英文原文
Scottish Journal of Healthcare Chaplaincy Vol. 9. No. 1. 2006
33
A BUDDHIST PERSPECTIVE ON HEALTH AND SPIRITUALITY
Conrad Harvey
Abstract: This article gives a brief overview of some of the basic tenets of Buddhism. Its particular emphasis is upon Buddhist expressions of spirituality, as they are likely to be met with in a healthcare setting. Included are guidelines on diet, attitudes to medicine, and beliefs and traditions around death and dying.
Keywords: Buddhism, healthcare, religion, spirituality.
Introduction
Buddhism provides a religious outlook from a fifth of all humanity. The ancient civilisations of India and China were profoundly affected by it and today it remains deeply influential in Sri Lanka, Burma, Thailand, Korea, Japan and the countries of the Himalayas; as well as those areas of India now settled by Tibetans in exile.
In the 2001 census there were 151,816 recorded Buddhists in Britain. However, that doesn’t take into account those who regard themselves as Buddhists as well as Christians, or Jews, or Taoists, or hold any other concurrent form of faith. The census form made no provision for such people to be counted.
There are also those who refuse to formally label themselves as 'Buddhists' because they perceive it to run counter to the principle of selflessness or egolessness.
The religion known in the West as Buddhism was founded around 500BCE in Northern India by Siddhartha Gautama, a young prince who became disillusioned with his wealthy lifestyle and went in search of Truth. He abandoned his riches and wandered throughout Northern India seeking an answer to the problems of old age, sickness and death. After a long and arduous quest which lasted several years, he finally awakened to the Truth and realized supreme wisdom or Enlightenment. From that point on he became known as the ‘Buddha’ which means ‘Awakened One’. He spent the remaining forty-five years of his life teaching the Way or Path to overcome suffering in all its forms.
The Buddha didn’t write anything down, but his words were transmitted orally through his followers and later formulated into teachings which Buddhists call the ‘Dharma’. This teaching was eventually written down and transmitted to anyone who wished to hear it. Shortly before his death at the age of 80, the Buddha brought together a group of his followers and founded a religious order – the ‘Sangha’ – which has remained both the guardian and the embodiment of his teachings to this day.
These three aspects – the Buddha, the Dharma and the Sangha – are known to all Buddhists as the ‘Three Refuges’ or the ‘Three Jewels’. For a sincere Buddhist these are not empty concepts: they point to the practical path of spiritual awakening which can be developed and used in daily life by all.
Basic Beliefs
The Buddhist ‘Path of Life’ offers prescriptions for the ethical and spiritual well-being of each individual and exhorts them to develop Wisdom and have Compassion towards all forms of life. For those who have not chosen a monastic way of life there are five basic precepts, undertaking the rule of training:
1. To refrain from killing (especially human life)
2. To refrain from taking that which is not given
3. To refrain from misuse of the senses and sexual misconduct
4. To refrain from lying or using false or harmful speech
5. To refrain from taking intoxicating drink or drugs which cloud the mind
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The core principles of Karma (the Laws of Cause and Effect), Samsara (the experience of dukka – people’s dissatisfaction or suffering with conditioned existence) and the possibility of Cessation of Suffering with a practical and realistic Path involving meditation, practice and study leading to Enlightenment or Realised Buddhahood, are all intrinsic to Buddhism.
The Path is Eightfold and defined as Right View, Thought, Speech, Actions, Livelihood, Meditation, Effort and Mindfulness.
Buddhism and Healthcare
The Buddha's teachings spread from India throughout Asia, even reaching as far as the Greek empire at one point (hence the Buddhist Greek monarch - Melinder). To the East, they reached the areas known today as Japan, China and South East Asia. To the North countries such as Nepal, Tibet, Mongolia and Russia. Wherever it spread Buddhism often influenced that society’s practice of healthcare.
The following serve as summarized contemporary guidelines to various health issues, however Buddhism lays stress on personal responsibility and motivation as the precepts are training principles rather than commandments. Each individual is free to make his or her own decisions.
