Der Buddhismus lehrt uns: Nur dem, der nicht in den Kategorien von Karma, Wiedergeburt und Nirvana denkt, kommt das Leben ungerecht vor.
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| Wan Athit, 05. Ganyayon 2553 | Sonntag, 05. September 2553 (2010 n.Chr.) |
Wie steht der Buddhismus zur Euthanasie, also der sog. Sterbehilfe?Für Buddhisten ist der Tod ein natürlicher Vorgang im Samsara, also dem steten Entstehen und Vergehen. Er ist deshalb keine Strafe Gottes für eine Erbsünde. Aus buddhistischer Sicht ist der Tod mit dem Leben verbunden und im Sinne der Wiedergeburtslehre die Voraussetzung für neues Leben. 
Geburt und Tod stellen im Grunde denselben Vorgang dar: Beide sind ein Wechsel von Werden und Zerfall, ein Übergabg von einem Zustand in einen anderen. Der Ablauf gleicht dem ständigen Kommen und Gehen durch ein und dieselbe Türe, die - je nach der begangenen Richtung, als "Eingang" oder "Ausgang" dient.
Hinsichtlich der Frage der aktiven oder passiven Sterbehilfe (Euthanasie) bestehen auch unter Buddhisten selbstverständlich durchweg unterschiedliche und oft entgegengesetzte Auffassungen. Grundsätzlich aber gilt, dass das Recht auf Leben auch das Recht auf ein würdiges Sterben beinhaltet. Der Wunsch eines schwerkranken Menschen, lebensverlängernde Maßnahmen zu unterlassen, lässt sich nicht als Ablehnung des Leben interpretieren. Wo unheilsames Leiden vorhanden ist, wo alle vitalen Prozesse sich erschöpfen und Leben nur noch künstlich erhalten werden kann, dort kündigt sich der Tod als Übergang zu einer neuen Daseinsform an, dem wir mit Gelassenheit entgegensehen sollten. Es besteht natürlich bei manchen Buddhisten die Ansicht, dass Schmerzen Folgen von Krankheiten sind, die u.U. von früherem Wirken durch karmische Reaktionen ausgelöst sind. Dabei handelt es sich aber oft um nicht ganz richtige Auslegungen der Lehre des Buddha. Im Milindapañha (Die Fragen des Königs Milinda) gab der Erw. Mönch Nágasena folgende Erläuterung auf die Frage des Königs nach den Ursachen von Krankheiten: Nicht alle Schmerzen wurzeln im (früheren) Wirken (kamma). Aus acht Gründen nämlich mögen Schmerzen entstehen, und zufolge dieser haben viele Menschen Schmerzen zu leiden.Es wäre also falsch, sog. passive Sterbehilfe als unheilsamen Einfriff in die von jedem Lebewesen "abzuarbeitenden" karmischen Folgen zu sehen. Natürlich ist von meiner Sicht aus nichts gegen sog. lebensverlängernde Massanhmen einzuwenden, wenn diese tatsächlich für einen abzusehenden Zeitraum dazu führen können, den Kranken wieder in einen für ihn lebenswerten Zustand zu versetzen und dies auch von der/dem Betroffenen nicht ausdrücklich als unerwünscht bezeichnet worden ist (sog. Patientenverfügung). Dr. Pitak Chaicharoen, M.D., und Herr Pinit Ratanakul, Ph.D., von der "Faculty of Medicine, Ramathibodi Hospital, Mahidol University - Center for Human Resources Development, Mahidol University," in Bangkok, Thailand, haben aus der Sicht von Theravada - Buddhisten für das Eubios Journal of Asian and International Bioethics, Ausgabe 8 - 1998, einen umfangreichen Artikel verfasst, den ich hier auszugsweise wiedergebe: Letting-Go or Killing: Thai Buddhist Perspectives on Euthanasia Pitak Chaicharoen, M.D. & Pinit Ratanakul, Ph.D.* Faculty of Medicine, Ramathibodi Hospital, Mahidol University *Center for Human Resources Development, Mahidol University, 45/3 Ladphrao 92 Bangkapi, Bangkok 10310, THAILAND The position of "passive euthanasia" is more difficult to resolve in Buddhist terms. In this case the ethical waters become more muddy. Because of its complexity involving scarce medical resources, the high costs of treatment, and medical uncertainty the majority of lay Thai Buddhists are more cautious in their approach to "passive euthanasia". Despite their belief in the law of kamma for some of them withdrawing life support systems can be justified in a case when, by the best medical wisdom and through rigid testing, there has occurred in the patient total brain death which means irreversible coma and no hope for recovery. Some Thai Buddhists recognize that there is a real moral distinction between "letting die" or allowing a patient to die and directly and intentionally taking life. For them, allowing a patient to die does not violate the precept and is considered an altruistic action for those involved. In Buddhist ethics intention is crucial in determining actions as right or wrong, but with regard to euthanasia other factors are also important. There can be mixed motivations behind the intention to act in seemingly good ways. The intent of family members and the doctor to let the patient die, may be motivated by selfish as well as altruistic desires. For example, for family members there may be the desire to relieve the suffering of a patient and the desire to inherit his fortune. In the case of the doctor he may have the desire to end the pain and suffering of one patient and the desire to have a viable organ for transplantation in another patient. A hospital can have a policy accepting passive euthanasia with both a desire to relieve the suffering of patients and families and to contain medical costs. For these