The importance of love in ancient Indian biomedical ethics

- Sunil K. Pandya , M.D.
Flat 11, 5th flr., Shanti Kutir, Marine Drive, Mumbai 400020, India
Email: sunil@pandya.ilbom.ernet.in
Eubios Journal of Asian and International Bioethics 9 (1999), 42-43.


Some fundamental Hindu principles

Both the human individual and the natural world are seen as manifestations of the eternal Brahman. The person and nature are constituted of six elements - the five mahabhutas (gross elements) earth, water, fire, air, ether and the atman - spirit or self in the person and Brahman in the universe. Man is thus a small but integral part of the cosmos. Spirit and matter are not alien or opposite but parts of an integral whole.

The strong belief that the earth, the heavens, the four directions, fire, air, sun, moon, stars, water, herbs, trees, the sky and the soul contribute to life and influence life made it necessary for man to treat them with affection and respect. Disrespect would bring upon man the wrath of the gods and condemn us to repeating the cycle of rebirth and death.

Love, for the ancient Hindu (and, later the Buddhist and Jain) did not refer to attachment to one or more persons for the purpose of having his longings satisfied. Love is an unlimited, self-giving compassion flowing freely to all living creatures.

Ahimsa (a = not, himsa = violence)

Mahatma Gandhi explained his understanding of this concept thus: "Ahimsa does not simply mean non-killing. Himsa means causing pain to or killing any life out of anger or from a selfish purpose, or with the intention of injuring it. Refraining from so doing is ahimsa." He elaborated: "It is utmost selflessness. Selflessness means complete freedom from a regard for one's body. If a man desired to realize himself, i.e., Truth, he could only do so on being completely detached from the body, i.e., by making all other beings feel safe with him. That is the way of ahimsa." This 'making all other beings feel safe with him' implied a positive duty and not just the avoidance of harm or violence.

Daya

The other quality that Hinduism calls upon in all situations, especially those with tragic connotations, is daya or compassion. In Hinduism, the justification of compassion comes not only from its nobility as a virtue but from the fact that all living beings are manifestations of the same universal Brahman.

The Golden Rule

Hinduism's strong sense of the sacredness of life expresses itself in diverse forms, including the Golden Rule. There are various instances in the epic literature. The Mahabharata first exhorts the norm of self-similitude: "Good people do not injure living beings; in joy and sorrow, pleasure and pain, one should act towards others as one would have then act toward oneself." And then, more broadly: "Whatever one would wish for oneself, that let one plan for another."

One verse sums up the entire body of relevant Hindu wisdom: "May all be at ease; may all be sinless; may all experience happiness; may none experience suffering." This, incidentally, could serve as the credo of all physicians.

Life and death

The philosophy of life and death also predisposed towards fostering a love of all mankind in the individual.

An important development in the ancient Sanskrit texts is the conception of man's duties - the triad of obligations (rnatraya). This comprehensive ideal involves not only a man's duty to the gods, through sacrifice; but his obligation to the perpetuation of the family and his obligations to society.

The classic texts put forward the scheme of asramas. Brahmacarya, Grhasthya, Vanaprasthya and Sanyasa. The concept of asrama had, as its corollary the thought that human needs and aspirations must change through time. This permitted an ethic of relativism with developmental values of life and death.

The Upanisads and other philosophical works focus on man's need to complete his long quest for unity - a quest which turns inward for the purpose of understanding Ultimate Reality. The sage prays (Brihadaranyaka Upanisad 1.3.28.):From the unreal (asat) lead me to the real (sat)!From darkness lead me to light!

From death lead me to immortality!

The logic of Upanisadic teaching suggested that once one's obligations under the asramas had been fulfilled, everyday existence is insignificant when compared with the experience of mystical union, which carries one past the cycle of death and rebirth and beyond this ephemeral world. The thirst for such knowledge could persuade one to leave all and enter the forest. The enlightened sanyasin is instructed to make the great journey or to choose voluntary death in some heroic manner.

