Written for the AQA syllabus by Upeksacitta (Robert Ellis), member of the Western Buddhist Order and a former Head of RS.
Buddhism and Organ Donation
Attitude to death and afterlife
Unlike the theistic religions, Buddhism does not have any belief that the human body was created by God. So there is nothing intrinsically wrong with organ transplantation because of its interference in the human body, whether living or dead, although obviously an organ should only be taken from a live donor with their consent. There are also no beliefs in bodily resurrection. Karmic processes move from one body to another, and there is no sense in which a body can continue to exist after death in Buddhist tradition. So there are no particular religious objections to organ donation from a corpse. Traditionally in Buddhism, funerals are an opportunity to reflect on impermanence, and the dead body is cremated rather than buried.
What is important for a person at the time of death for a Buddhist is not the condition of their body but of their mind. A state of non-attachment to the body is desirable at this time, and this could be aided by the generosity involved in deciding that one’s body could be used to help others after death.
There are a number of Buddhist doctrines which might be used to give positive reasons for supporting organ donation.
Second precept
The main precept of the five which may be seen as having a bearing on organ donation is the second precept in its positive form. The giving of an organ is an opportunity for generosity. The giving of part of one’s body to a person in need is an example of a very high level of generosity, in which the distinction between one’s own interests and those of others (a result of unenlightened ignorance) becomes much weaker. This would obviously be particularly the case with donation from a live donor, but donation from a corpse is also an instance of worthwhile generosity. So there seem to be no good reasons why a Buddhist could not carry a donor card.
There are examples from Buddhist scriptures which illustrate an extreme version of the kind of generosity which might be called for here. In the Jataka tales (stories of the Buddha’s previous lives) in the Pali Canon, there are some where the Buddha is an animal who gives him/herself voluntarily for food to a starving person. This theme is also found in the Sutra of Golden Light, a Mahayana Sutra, where the Buddha in a previous lifetime (as a young prince) is said to have encountered a starving tigress and her cubs and killed himself in front of her to provide her with food (See Buddhist Scriptures p.24-6). Obviously this sacrifice goes further than most organ donors would need to go! It can also perhaps be read as an exaggerated popular story to make a point, for the wisdom of sacrificing one’s life in this way could be questioned from a Buddhist point of view, given the other good things one might achieve with a human birth.
The negative form of the second precept also suggests that the consent of those giving organs, whether living or dead, is important, for taking an organ without consent is taking the not-given. For this reason more conservative Buddhists might be inclined to reject any proposal to introduce an objector’s card system.
Impermanence and insubstantiality
The doctrines of impermanence (anicca) and no-self or insubstantiality (anatta) are part of the First Noble Truth, of the existence of dukkha (frustration or suffering). These doctrines will be studied in more detail in the A2 Buddhism course, but in brief it can be said that dukkha occurs because, although we have both pleasant and unpleasant experiences, the pleasant experiences will be impermanent (they will always come to an end) and insubstantial (they will not be exactly as we think them to be, and thus be disappointing). Impermanence and insubstantiality thus have a close supportive relationship with dukkha.
Impermanence and insubstantiality also apply very much to our bodies. Our bodies are constantly changing, and will eventually die. So although they may enable us to have pleasant experiences, those experiences will soon come to an end because our body does, as well as because the source of the pleasant experience (e.g. the bar of chocolate) will end. Even if life consisted of one non-stop pleasant experience, it would still be impermanent. Are bodies are also insubstantial because they are not always what we take them to be. We tend to assume they are reliable but then we have illnesses and injuries. We also often take the body to be beautiful, but Buddhist texts often stress that this involves a very selective view of the body, not taking much account of all the unpleasant substances our bodies contain and frequently excrete. We should also not identify ourselves with our bodies: for we do not have a self, either in our bodies or in our minds, the self being ultimately an illusion.
So, if the body is impermanent and insubstantial, this provides a further reason for not getting too attached to it. An organ of the type we might donate is not in any sense 'ours' other than due to the fact that the being I conveniently call 'me' for the time being happens to be temporarily using this organ. If it’s not really 'mine' to begin with, and it’s impermanent anyway, there’s really no reason why I shouldn’t give it away when someone else needs it, especially if I definitely don’t need it any more because I’m dead.
Some Buddhist views
Organ donation is an extremely positive action. As long as it is truly the
wish of the dying person, it will not harm in any way the consciousness that
is leaving the body. On the contrary, this final act of generosity accumulates
good karma.
Sogyal Rinpoche – The Tibetan Book of Living & Dying, published by
Rider.
I would be happy if I was able to help someone else live after my own death.
Dhammarati, Western Buddhist Order
Non-attachment to the body can be seen in the context of non-attachment
to self and Buddhist teachings on impermanence. Compassion is a
pre-eminent quality. Giving one’s body for the good of others is seen
as a virtue.
The Amida Trust
Organ donation is acceptable in Theravada Buddhism. It is a Buddhist
virtue to generously extend help to other sentient beings and this covers the
case of organ donation.
Phramaha Laow Panyasiri, Abbot, The Buddhavihara Temple
Resources issues and the Middle Way
In general then, organ donation seems a good action for Buddhists. However, wherever a gift is given there can always be questions about the wisdom of that gift. Obviously some gifts can be unwise compared to others. If you have a moderate amount of money to give away, it is better to give it to someone in great need than someone who is already rich. In the case of organ donation, some have argued that these expensive and risky operations are not justified by their results, given that both money and the time and skills of doctors could be more effectively applied to simpler treatments which might save more lives in the long run.
In Buddhist terms, this may be an obvious case where it is useful to apply the Middle Way. The Precepts tell one only to save lives and be generous, but not how to judge between conflicting ways of doing this. The Middle Way might suggest that both the suffering of those needing transplants and those of others need to be taken into account. It may be that more money and doctors could be provided for both, but if not then a fair allocation needs to be made which meets the long-term needs of all as far as possible. But anyone making decisions about the allocation of medical resources in this way needs to carefully check how far they might be motivated by greed or hatred in relation to either rich or poor.
Questions for discussion
1. Do you think Buddhists should support a switch to an objector’s card system for organ donation? Why/ why not?
2. How far do you think Buddhists should support particularly expensive and risky transplant operations such as heart transplants?
Read and take notes on Cush p.65-68 on anatta and rebirth