Facing Illness and Death By: Prof. Lily de Silva

Facing Illness and Death  

By: Prof. Lily de Silva

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(Translate Version by Google Translation)

The Buddha advised his disciples about the importance of ministering to the sick. He said: "Someone who is caring for the sick, it means that he has cared for Me." This famous statement was made ​​by the Blessed One when he discovered a monk lying in soiled robes. The monk is in a state of severe pain due to an attack of dysentery. With the help of Ananda, the Buddha washed and cleaned the sick monk with warm water. On this occasion, he reminded the monks that they do not have parents or relatives who take care of them, then they have to take care of one another. If the teacher is sick, students have an obligation to preserve it, and if students are sick, the teacher is obliged to keep a sick student. If there are no teachers or students, the society is obliged to keep the sick (Vin.i, 301ff.).




On another occasion, the Buddha met a monk whose body was filled with sores, hair stuck to his body with pus out of wounds. Fellow monks had left because they could not keep. On discovering this monk, the Buddha boil water and wash the monk with his own hands, then cleaned and dried his robes. When the monk was comfortable, the Buddha gave a sermon to him and he became arahatta, shortly after becoming arahatta, he died (DhpA.i, 319). Therefore the Buddha not only supports the importance of caring for the sick, He also gives examples of good with himself ministering to those who are very ill, they are even considered to be repulsive to others.

The Buddha describes the properties that must be possessed by a good nurse. He must be able to deliver the drug, he should know what is beneficial to the patient and what is not. He should keep what not and give only what is beneficial to the patient. He must have compassion and generous, he should do his duty and a sense of service not only to reward (mettacitto gilanam upatthati no amisantaro). He should not feel disgusted with saliva, mucus, urine, faeces, wounds, etc.. He should be able to advise and encourage patients with noble ideas, the Dhamma talks (A.iii, 144).

It is noteworthy here that the nurses are not only expected to be efficient in treating the body by giving food and medicine, but is also expected to treat mental condition of patients. It is known that the kindness of the nurses and doctors are almost as effective as drugs for morale and recovery of a patient. When someone is seriously ill and feeling powerless, a kind word or an act becomes a source of comfort and hope. That's why loving kindness (metta) and compassion (karuna), which is also a noble feelings (brahmaviharas), considered as the properties were laudable in a nurse. The suttas adds another dimension to the nursing profession by incorporating spiritual elements in talks nurses. Sickness is when a person is facing the realities of life and it is a good opportunity to instill a sense of spiritual urgency, even in the most materialistic. Furthermore, a person who is ill must have a fear of death that is greater than when he was healthy. Ways best to calm this fear is to divert attention to the Dhamma. In supervision, nurses are expected to provide spiritual guidance to patients as a part and parcel of the duties of a nurse.

In the Anguttara Nikaya, the Buddha mentions three types of patients (Ai, 120). There are patients who do not recover if they get or do not get proper medical attention and nursing care; contained patients who recover do not care whether they get or do not get proper medical attention and nursing care; contained patients who will be cured only by medical and nursing care appropriate. Because of this third type of patient, then all the sick should be given the best treatment available, food is beneficial and appropriate care. As long as the patient is alive, everything possible should be done to cure.

Here, we are reminded of an event (MA.i, 203) where a mother who was very sick rabbit meat as requiring treatment. The son did not get rabbit meat in the public market, he looks for a rabbit. He managed to catch a rabbit but he hated to kill him while killing for the sake of his mother. He releases a rabbit and expecting mother recovered. Moral virtues simultaneously son with hopes to bring healing mother. Buddhist tradition seems to hold that the power of virtue in certain circumstances have healing properties that can work even in cases when treatment fails.

Chapter treatments in Vinaya Mahavagga (Vin.i, 199ff.) Suggests that the Buddha relaxed some minor disciplinary rules to suit the needs of sick monks. Despite the harsh discipline, the Buddha showed great sympathy and understanding to those who are sick. Health value has been fully realized and even recognized as the largest (arogyaparama labha, Dhp.204).

The Buddha taught that in order to heal, the patient should also work closely with physicians and nurses. A good patient should take and do what is beneficial to him. Even in eating foods that are beneficial though, he must know the exact amount. He should take prescription drugs without a hassle. He should honestly tell their diseases to nurses who are aware of the obligations. He should patiently endure the physical pain even when the pain is acute and excruciating (A.iii, 144).

