism is identified asthe authority par excellence on matters pertaining to death, and isclosely linked to the rites and ceremonies associated with thetransition from this life to the next. Buddhist literature emphasisesthe importance of meeting death mindfully since the last moment of onelife can be particularly influential in determining the quality of thenext rebirth. General reflections on death will be found in PhilipKapleau's 1972 anthology The Wheel of Death and his 1989 TheWheel of Life and Death. Stephen Levine is the author of severalbooks dealing with the subject of death from a Zen perspectivewhile a contemporary Tibetan perspective is provided by SogyalRinpoche's popular Tibetan Book of Living and Dying, Glenn H.Mullin (1986) and John Powers (1995, Ch.10). James Whitehill (1974)discussed what can be learned from the death of the Buddhistmasters, and the development of a corpus of "Great Death" storiesof various Buddhist masters is examined by LaFleur (1974). Otherwritings on death in Buddhism include Smart (1968), Amore (1974),and Bowker (1991). In a 1993 monograph on the subject of death in Buddhism, Beckerasserts that the Buddhist tradition, especially in Japan, is verytolerant of suicide and euthanasia. Evidence of this is the Buddha'stolerance of suicide by monks (Wiltshire, 1983) and Japanese storiespraising suicide by monks, samurai and laypeople. Beckersuggests that Buddhism values self-determination and praises thosewho decide when and how they will die when they do so in order tohave a dignified conscious death. Becker also concludes that the keypoint is not whether there is still warmth or reflexes (as suggestedby some readings of the Visuddhimagga) but whether the patient'sskandhas have permanently left, i.e. the patient is permanentlyunconscious. In other words, Buddhism would endorse a brain deathdefinition of death. On the understanding of death in Japanesereligion see also Picken (1977). A number of issues in medical ethics turn upon the problem ofdefining death, but few writers have addressed the question of aBuddhist definition of death directly. Only van Loon (1978), Keown(1995), and Mettanando (1991) have argued for a specific definition:van Loon equates death with neocortical death whereas Keown andMettanando support the "whole brain" criterion. There has been considerable resistance to the adoption of thebrain death standard in Japan, both from the public and within themedical profession, due in no small measure to its association withorgan transplantation. The brain death criterion allows organs tobe harvested with the minimum delay, thereby enhancing theprospects for a successful transplant. Japanese tradition, however,requires the performance of rituals over a lengthy period before anindividual is regarded as having passed on, and is also reluctantto countenance plundering the bodily organs of future ancestors.Some commentators suggest that public acceptance of brain death isgrowing as professional groups and universities develop criteria,and as pressure from potential beneficiaries grows. Also, countriessuch as the Philippines have raised objections to Japanese patientsgoing abroad for transplants rather than building an organretrieval system of their own. The best analysis available (inEnglish) of the Japanese situation is Hardacre (1994), butrelevant material may also be found in Lock and Honde (1990),Feldman (1988), Becker (1990), and Nudeshima (1991). Fordiscussions of the issue outside of Japan see Ratanakul (1988,1990), Sugunasiri (1990), and Nakasone (1994). A more positive attitude towards transplantation is revealed inTsomo (1993). The