reasons lay Thai Buddhists are cautious about extending the grounds for "letting-go-of-life" by the withdrawal of medical technologies beyond the strict and narrow grounds in the case just mentioned above. And because of many factors entering into decisions about withdrawing life-support treatments such decisions have to be made on a case to case base. They also recognize that sometimes in real life human choices are only between two evils. Yet even in this tragic life situation one still has responsibility to choose the lesser evil. But for such agonizing decisions there has been little guidance culled so far from Buddhist sources to help Buddhists and to ease their conscience. As generally known, Buddhism encourages each person to face the troubles by relying on oneself alone, without expecting any divine power to intercede and help. Choosing among evils requires wisdom (panna) or insight arising from the regulated mind (samadhi), right understanding (sammadhithi) of the real nature of existence characterized by conditionality (paticcasamuppda), impermanence (anicca), suffering (dukkha) and unsubstantiality (anatta), and from continuing learning (sikkha). With samadhi and sammadithi one is able to make a realistic evaluation of a given situation and to act unselfishly. Sikka enriches panna diminishing the number of mistakes made. Since there have been cases especially with younger people where remarkable recoveries have occurred even after doctors pronounced them terminally ill or as being in irreversible coma, Thai lay Buddhists also are unwilling to see general policies adopted accepting passive euthanasia. As there are always risks and uncertainties, they would favor risking in favor of life and not against it. Euthanasia is an agonizing problem of Thai society as more and more high-tech treatments are being used by doctors. It has raised many unresolved ethical problems as the issue is further complicated because of the increased of the practice of organ transplantation. The question being raised now is whether the Buddhist compassion as practiced by doctors should go beyond their concern for their own immediate patients to those patients whose lives could be saved by their own dying patients' organs, as Buddhist compassion is impartial and is directed to all involved in a given situation. There should be extensive dialogue between members of the public and medical profession about this issue. Doctors, patients and the public alike will be benefited by this discussion of the reality and possibility of organ transplantation. While active euthanasia violates the Buddhist first precept against killing passive euthanasia presents a complex ethical challenge to Buddhist morality. Doctors cannot prolong the use of life-support systems indefinitely because of complicated factors involved such as medical cost for family members, scarce medical resources, medical uncertainty, and the resulting quality of patients' lives saved or sustained. Contemporary emphasis upon patients' autonomy, that patient should have the right to choose and refuse treatment and the possibility of conflicts between patients and doctors, doctors and family members are the other factors that complicated the issue. But the situation is even more aggravated when cases involved incompetent patients such as seriously defective infant (e.g. spina bifida babies, and anencephalics) who may be spared the agony of short but futile life by stopping life-sustaining treatments. In this case it is not the length of life that is really significant in making life and death decision it is the infants' own agony and the futility of treatment that matter. Suggestions are given by some Thai Buddhists that one can draw a distinction between "killing" and "letting-go-of-life" is worthy of serious consideration because in Buddhist ethics the motivation and intention behind actions are morally significant factors not simply the end result. If there really is such distinction Thai Buddhists may feel that letting-go-of-life does not constitute a breach of the Buddhist first precept, and Buddhism can offer a "middle way" between the two extremes i.e. active euthanasia including assisted suicide and the position of sustaining life at all costs and under all circumstances. However for general public there is still uncertainty about distintinguishing between "killing" and "letting-go-of-life", and passive euthanasia remains problematic for them. It is even more problematic for the doctors who strongly believe that sustaining the lives of their patients is their primary duty and obligation. Therefore the question of to save or let-go-of-life is a continuing ethical issue as Thai Buddhists grapple with the reality of existence in the modern world and the need to be faithful to Buddhist teachings. More and more elderly Buddhists, monks and lay people alike, express their wishes to be allowed to die in the last stage of their lives accepting death as a natural end simply because, they believe, this is the Buddhist way of facing the inevitable death. Ganzer Artikel im Internet 
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