The suttas show that the Buddha uses the power of determination and composure when he fell ill. He suffered excruciating pain when the sharp pieces of rock thrown by Devadatta Her legs poking him. He was in pain with full awareness and tranquility, and is not controlled by pain (Si, 27, 210). During his last illness, the Buddha also mindful withstand great physical pain, and with admirable courage he walked from Pava to Kusinara with his steadfast companion, Ananda, while resting in some places to reduce fatigue (D.ii, 128.134 ). Maha-Parinibbana Sutta also reports that the Buddha once hard to hide a dangerous disease and he Beluvagama healthy again (D.ii, 99).

It seems that those who have higher mental development able to withstand disease, at least in certain conditions. Once Nakulapita visited the Buddha in old age, and the Master advised him to remain mentally healthy even though the body is weak (S.iii, 1). There are physical and mental pain (vedana DVE Kayika cetasika ca ca). When a person has a physical pain, if he becomes anxious and adding inner pain as well, then it's like being shot with two arrows (S.iv, 208). Someone who develop spiritually capable of keeping the mind healthy balanced with spiritual development. Because a spiritual arahatta fully developed, he was able to only experience physical pain with no inner pain (so Ekam vedanam vediyati kayikam na cetasikam, S.iv, 209).

A number of sutta recommends reading the elements of enlightenment (Bojjhanga) in order to cure physical ailments. On two occasions, when the Elders Mahakassapa and Mahamoggallana were ill, the Buddha recited the elements of enlightenment and reported that the monks are back healthy (Sv 0.79 to 80). It may be noted that all the monks in question is arahatta, they have developed the elements of full enlightenment. Bojjhanga Samyutta also told that at one time the Buddha was ill, he asked Cunda to recite the elements of enlightenment (Sv, 81). The Buddha was pleased with the reading and it is said that he regained health. On another occasion, when the monk Girimananda ill (Av, 109), the Buddha told Ananda that if the sermon on the ten-consciousness (dasa sañña) delivered to him, he might be healthy. Ten consciousness is awareness of impermanence, not-self, body dirtiness, bad consequences (of the body), annihilation (the pleasures of lust), detachment, cessation, disillusionment with the entire worldly impermanence all the objects, and mindfulness of breathing. Ananda learned the discourse of the Buddha, repeated the sermon to Girimananda, and reported that Girimananda be healed.

Once upon a time, the Buddha heard that a newly ordained monk who was seriously ill, he was not well known among members of the monks. The Buddha visited. When he saw the Buddha approaching, he moved on his bed and tried to stand, but the Buddha cautioned not to rise. Once seated, the Buddha asks health, whether the pain is reduced or not reduced. The monk replied that he was very sick and weak, that the pain is increasing and not decreasing. The Buddha then asked if he had a sense of hesitation or remorse. The monk replied that he had a lot of doubt and regret. The Buddha then asked if he blamed himself for any offense. He said no. Then the Buddha asked him why he was sorry if he was not guilty of any offense. The monk replied that the Buddha did not preach the doctrine for the purity of virtue, but a detachment from lust (ragaviragatthaya). Feeling happy, the Buddha said 'Sadhu ... Sadhu 'in praise.

Then the Buddha spoke to the monk's teachings. He explained that these feelings are impermanent, unsatisfactory and without a nucleus, then they should not be considered as "I" and "mine". Understanding of their true nature, good students become attached to feelings. Currently Dhamma explanation is given, the vision of the truth (dhammacakkhu) occurs on the monk, and he realized that whatever nature arising must have had a sinking properties. In other words, he became a sotapanna, a stream-entry.

According Sotapattisamyutta Anathapindika was once very ill, and the Venerable Sariputta visited upon request him (Sv, 380). On being told that the pain is severe and increasing Sariputta Anathapindika reminded of the goodness-n-his own good. Sariputta explains that ordinary beings, who do not have faith in the Buddha, Dhamma and Sangha and do not maintain good habits, will feel sorrow for the destruction of the body. But Anathapindika have unshakable faith in the Buddha, Dhamma and Sangha, and has maintained good moral habits. Sariputta told him that when these noble qualities are mindfully, the pain will subside.