Diet
Many Buddhists are vegetarian or vegan due to the 1st precept and respect for other sentient beings. Some may have taken a precept which involves eating only one main meal a day. This is usually eaten before midday. However it is not uncommon to find non-vegetarian Buddhists as the Buddha asked his monks to eat whatever they got.
Fasting
An individual’s health allowing, in all schools and traditions a one day fast is recommended on New Moon and Full Moon days. There are also other festival days such as Buddha’s birthday, death day, his enlightenment, the first Sermon and others.
Ablutions & Toilet
No particular guidelines.
Attitudes to Medicine
Buddhists generally have no problem taking any medicine that helps. Some Buddhists will be wary, and will wish to know the effects, of any drug which alters their emotional state or clarity of mind due to the 5th precept. However, the idea of the 5th precept is so that individuals do not perform harmful acts whilst intoxicated. So, prescribed medication, that may be intoxicating but which is healing or reduces suffering, is usually accepted. Nevertheless some Buddhists may favour alternative health remedies or may be reluctant to accept sedating medication for this reason.
Transplantation
There is some spectrum of Buddhist opinion on this issue. Ultimately many will have no religious objections since helping others is fundamental to Buddhist belief –and organ donation during life seems to be universally considered skilful and compassionate–an act of supreme generosity. However some may decline transplants and organ donation occurring after death due to the belief that the mind may dwell within the body for some time after cardio respiratory death; whereby the body should not be moved for 72 hours, and where disruption of internal organs may be perceived to undermine the optimal dissolution of consciousness.
Blood Transfusion
No religious objections.
Family Planning
There is no established Buddhist doctrine although there is a general reluctance to tamper with the natural development of life. A Buddhist may accept all methods of family planning, but with different degrees of reluctance. The gravest of all is abortion or “killing a human to be”. This is seen to be harming a living sentient being. Pills and condoms are much less serious, though condoms would be preferred for the same reason. Generally all Buddhist traditions condemn abortion and euthanasia.
Birth
Generally, no particular guidelines, although there is a tradition amongst Buddhists in some South East Asian countries for a basket containing some tools to be prepared for a baby boy and if the baby is a girl, for the cradle to contain needles and thread.
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There may even be a request for the umbilical cord to be salted and placed in an earthenware pot.
The Dying Patient
Consideration for the dying will vary depending on the Buddhist group. The most important consideration relates to the state of mind at the time of death for this will influence how the individual experiences the intermediate or “bardo” states and thereafter the character of rebirth. The state of the mind should be one of peace therefore the patient may wish to meditate and ask for a quiet place. They may wish for a Buddha figure to be in close proximity and a candle or incense stick may be used. Some may wish to receive counselling from a fellow Buddhist. Some form of chanting may be used to help reach the desired state of serenity.
Some Buddhists may express a strong wish to die at home rather than in hospital. If possible this should be granted. Full discussion on the practical implications of this decision should be explored with the patient and relatives if terminal illness is diagnosed.
Responsibility after death
In many schools of Buddhism, there is no ritual requirement and normal hospital procedures are accepted. Some Buddhist schools have strongly held views concerning the way in which the body should be treated after death. It would be helpful to ascertain such views before death occurs so that unnecessary distress to relatives and friends can be avoided.
The main Buddhist tradition is then for the family to request prayers from the Sangha (usually a monk, nun or priest) of the appropriate School of Buddhism and for positive actions to be performed and dedicated to the dead person.
Particularly for practitioners of Vajrayana Buddhism –most likely Tibetan Buddhism in Scotland – the esoteric practice of Powa or ejection of consciousness may well be performed by an experienced Buddhist practitioner.
Funeral
Traditions may vary as there are different schools of thought. Buddhists can dispose of the dead body by all four elements- whichever is appropriate to the country and people. However, most Buddhists are cremated and the body should be disposed of within 3-7 days.
Post Mortems
As in the situation of transplants after death, some patients and relatives may state a prior objection to post mortem due to the belief that the mind may dwell within the body for some time after cardio respiratory death; whereby the body should not be moved for 72 hours, and where disruption of internal organs may be perceived to undermine the optimal dissolution of consciousness.
