Written for the AQA syllabus by Upeksacitta (Robert Ellis), member of the Western Buddhist Order and a former Head of RS.
Buddhism and the allocation of medical resources
Very little has been written by Buddhists on this. However, there are certainly some specific teachings in Buddhism which could be used to help determine an order of priorities in resource allocation.
The First Precept and Four Noble Truths
The First Precept (particularly in its positive form) and Buddhist ideals of compassion provide a strong reason for providing medical care. Medicine of different types has been practised in Buddhist countries through the ages, although the type has depended more on culture than religion (e.g. Ayurvedic medicine in India, Chinese medicine in China, Tibetan medicine in Tibet).
Another basic justification lies in the Four Noble Truths, which start with the recognition of suffering and set out to overcome it through a process of identifying the cause, the cure, and the prescription. The similarity of the Four Noble Truths to the activities of a doctor has often been noted, and there is even a figure known as the Medicine Buddha who symbolically represents this.
This does not take us much further, though, than the general idea that medical treatment to relieve suffering and to save life is good. It doesn’t help in deciding priorities between different forms of medical treatment.
Holistic medicine
Holism is the idea that we should think about things as a whole rather than just isolating specific parts and taking them out of context. The tradition of Western medicine tends not to be very holistic, but rather to concentrate on finding a 'magic bullet': a specific cure for each specific ailment. Confronted by a patient with, say, appendicitis, a Western-trained doctor is quite likely to start thinking immediately about how to cure the appendicitis, rather than other aspects of the patient’s health and well-being, whether they are happy in their job or whether their lifestyle is sustainable for them. This contrasts with the traditions of Indian and Chinese medicine, which tend to be more holistic, i.e. they treat the whole person rather than just the disease. Chinese doctors are traditionally paid for keeping their patients in health rather than for curing them of diseases.
Indian and Chinese forms of medicine have come out of complex cultural background, but Buddhism is certainly one important influence on them. Holistic views of health care can certainly be defended using Buddhist teachings about the interdependency of all conditions. The doctrine of dependent origination, symbolised by the outer ring of the Wheel of life, suggests most basically that all aspects of our existence are interrelated and interdependent, particularly our nature with our desires. A lot of traditional Buddhist practice reflects this by working with all parts of the body and mind on the assumption that they affect each other: meditating one loving-kindness could help relax your body, doing Tai-Chi could help you concentrate, and increased awareness through meditation can help you develop wisdom. For this reason many modern Western Buddhists use or even practise alternative (and usually more holistic) forms of health care such as homeopathy, acupuncture, massage and reflexology.
If you take this tendency towards holism into account it would suggest that Buddhist ethics would favour long-term solutions to health problems over short-term 'magic bullets', so that stress might be given to preventative medicine and health education. When an illness does occur, it might be seen not simply as the responsibility of the NHS to cure it, but of the person to change their lifestyle in a way that could allow their health to improve and remain improved.
Saving lives vs quality of life
There would probably be much more disagreement between Buddhists on the issue of saving lives vs. quality of life. Traditionalists who stress the importance of the First precept are more likely to prioritise saving lives. However, the idea of spiritual instrumentalism (see abortion) might lead other Buddhists to put more emphasis on the quality of life.
Questions
1. Do you think doctors should be paid for curing people or for keeping them healthy?
2. What do you think are the advantages of a holistic approach to medicine?
3. What might be the disadvantages?
4. How well do you think a Buddhist approach to the prioritisation of medical resources compares to a utilitarian approach?