author surveyed teachers from many differenttraditions about their attitudes to donation. All were verypositive, and emphasized that the corpse is merely an empty vessel,and that to give of oneself is a great thing, and an act ofcompassion.EUTHANASIA There are no monographs devoted specifically to euthanasia inBuddhism. There are a few periodical articles and the subject is dealtwithin one or two books. Relevant issues are the distinction betweenvarious forms of euthanasia (e.g. "active" and "passive") and the useof narcotics in palliative care which may cloud the mind and interferewith the process of dying (Keown, 1995; Kapleau, 1989; Lecso, 1986;Ratanakul, 1988, 1990). Kapleau's volume The Wheel of Life and Death (1989) contains ashort discussion of euthanasia in conjunction with suicide and it issuggested that Buddhism would reject the practice of either.Ratanakul concurs, reporting "a growing consensus among the Thaipublic that euthanasia (passive or active) is morallyunjustifiable" (1990:27). Keown and Keown (1995) explore Buddhistand Christian attitudes to euthanasia and suggest both oppose it forsimilar reasons. Nakasone, however, is of the opinion that "Evidenceindicates that Buddhists would favor the 'right-to-die' position"(1990:76). Jennifer Green's short article "Death with Dignity:Buddhism" (1989:40-41) discusses only the practicalities of funeralarrangements and does not mention euthanasia. Neuberger(1987) is likewise concerned with practical as opposed to moralissues. Euthanasia has been a special feature in two Buddhist magazines,Raft, and Tricycle. London-based Raft, the Journal of theBuddhist Hospice Trust, devoted its No. 2 Winter 1989/90 issue toEuthanasia. Sixteen pages in length it contains short pieces byauthors such as Elisabeth Kubler-Ross, Ajahn Sumedho, Dame CicelySaunders and David Stott, exploring the cases for, against, and interms of a middle way. A similar range of opinions will be found inthe Winter 1992 edition of Tricycle, which contains short articlesby Patricia Anderson, Jeffrey Hopkins, Philip Kapleau, Chogyam Trungpa,and an interview with author Stephen Levine. Note: not all the items in the bibliography which followsare mentioned in the discussion above.BIBLIOGRAPHYBUDDHISM AND MEDICINEBirnbaum, Raoul 1979. The Healing Buddha. Boulder,Co: Shambhala. Clifford, Terry 1984. Tibetan Buddhist Medicine: the Diamond Healing. York Beach, Maine: Samuel Weiser. Demieville, P. 1985. Buddhism and Healing: Demieville's article 'Byoo' from Hooboogirin, translated by Mark Tatz. Lanhan, Md:University Press of America. Dhonden, Dr. Yeshe 1986. Health Through Balance: An Introduction to Tibetan Medicine. Ithaca: Snow Lion. Duncan, A. S., G. R. Dunstan, and R. B. Welbourn. 1981. "Buddhism", Dictionary of Medical Ethics. London: Darton, Longman and Todd. Fenner, Edward Todd. 1982. Rasayana Siddhi: Medicine and Alchemy in the Buddhist Tantras. Ann Arbor, Mich: University Microfilms International. Haldar, J. R. 1977. Medical Science in Pali Literature. Indian Museum Monographs, 10. Calcutta: Indian Museum. ---. 1992. Development of Public Health in Buddhism. Varanasi: Indological Book House. Jaqqi, Q. P. 1987. "India" (Medical Ethics of). In Encyclopedia of Bioethics, ed. W. Reich, London: Macmillan, 906-11. Majupu, Trilok Chandra. 1989. Religious and useful plants of Nepal and India: medicinal plants and flowers as mentioned in religious myths and legends of Hinduism and Buddhism. Lashkar (Gwalior): M.Gupta. Massin, Christopher. 1982. La medicine Tibetaine. Paris: Editions de la Maisnie. Meulendbeld, G. Jan (ed.). 