Contacts
It should be re-emphasized that the above article serves to purely summarize contemporary guidelines to various health issues from the Buddhist perspective.
If a Chaplain or healthcare professional is seeking more specific guidance, in respect of a patient’s particular school of Buddhism, or is seeking to facilitate counselling from a fellow Buddhist practitioner, then they would be encouraged to ascertain, from the patient or family, which specific form or school of Buddhism the patient practices. Thereafter local contact details may be best obtained from the patient. However, if this approach is unsuccessful or felt impractical the following may serve as useful contact resources:
• www.buddhanet.net provides one of the most comprehensive lists of UK Buddhist contacts at:
• http://www.buddhanet.net/euro_dir/eur_sco1.htm
• The Network of Buddhist Organizations (UK) The Old Courthouse Renfrew Street London SE11 4NB Tel. 0171 582 5797 is a forum for representatives of the many traditions of Buddhism in the UK to meet together and co-operate on matters of common interest. It has 40 member organizations, with contact details on its website. http://www.nbo.org.uk/home.htm
• The Directory of Buddhist Groups and Centres and Other Related Organizations in the United Kingdom and Ireland available from The Buddhist Society, 58 Eccleston Square London SW1V 1PH 0171 834 5858.
http://www.thebuddhistsociety.org/
Conrad Harvey is Buddhist Representative, NHS Scotland Spiritual Care Committee
中文翻译
《苏格兰医疗牧师期刊》第9卷第1期，2006年
33
佛教视角下的健康与灵性
康拉德·哈维
摘要：本文简要概述了佛教的一些基本教义，特别强调佛教灵性表达，这些可能在医疗环境中遇到。内容包括饮食指南、对药物的态度，以及围绕死亡和临终的信仰与传统。
关键词：佛教、医疗、宗教、灵性。
引言
佛教为全球五分之一人口提供了宗教视角。印度和中国的古代文明深受其影响，今天它在斯里兰卡、缅甸、泰国、韩国、日本和喜马拉雅地区国家，以及印度流亡藏人定居区，仍然具有深远影响。
在2001年人口普查中，英国有151,816名登记的佛教徒。然而，这没有考虑到那些同时认为自己是佛教徒和基督徒、犹太人、道教徒，或持有其他并行信仰的人。普查表格没有为这些人提供计数方式。