Furthermore, Sariputta suggests that ordinary people reach a state of sorrow over the destruction of the body because they have not developed the Noble Eightfold Path. But instead Anathapindika has developed the Noble Eightfold Path. When attention is paid to them and noble qualities understood, the pain will subside. Told that the pain subsided and Anathapindika recovered from the disease. Furthermore, Anathapindika get out of bed and serve Sariputta with food provided by himself.

Sotapattisamyutta recorded another occasion when Anathapindika ill (Sv, 385). Venerable Ananda was called to the bed and he gave a sermon. Ananda explains that ordinary people who do not have faith in the Buddha, Dhamma and Sangha as well as having immoral habits will experience anxiety and fear when death is imminent. But the followers of both the firm had confidence in the Buddha, Dhamma and Sangha and to develop moral habits will not experience anxiety and fear of death. Furthermore Anathapindika recognizes unshakable faith in the Buddha, Dhamma, and Sangha, and stated that he is endowed with virtue unsullied. Ananda said that it is indeed a great achievement that Anathapindika have shown the fruit of stream-attainment. However, it is not reported whether Anathapindika recovered instantly.

The Buddha suggested that a monk should not detract from the power and determination for spiritual progress, even when he was sick (A.iv, 335). Possible that the illness will get worse, and before that happens, spiritual development should be implemented as much as possible. After recovering from the illness, one should also not be negligent, because if disease recurrence, the possibility of a higher spiritual attainment will be reduced.

The Buddhist method of ministering to the sick, as is evident from the above texts, not only affirms the importance of proper treatment and care, but also the mind of the patient to good thoughts. It seems that there is a belief that the attention on topics related to teaching, especially the reminder about the virtues that have been developed by someone, have healing properties. In the case of the Buddha and the arahatta, recitation of the bojjhangas has restored health. In the case of the monk who was probably not Girimananda arahatta early in the illness, the ten perceptions that restored his health. Anathapindika is a sotapanna and conversation about the special properties of an instrument for his speedy recovery. Maybe when someone reminded inner traits that have been obtained, the excitement came to mind. The excitement thus may be able to change a person's body chemistry in a positive and healthy manner.

Here we are reminded of the same events told in Papañcasudani (MA.i, 78). A monk bitten by a snake when she was listening to the Dhamma. He ignored the snake bites and keep listening to the Dharma. Venom spread and became very ill. He then reflected on the sanctity of the act of virtue he has done since his ordination. When he realized the nature of the spotless, joy and satisfaction exceptional appear in them. Healthy physiological changes act as an anti-venom and he was healed instantly. These events seem to show that at the time was seriously ill, attention was focused on one's spiritual nature, the incredible excitement in the mind, and the factors that promote health to be active in the body, perhaps by way of hormones restore health. Maybe that's how the high berspiritual individuals get health back when appropriate suttas read.

In the Pali canon there are many instances of giving advice to the terminally ill. Speaking about death to a terminally ill patient is an unpleasant subject. Instead, the reality of death and the possibility of death must be accepted immediately without pretense and the patient is prepared to face death with confidence and poise.

The advice given by Nakulamata to Nakulapita very helpful in terms of dealing with this (A.iii 0.295 to 98). Once Nakulapita Nakulamata serious and his wife noticed that he was nervous and anxious. She advised him thus: "Please, sir, do not face death with anxiety.'s Death is a painful thing for someone who is agitated. Buddha despise death anxiety. Perhaps you are worried that I will not be able to support the family after your death. Kindly do not think so. I was able to spin and weave, and I will be able to raise children if you are not in the world anymore. Perhaps you are worried that I would get married again after the death of you. Kindly do not think so. Both of us live holy lives according to the rules noble householders. then Do not worry about it. Perhaps you are worried that I will neglect attention to the Buddha and the Sangha. Kindly do not think so. I will be more faithful to the Buddha and the Sangha after your death. Perhaps you are worried that I'm going to ignore the behavior guidelines. Kindly do not have any doubts on this matter. I was one of those who fully practice the moral habits made ​​for the layman, and if you want, please ask the Buddha about it. Maybe you fear that I have not achieved inner peace. Please do not think so. I was one of those who have earned as much inner peace that can be achieved by a householder. If you have any doubt about this, the Buddha was in Bhesakalavana, ask him. Maybe you think that I have not reached proficiency in the teaching of the Buddha, that I am not free from doubt and confusion without relying on others. If you want clarity on this, ask the Buddha. But please do not face death with anxiety, because it is very painful and prohibited by the Buddha. " Reported that after Nakulapita advised by Nakulamata, he regained his health, the disease disappeared and never relapse. Later, the whole incident was narrated to the Buddha, he praised Nakulamata wise advice.