1991. Medical Literature from India, Sri Lanka and Tibet. Leiden: E.J. Brill. Mitra, J. 1985. A Critical Appraisal of Ayurvedic Materials in Buddhist Literature (with special reference to Tripitaka). Varanasi: The Jyotirlok Prakashan. Ohnuki-Tierney, Emiko 1984. Illness and Culture in Contemporary Japan. Cambridge: Cambridge University Press. Rechung Rinpoche, Ven. 1976. Tibetan Medicine: Illustrated in Original Texts. Berkeley: University of California Press. Redmond, Geoffrey P. 1992. "Concepts of Disease in Buddhism," in Buddhist Studies Present and Future, ed. Ananda W.P. Guruge, Paris: The Permanent Delegation of Sri Lanka to Unesco, 143-159. Soni, R. L. 1976. "Buddhism in Relation to the Profession of Medicine" in Religion and Medicine, ed. D. W. Millard, Vol.3. London: SCM Press, 135-51. Unschuld, P.U. 1979. Medical Ethics in Imperial China. A Study in Historical Anthropology. Berkeley: University of California Press. ---. 1987. "General Historical Survey" (of Asian Medical Ethics) in Encyclopedia of Bioethics, ed. W.Reich, London: Macmillan, 901-6. Umezawa, K. 1988. "Medical Ethics in Japan," Biomedicine and Pharmacotherapy 42:169-172. Zysk, K. G. 1991. Asceticism and Healing in Ancient India: Medicine in the Buddhist Monastery. Oxford: Oxford University Press.BUDDHISM AND MEDICAL ETHICSBeauchamp, Tom L. and James F. Childress 1989. Principles of Biomedical Ethics, Third ed. Oxford: Oxford University Press. Epstein, Mark. 1993. "Awakening with Prozac: Pharmaceuticals and Practice." Tricycle Fall:30-34. Florida, R. E. 1994. "Buddhism and the Four Principles". In Principles of Health Care Ethics, ed. R. Gillon and A. Lloyd, Chichester: John Wiley & Sons, 105-16. Jones, Ken. 1989. The Social Face of Buddhism: An Approach to Political Activism. Boston: Wisdom Publications. Kabat-Zinn, Jon. 1990. Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain and Illness. New York: Dell. ---. 1994. Wherever You Go, There You Are: Mindfulness Meditation in Everyday Life. Westport, Conn.: Hyperion. Keown, Damien. 1995. Buddhism & Bioethics. London and New York: Macmillan/St. Martins Press. Kitagawa, J. 1987. "Medical Ethics of Japan through the Nineteenth Century," in Encyclopedia of Bioethics, ed. W.Reich, London: Macmillan, 922-924. Leland, Charmiere. 1995. "Bear Bile and Musk," International Journal of Alternative and Complementary Medicine 13:16-17. Lindbeck, Violette. 1984. "Thailand: Buddhism meets the Western Model," The Hastings Center Report 14:24-26. Mettanando, Bhikkhu. 1991. "Buddhist Ethics in the Practice of Medicine" in Buddhist Ethics and Modern Society: An International Symposium, ed.C.Wei-hsun Fu and S. A. Wawrytko, New York, etc: Greenwood Press, 195-213. Nakasone, R. Y. 1990. Ethics of Enlightenment. Fremont, Ca: Dharma Cloud Publishers. ---. 1994. "Buddhism". Encyclopedia of Bioethics. London: Macmillan. Ratanakul, P. 1986. Bioethics, an introduction to the ethics of medicine and life sciences. Bangkok: Mahidol University. ---. 1988. "Bioethics in Thailand: The Struggle for Buddhist Solutions," Journal of Medicine and Philosophy 13:301-12. ---. 1990. "Thailand: refining cultural values." The Hastings Center Report 20:25-27. Sizemore, Russell and Donald Swearer, eds. 1990. Ethics, Wealth and Salvation: A Study of Buddhist Social Ethics. Columbia SC: University of South Carolina Press. Taniguchi, S. 1987a. "A Study of Biomedical Ethics from a Buddhist Perspective". MA Thesis, Berkeley: Graduate Theological Union and the Institute of Buddhist Studies. ---. 