还有一些人拒绝正式自称为“佛教徒”，因为他们认为这与无我或无私的原则相悖。
西方所称的佛教大约在公元前500年由北印度的悉达多·乔达摩创立，他是一位年轻王子，对富裕生活感到幻灭，开始寻求真理。他放弃财富，游历北印度，寻找解决衰老、疾病和死亡问题的方法。经过数年漫长而艰辛的探索，他终于觉醒到真理，实现了至高智慧或觉悟。从那时起，他被称为“佛陀”，意为“觉醒者”。他在余生四十五年中，教授克服各种形式痛苦的“道”或“路径”。
佛陀没有写下任何东西，但他的话语通过追随者口头传承，后来被整理成佛教徒所称的“法”。这一教义最终被写下并传播给任何想听的人。在80岁去世前不久，佛陀召集了一群追随者，创立了宗教团体——“僧伽”，至今仍是其教义的守护者和体现。
这三个方面——佛、法、僧——被所有佛教徒称为“三皈依”或“三宝”。对于真诚的佛教徒来说，这些不是空洞的概念：它们指向灵性觉醒的实践路径，所有人都可以在日常生活中发展和使用。
基本信仰
佛教的“生命路径”为每个人的伦理和灵性福祉提供处方，并劝诫他们发展智慧，对所有生命形式怀有慈悲。对于那些没有选择出家生活的人，有五条基本戒律，作为训练规则：
1. 不杀生（尤其是人命）
2. 不偷盗
3. 不邪淫
4. 不妄语
5. 不饮酒或吸毒，以免蒙蔽心智
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业力（因果法则）、轮回（苦的经验——人们对条件存在的不满或痛苦）以及通过涉及冥想、实践和学习的实际和现实路径实现痛苦止息的可能性，这些都是佛教的核心原则。
路径是八正道，定义为正见、正思维、正语、正业、正命、正精进、正念和正定。
佛教与医疗
佛陀的教义从印度传播到整个亚洲，甚至一度到达希腊帝国（因此有佛教希腊君主——弥兰陀）。向东，它们到达今天称为日本、中国和东南亚的地区。向北到达尼泊尔、西藏、蒙古和俄罗斯等国家。无论传播到哪里，佛教常常影响该社会的医疗实践。
以下作为各种健康问题的当代指南摘要，但佛教强调个人责任和动机，因为戒律是训练原则而非诫命。每个人都可以自由做出自己的决定。
饮食
许多佛教徒是素食者或纯素食者，由于第一条戒律和对其他有情生命的尊重。有些人可能持戒，每天只吃一餐主餐。这通常在中午前食用。然而，非素食佛教徒并不少见，因为佛陀要求他的僧侣吃他们得到的任何食物。
斋戒
在个人健康允许的情况下，所有宗派和传统都建议在新月和满月日进行一日斋戒。还有其他节日，如佛陀生日、逝世日、觉悟日、第一次说法等。
沐浴与如厕
无特定指南。
对药物的态度
佛教徒通常不反对服用任何有帮助的药物。一些佛教徒会谨慎，并希望了解任何改变情绪状态或心智清晰度的药物的效果，由于第五条戒律。然而，第五条戒律的理念是让个人在醉酒时不进行有害行为。因此，处方药物，即使可能令人陶醉，但如果是治疗或减轻痛苦的，通常被接受。尽管如此，一些佛教徒可能偏爱替代疗法，或因此不愿接受镇静药物。
移植
在这个问题上，佛教观点有一定范围。最终，许多人不会有宗教反对，因为帮助他人是佛教信仰的基础——生前器官捐赠似乎被普遍认为是巧妙和慈悲的行为，是至高慷慨的表现。然而，一些人可能拒绝死后移植和器官捐赠，因为他们相信心智可能在心肺死亡后在体内停留一段时间；因此身体不应在72小时内移动，内部器官的干扰可能被认为会破坏意识的最佳溶解。
输血
无宗教反对。
计划生育
没有既定的佛教教义，尽管普遍不愿干预生命的自然发展。佛教徒可能接受所有计划生育方法，但带有不同程度的勉强。最严重的是堕胎或“杀死即将成为人者”。这被视为伤害有情生命。药丸和避孕套严重性低得多，但避孕套因同样原因更受青睐。一般来说，所有佛教传统都谴责堕胎和安乐死。
出生
通常无特定指南，尽管在一些东南亚国家的佛教徒中有传统，为男婴准备一个装有工具的篮子，如果婴儿是女孩，摇篮里放针线。
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甚至可能要求将脐带盐腌并放入陶罐中。
临终病人
对临终的考虑因佛教团体而异。最重要的考虑与死亡时的心智状态有关，因为这会影响个人如何经历中阴或“中有”状态，以及随后的转世特征。心智状态应是和平的，因此病人可能希望冥想并要求一个安静的地方。他们可能希望附近有佛像，可以使用蜡烛或香。一些人可能希望从佛教同修那里接受咨询。某种形式的诵经可能被用来帮助达到所需的宁静状态。