Sotapattisamyutta contains valuable advice to people ill (Sv, 408). Once Mahanama Sakyan asked the Buddha how a prudent layperson should advise other wise layman who is terminally ill. It should be noted here that the counselor and the patient are both prudent lay Buddhists. The Buddha gave a whole discourse on how this is done. First, lay people should calm wise wise layman who is terminally ill with four beliefs: "Relax friend, you have an unshakable faith in the Buddha, Dhamma and Sangha, that the Buddha was fully enlightened, well-expounded Dhamma, and Sangha bertata good order. You also have to develop prudent measures that help concentration unsullied. " So after entertaining patients with four convictions, he should ask him whether he has the desire / attachment to any of the parents. If he says yes, it should be pointed out that death will surely come if he has an attachment to their parents or not. Thus, it would be better to stop the attachment. Furthermore, if he says he has decided attachment to his parents, he should be asked whether he has the desire / attachment to his wife and children. For the same reason, he had to be convinced to stop the attachment anyway. Furthermore, he should be asked whether he has an attachment to worldly desires. If he says yes, he must be convinced that the spiritual desires are higher than human desires, and should be encouraged to achieve spiritual desires. Furthermore, he slowly led up the scale of spiritual and when he reached the highest heaven of consciousness, attention shifted to the world of Brahma. If he said he had completed the achievement of world Brahma, he should be advised that even Brahma world are impermanent and rebirth. So, it's better to aspire cessation of rebirth. If he can concentrate his mind on the cessation of rebirth, the Buddha said there is no difference between him and the monk who has attained liberation.

No doubt that this advice is the highest form of advice that can be provided by people who are more advanced to terminally ill people who have the same spiritual high. Preaching is very clear that the patient must be as advanced as the current entry, because the four-confidence or comfort factors mentioned at the beginning of the sermon is similar to the properties of a stream-entry.

Cittasamyutta contains an interesting event of the death of a lay follower who has developed his inner (S.iv, 302). Citta the householder was not a born again (anagami, A.iii, 451). When he was seriously ill, a group of deities invited Citta to set his mind to become king of the whole universe (cakkavattiraja) because of his virtue. He refused, saying that it too is impermanent. While lying on his bed, he advised that surrounds relatives about the importance of developing confidence in the Buddha, Dhamma and Sangha, and about the importance of charity, eventually he died.

According Sotapattisamyutta the Buddha visited Dighavu laypeople who was gravely ill near death in her bed (Sv, 344). The teacher advised him to appoint his attention on the firm belief would the noble Triple Gem and determined that he was awarded with the behavior of unsullied virtue. Dighavu replied that it is the properties of a feeder stream that had been found on him. Furthermore, the Buddha advised him to bertetap the virtues and developing six properties that help towards an understanding, that awareness of the impermanence of all elements of the object, the dissatisfaction of all impermanence, without a point of dissatisfaction, awareness of the disappearances, release and termination. Dighayu replied that these qualities are also found in him, but he worried that his father would be upset when he died. Furthermore father, Jotipala, advised him not to worry over it, and see what the Buddha says. The Buddha, having advised and Dighavu soon died. Later, the Buddha states that Dighavu died as a non return.

Dhananjani Brahmin was a tax collector who was right, he extorted the king and the general public (M.ii 0.184 to 96). Venerable Sariputta met him and advised him of the consequences of the life that is not true. Soon after Dhananjani ill, Sariputta summoned by him. After being told about his health, Dhananjani told Sariputta that he had an unbearable headache. Furthermore Sariputta talked to him, slowly guiding his attention away from the lower realms to a higher extent Brahma. After distracting the verge of death of patients to the Brahma, Sariputta went on to explain the way to the attainment of the Brahma, the full development brahmaviharas - universal love, compassion, sympathy and equanimity - to cover all directions. Sariputta went and soon Dhananjani died. It was reported that he was reborn in the Brahma. Later, when the matter was related to the Buddha, he found fault Dhananjani Sariputta for not guiding the spiritual path further.