1987b. "Biomedical Ethics from a Buddhist Perspective". Pacific World New Series 3 Fall:75-83. Umezawa, K. 1988. "Medical Ethics in Japan," Biomedicine and Pharmacotherapy 42:169-172.BUDDHIST APPROACHES TO PERSONHOODChaube, D. B. 1991. Mind-Body Relation in Indian Philosophy. Varanasi: Tara Book Agency. Collins, Steven. 1982. Selfless Persons: Imagery and Thought in Theravada Buddhism. Cambridge: Cambridge University Press. Harvey, P. 1987a. "The Buddhist Perspective on Respect for Persons". Buddhist Studies Review 4:31-46. ---. 1987b. "A Note and Response to 'The Buddhist Perspective on Respect for Persons'". Buddhist Studies Review 4:97-103. Klein, A. 1987. "Finding a Self: Buddhist and Feminist Perspectives" in Shaping New Vision: Gender and Values in American Culture, ed. C. Atkinson, C. Buchana, and M. Miles, Ann Arbor: UMI Research Press. Koyeli, G. D. 1987. "Individual Autonomy in Traditional Indian Thought," Journal of Indian Philosophy 15:99-107.MEDICAL ETHICISTS ON PERSONHOODFletcher, Joseph. 1979. Humanhood: Essays in Biomedical Ethics. Buffalo: Prometheus Books. Gervais, Karen. 1986. Redefining Death. New Haven: Yale University Press. Lizza, John P. 1993. "Persons and death: what's metaphysically wrong with our current statutory definition of death?" Journal of Medicine & Philosophy 18:351-74. More, Max. 1993. "The Diachronic Self: Identity, Continuity, Transformation" (Unpublished dissertation thesis, available at gopher://gopher.etext.org:70/00/Politics/ Extropy.Institute/more.03049* Nelkin, Dorothy. 1983. "The Politics of Personhood," Milbank Quarterly 61(1):101-12. Tooley, Michael. 1984. Abortion and Infanticide. Oxford: Oxford University Press.PARFIT'S DECONSTRUCTION OF PERSONHOODGruzalski, B. 1986a. "Parfit's impact on utilitarianism," Ethics 96:760-83. ---. 1986b. Symposium on Reasons and Persons. Ethics 96:832-72. Kuczewski, Mark G. 1994. "Whose Will Is It Anyway? A Discussion of Advance Directives, Personal Identity and Consensus in Medical Ethics," Bioethics, 8(1):27-48. Parfit, Derek. 1984. Reasons and Persons. Oxford: Oxford University Press.BUDDHISM AND ABORTIONFlorida, R. 1991. "Buddhist Approaches to Abortion," Asian Philosophy 1:39-50. Imamura, Ryo. 1984. "The Shin Buddhist Stance on Abortion." Buddhist Peace Fellowship Newsletter 6:6-7. Jones, K. 1989. The Social Face of Buddhism. London: Wisdom Publications. Lecso, P. A. 1987. "A Buddhist View of Abortion," Journal of Religion and Health 26:214-18. Stott, D. 1985. A Circle of Protection for the Unborn. Bristol: Ganesha Press. Tworkov, H. 1992. "Anti-abortion/pro-choice: taking both sides," Tricycle Spring:60-69.KEY WESTERN WRITINGS ON ABORTIONBennett, Michael. 1989. "Personhood from a Neuroscientific Perspective" in Abortion Rights and Fetal Personhood, eds. Edd Doer and James Prescott. Long Beach, California: Centerline Press, 83-86. Flower, Michael J. 1985. "Neuromaturation of the human fetus," Journal of Medicine and Philosophy 10:237-251. Luker, K. 1984. Abortion and the Politics of Motherhood. Berkeley: University of California Press. Tooley, Michael. 1984. Abortion and Infanticide. Oxford: Oxford University Press.WRITINGS ON EMBRYOLOGY, REBIRTH AND KARMA"Abortion" in Encyclopaedia of Buddhism.Batchelor, Stephen. 1992. "Rebirth: A Case for Buddhist Agnosticism," Tricycle Fall:16-23. Dhonden, Y. 1980. "Embryology in Tibetan Medicine" in Tibetan Medicine. Dharamsala: Library of Tibetan Works and Archives. King, Winston. 