The origins of medicine

The science of Ayurveda owes its origins in legend to love of mankind. As ill-health and disease became wide-spread, the ancient Indian sages gathered at the foothills of the Himalayas around 2000 B.C. in what might be termed the first medical conference ever. The theme of the conference was: "By what means can disease be checked?" The penance and entreaties of these venerable men moved the gods and eventually Indra granted an audience to their representative, Bharadvaja, at his celestial abode and revealed the principles of Ayurveda to him so that he could return to earth and use them for public benefit. We are told that Bharadvaja grasped the "boundless, shoreless, eternal and auspicious science" consisting of knowledge on the causes of disease (hetu), symptoms (linga) and remedies (ausadha). [A variant of this legend has Indra granting this knowledge to Dhanwantari.]

Ancient Indian medical education

The spirit that prompted the gods to part with the principles of Ayurveda permeated their recipients on earth who passed them on from one generation to another. The emphasis on love for all living creatures and the need to be polite and courteous to everyone is a recurrent theme in all ancient Indian medical and philosophical works. The medical student was directed to seek the welfare of all those who came under his care. Consider the requirements of a good teacher as laid down in the ancient Indian classics - the Caraka Samhita and the Susruta Samhita:
. He should be compassionate towards those who approach him.
. He should be well-disposed towards disciples and dedicated to teaching them.
. He should be pure of conduct.
. He should be without malice.
. He should be without a wrathful disposition.

Likewise, consider the qualities required of the student ere he could seek instruction in Ayurveda:
. He should seek the good of all creatures.
. He should be noble by nature.
. He should be of a thoughtful disposition.
. He should possess an excellent character; be pure in his behaviour; devoted, clever and compassionate to all.

These injunctions were elaborated upon in the instructions to the disciple at the consecration ceremony:. "If thou desirest to achieve success of treatment and win heaven hereafter, though shouldst always seek _ the good of all living creatures.

. "Thou shouldst speak words that are soft, unstained by impurity, full of righteousness, incapable of giving pain to others, worthy of praise, truthful, beneficial and properly weighed and measured.

. "Thou should give up lust, anger, avarice, folly, vanity, pride, envy, rudeness, deception, falsehood, idleness and all other reprehensible conduct.

. "It is the duty of all good physicians to treat gratuitously with their own medicines, all Brahmins, spiritual guides, paupers, friends, ascetics, neighbours, devotees, orphans and people who come from a distance as if they are his own friends.

. After having studied the sastras and learnt their meaning, after having acquired a practical knowledge of surgical treatment, the physician should be polite in his speech and friendly to all living beings and he should have an attendant of good character.

Relationships between doctors

Love and mutual respect were encouraged. Caraka advised medical men to hold discussions (sambhasa) with their colleagues. Discussion, he said, increases the zeal for knowledge (samharsa), clarifies knowledge, increases the power of speech, removes doubts in the learning acquired earlier and strengthens convictions.

Love as the basis for euthanasia

Hinduism believes that living is more important than being alive. This places Hinduism squarely on the side of those who would argue for active euthanasia on the grounds of the quality of life over the claims of vital existence. In Ayurveda, health itself is spiritually defined. The term used to define a healthy person is svastha (sva = self; stha = to `establish', `stand' or `maintain'). A healthy person is one who is established, in his self, the soul.

In the Hindu tradition, the person who has conquered all attachments and who has thereby acquired liberating knowledge is eulogised as the highest type of renouncer. Detachment is the necessary condition for renunciation, especially detachment from the body. As the composite of matter, the body is impermanent and therefore to relate to it as permanent is gross ignorance.

Hinduism says that agonising situations sometimes arise when the drive for self-preservation must halt, and even ahimsa must yield to the request to end it all. Hindu ethics is not passive in the face of suffering. Karma does not give us the right to keep such people alive and in pain when all they want is a peaceful death. Their karma is our dharma. We have a duty to our fellow-beings. If they are suffering because of some sin, it is no less a sin to let them suffer. Mahatma Gandhi asked, "God comes to a hungry man in the form of a slice of bread." In what form does God come to a person begging to die?


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Bioethics is Love of Life An alternative textbook on cross-cultural ethics by Darryl Macer
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