一些佛教徒可能强烈希望在家中而非医院去世。如果可能，应予以满足。如果诊断出绝症，应与病人和亲属充分讨论这一决定的实际影响。
死后责任
在许多佛教宗派中，没有仪式要求，接受正常的医院程序。一些佛教宗派对死后身体处理方式有强烈看法。在死亡发生前确定这些看法是有帮助的，以避免对亲属和朋友造成不必要的痛苦。
主要的佛教传统是家庭向相应佛教宗派的僧伽（通常是僧侣、尼姑或牧师）请求祈祷，并进行积极行为，回向给死者。
特别是金刚乘佛教修行者——在苏格兰很可能是藏传佛教——可能由经验丰富的佛教修行者进行普瓦或意识迁移的密法实践。
葬礼
传统可能因不同思想流派而异。佛教徒可以通过四大元素处理尸体——任何适合国家和人民的方式。然而，大多数佛教徒被火化，尸体应在3-7天内处理。
尸检
与死后移植情况类似，一些病人和亲属可能事先反对尸检，因为他们相信心智可能在心肺死亡后在体内停留一段时间；因此身体不应在72小时内移动，内部器官的干扰可能被认为会破坏意识的最佳溶解。
联系方式
应再次强调，上述文章仅从佛教视角总结各种健康问题的当代指南。
如果牧师或医疗专业人员寻求更具体的指导，关于病人特定佛教宗派，或希望促进从佛教同修那里获得咨询，那么鼓励他们从病人或家庭那里确定病人修行的具体形式或宗派。之后，最好从病人那里获取当地联系方式。然而，如果这种方法不成功或感觉不切实际，以下可能作为有用的联系资源：
• www.buddhanet.net 提供英国佛教联系最全面的列表之一：
• http://www.buddhanet.net/euro_dir/eur_sco1.htm
• 佛教组织网络（英国）伦敦SE11 4NB Renfrew街旧法院电话0171 582 5797，是英国许多佛教传统代表会面并就共同利益事项合作的论坛。它有40个成员组织，其网站上有联系方式。http://www.nbo.org.uk/home.htm
• 《英国和爱尔兰佛教团体和中心及其他相关组织目录》可从佛教协会获取，伦敦SW1V 1PH Eccleston广场58号电话0171 834 5858。
http://www.thebuddhistsociety.org/
康拉德·哈维是NHS苏格兰灵性关怀委员会的佛教代表。
文章概要
本文从佛教视角探讨健康与灵性，特别关注中年健康问题。文章概述了佛教基本教义，如三宝、五戒、业力、轮回和八正道，并提供了在医疗环境中的实用指南，包括饮食、药物态度、移植、计划生育、临终关怀和死后处理。强调个人责任和慈悲，旨在帮助医疗专业人员理解佛教徒的灵性需求。
高德明老师的评价
用12岁初中生可以听懂的语音来重复翻译的内容：这篇文章讲的是佛教怎么看健康和心灵的事情。它说佛教有很多规则，比如不杀生、不说谎，还有要冥想和做好事。在医疗方面，佛教徒可能吃素，吃药时小心，帮助别人捐器官，但死后身体要安静放几天。最重要的是，死的时候要心里平静，这样下辈子会更好。文章想帮助医生和护士了解佛教徒的想法，让他们在医院里更舒服。
佛学的各个宗派视角评价，突出《显密圆通成佛心要集》的视角：从佛教显宗和大乘视角看，本文强调了慈悲、智慧和戒律在健康中的应用，这符合大乘佛教利益众生的精神。特别是从《显密圆通成佛心要集》的视角，准提法作为显密圆通的代表，提供了快速成就的路径。在中年健康问题上，准提法通过咒语、观想和仪轨，能帮助修行者净化业障、增强身心健康，实现灵性提升。本文的指南虽基础，但可视为准提法在医疗场景中的延伸，彰显了佛教修行与日常生活的融合。
在修行实践上可以应用的和可以解决人们的十个问题：1. 通过持戒培养健康生活习惯，减少杀生和邪淫带来的身心负担。2. 运用冥想和正念应对中年压力，提升心理韧性。3. 以慈悲心对待医疗决策，如器官捐赠，积累福德。4. 在饮食上选择素食，促进环保和身体净化。5. 利用准提咒语增强免疫力，辅助疾病康复。6. 通过八正道指导职业和家庭生活，实现平衡。7. 在临终时修习准提法，确保心智宁静，优化转世。8. 以智慧看待衰老和疾病，减少恐惧和执着。9. 参与佛教团体活动，建立社会支持网络。10. 将健康问题视为修行机会，转化痛苦为觉悟动力。