1994. "A Buddhist Ethics Without Karmic Rebirth?" Journal of Buddhist Ethics 1:33-44. Lipner, J. J. 1989. "The Classical Hindu View on Abortion and the Moral Status of the Unborn." In Hindu Ethics, ed. H. G. Coward, J. J. Lipner, and K. K. Young, Albany, New York: State University of New York Press, 41-69. McDermott, James Paul 1984. Development in the Early Buddhist Concept of Kamma/Karma. New Delhi: Munshiram Manoharlal. O'Flaherty, W. D., ed. 1980. Karma and Rebirth in Classical Indian Traditions. Berkeley: University of California Press. Saksena, B. 1935. "Pali Bhuunahan," Bulletin of the School of Oriental and African Studies 8:713-14.JAPAN AND ABORTIONBrooks, Anne Page. 1981. "Mizuko Kuyoo and Japanese Buddhism," Japanese Journal of Religious Studies 8:119-47. Eiki, H., and T. Dosho. 1987. "Indebtedness and comfort: the undercurrents of mizuko kuyoo in contemporary Japan," Japanese Journal of Religious Studies 14:305-20. LaFleur, W. A. 1990. "Contestation and Confrontation: The Morality of Abortion in Japan," Philosophy East and West 40:529-42. ---. 1992. Liquid Life: Abortion and Buddhism in Japan. Princeton: Princeton University Press. ---. 1995a. "The Cult of Jizo: Abortion Practices in Japan and What They Can Teach the West," Tricycle Summer:41-44. ---. 1995b. "Silences and Censures: Abortion, History, and Buddhism in Japan. A Rejoinder to George Tanabe," Japanese Journal of Religious Studies 22/1-2:185-196. Miura, D. 1983. The Forgotten Child. Henley-on-Thames, England: Aidan Ellis. Rand, Yvonne, Sensei. 1994. "The Buddha's Way and Abortion - Loss, Grief and Resolution." Mind Moon Circle Autumn:5-8 (also available electronically, filename jizo.zip, original site coombs.anu.edu.au). Smith, B. 1988. "Buddhism and Abortion in Contemporary Japan: Mizuko Kuyoo and the Confrontation with Death," Japanese Journal of Religious Studies 15:3-24. Werblowsky, Z. 1984 "Mizuko Kuyoo; Notulae on the most important 'New Religion' of Japan," Japanese Journal of Religious Studies 18:295-354. Young, R. F. 1989. "Abortion, Grief and Consolation: Prolegomenon to a Christian Response to Mizuko Kuyoo," Japanese Christian Quarterly (Tokyo) 55:31-39.BUDDHISM ON SEXUALITY AND CONTRACEPTIONLing, T. 1969. "Buddhist Factors in Population Growth and Control," Population Studies 23:53-60. ---. 1980. "Buddhist Values and Development Problems: A Case Study of Sri Lanka," World Development 8:577-586.GENETICS AND REPRODUCTIVE TECHNOLOGIESKimura, R. 1990. "Religious aspects of human genetic information" in Science, Law and Ethics, Ciba Foundation Symposium. Chichester: Wiley. Schenker, J. G. 1992. "Religious views regarding treatment of infertility by assisted reproductive technologies," Journal of Assisted Reproduction & Genetics 9:3-8.DEATH, DYING AND EUTHANASIAAmore, R. C. 1974. "The Heterodox Philosophical Systems" in Death and Eastern Thought, ed. Frederick H. Holck. Nashville, Tennessee: Abingdon, 114-163. Becker, C. B. 1990. "Buddhist views of suicide and euthanasia," Philosophy East and West 40:543-56. ---. 1993 Breaking the circle: death and the afterlife in Buddhism. Carbondale, Illinois: Southern Illinois University Press. Bilimoria, P. 1992. "The Jaina Ethic of Voluntary Death," Bioethics 6:330-55. Bowker, John. 1991. The Meaning of Death. Cambridge: Cambridge University Press. Feldman, E. 1988. "Defining Death: Organ Transplants, Tradition and Technology in Japan," Social Science and Medicine 27: 339-43. Florida, Robert 1993. "Buddhist Approaches to Euthanasia," Studies in Religion/Sciences Religieuses 22(1):35-47. Green, J. 1989. "Death with dignity: Buddhism," Nursing Times 85: 40-41. Hardacre, Helen. 1994. "Response of Buddhism and Shinto to the Issue of Brain Death and Organ Transplant," Cambridge Quarterly of Healthcare Ethics 3:585-601. Kapleau, P. 1989. The Wheel of Life and Death. New York: Doubleday. ---. 1972. The Wheel of Death. London: George, Allen and Unwin. Keown, D. and Keown, J. "Killing, Karma and Caring: Euthanasia in Buddhism and Christianity," Journal of Medical Ethics (forthcoming, October 1995). LaFleur, W. R. 1974. "Japan" in Death and Eastern Thought, ed. Frederick H. Holck. Nashville, Tennessee: Abingdon Press, 226-256. Lamotte, E. 1987. "Religious Suicide in Early Buddhism," Buddhist Studies Review 4:105-26. Lecso, P.A. 1986. "Euthanasia: A Buddhist Perspective," Journal of Religion and Health 25:51-57. Levine, S. 1982. Who Dies? An Investigation of Conscious Living and Conscious Dying. New York: Doubleday. Lock, M. and C. Honde 1990 "Reaching Consensus about Death: Heart Transplants and Cultural Identity in Japan," in Social Science Perspectives on Medical Ethics, ed. G. Weisz, New York: Kluwer, 99-119. Miura, D. 1983. The Forgotten Child. Henley-on-Thames, England: Aidan Ellis. Mullin, Glenn H. 1986. Death and Dying in Tibetan Tradition. London: Routledge and Kegan Paul. Nakasone, R. Y. 1994. "Buddhism," in Encyclopedia of Bioethics, London: Macmillan, 312-318. Neuberger, J. 1987. Caring for Dying People of Different Faiths. The Lisa Sainsbury Foundation Series, ed. V. Darling and P. Clench. London: Austen Cornish Publishers. Nudeshima, J. 1991. "Obstacles to brain death and organ transplantation in Japan," Lancet 338(8774):1063-64. Picken, S. 1977 "The Understanding of Death in Japanese Religion," Japanese Religion (July) 9,4,48. Powers, John 1995. Introduction to Tibetan Buddhism. Ithaca: Snow Lion. Raft. 1989. "Euthanasia." Raft, the Journal of the Buddhist Hospice Trust 2 Winter:1-16. Ratanakul, P. 1986. Bioethics, an introduction to the ethics of medicine and life sciences. Bangkok: Mahidol University. Sharma, A. 1987. "Emile Durkheim on Suicide in Buddhism," Buddhist Studies Review 4:119-26. Smart, N. 1968. "Attitudes towards death in eastern religions," in Man's concern with death, ed. Arnold et al Toynbee, Kent: Hodder and Stoughton, 95-115. Sogyal Rinpoche 1992. The Tibetan Book of Living and Dying. San Francisco and London: Harper/Rider. Sugunasiri, S. H. 1990. "The Buddhist view concerning the dead body," Transplantation Proceedings 22:947-49. Thakur, U. 1963. The History of Suicide in India. New Delhi: Munshiram Manoharlal. Tsomo, K. L. 1993. "Opportunity or Obstacle: Buddhist views of organ donation," Tricycle Summer:30-35. Van Loon, L. H. 1978. "A Buddhist Viewpoint." In Euthanasia. Human Sciences Research Council, Publication No.65, ed. Oosthuizen.G.C., H. A.Shapiro, and S. A. Strauss, Cape Town: Oxford University Press, 56-79. ---. 1983. "Some Buddhist Reflections on Suicide," Religion in Southern Africa 4:3-12. Whitehill, James 1974 "Mystological Death: Some Buddhist Lessons on Dying and Selfhood," The Drew Gateway:82-99. Wiltshire, M. G. 1983. "The 'Suicide' Problem in the Pali Canon," Journal of the International Association of Buddhist Studies 6:124-40.KEY WESTERN WRITINGS ON EUTHANASIAGrisez, Germain and Joseph M. Boyle 1979. Life and Death with Liberty and Justice. Notre Dame and London: University of Notre Dame Press.Gormally, Luke, ed. 1994. Euthanasia, Clinical Practice and the Law. London: The Linacre Centre for Health Care Ethics. Horan, Dennis J. and David Mall, eds. 1980. Death, Dying and Euthanasia. Frederick, Maryland: Aletheia Books, University Publications of America Inc. Humphry, Derek and Ann Wickett 1986. The Right to Die. London: The Bodley Head. Keown, John, ed. 1995. Euthanasia Examined: Ethical, Clinical and Legal Perspectives. Cambridge: Cambridge University Press. Rachels, James 1986. The End of Life. Oxford: Oxford University Press.Copyright 1995 |
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