Sutta shows that people who have no right livelihood can also be guided toward a rebirth happier with the provision of advice at a crucial time before dying. It is doubtful whether any offenders can be guided toward rebirth in nature happy. Perhaps the good qualities Dhananjani exceed bad deeds (Dhp.173) and maybe that's why a arahatta be guided toward rebirth in the happy realm at death.

It can be inferred from the facts reported in the sutta (M.ii, 185). When Sariputta himself was to travel far in Dakkhinapata, he inquired about the health of the Buddha from a monk who came from Rajagaha, at the same deliberate Sariputta inquired about Dhananjani spirit spiritual quest. Chances are that Dhananjani is a staunch supporter of the Sangha as his first wife, a woman who has conviction, is still alive. His second wife is a woman who has no convictions. When Sariputta heard that Dhananjani was negligent he was worried, and decided to talk to Dhananjani if there is a chance to meet him.

Another important noteworthy in this discourse is the Venerable Sariputta start preaching from the low natural birth, and one by one up to the top as far as the Brahma. Perhaps he started from the Hell-Fire because Dhananjani has dropped to that level. Sariputta had helped him remember the good deeds before, and has also drawn attention to the Dhamma discourses related, and maybe preaching Dhamma by Sariputta had given him only a few days before he fell ill. So to draw attention to the hidden spiritual potential in them, Sariputta can help achieve rebirth Dhananjani happy with his advice at the last minute.

Here we are reminded of the events of the young Mattakundali (DhpA.i, 26). As he was lying on his bed, the Blessed and Mattakundali appear to be very excited, excitement was aroused faith in the Buddha. Soon after, he was reborn in heaven.


A sutta in Sotapattisamyutta (Sv, 386) explains that the common man on the brink of death to see that he had no faith in the noble Buddha, Dhamma and Sangha, and he lived an immoral life, the death of the great fear and anxiety will appear in it. But a person who has a firm belief in the noble Triple Gem, and whose behavior is not tarnished, will not experience such fear and anxiety. Seems to be the guilty conscience causes suffering at death. If fear and anxiety at this crucial moment, the rebirth of nature must take place in a balanced and appropriate to the experience suffering.

Fitting here to record a conversation between a Sakya Mahanama and the Buddha on the fate of a person who met with sudden death (Sv, 369). Mahanama tells the Buddha that when he came to the monastery a quiet atmosphere and is associated with pious monks who have noble qualities, he felt quite calm and has self-control. But when he went to Kapilavatthu busy streets that have busy traffic, it has the feeling of fear that he will experience sudden death from a traffic accident. The Buddha assured him that a man who has developed a moral virtues and lead a righteous life need not entertain such fears. He explained the situation with a parable. If a pot of butter oil broke after drowning in the water, chips pot will sink into the river, but the butter oil will appear on the surface. In the same way, the body will be destroyed, but unsullied mind will arise as butter oil.


The Buddha advised his disciples about the importance of ministering to the sick. He said: "Someone who is caring for the sick, it means that he has cared for Me." This famous statement was made ​​by the Blessed One when he discovered a monk lying in soiled robes. The monk is in a state of severe pain due to an attack of dysentery. With the help of Ananda, the Buddha washed and cleaned the sick monk with warm water. On this occasion, he reminded the monks that they do not have parents or relatives who take care of them, then they have to take care of one another. If the teacher is sick, students have an obligation to preserve it, and if students are sick, the teacher is obliged to keep a sick student. If there are no teachers or students, the society is obliged to keep the sick (Vin.i, 301ff.).

On another occasion, the Buddha met a monk whose body was filled with sores, hair stuck to his body with pus out of wounds. Fellow monks had left because they could not keep. On discovering this monk, the Buddha boil water and wash the monk with his own hands, then cleaned and dried his robes. When the monk was comfortable, the Buddha gave a sermon to him and he became arahatta, shortly after becoming arahatta, he died (DhpA.i, 319). Therefore the Buddha not only supports the importance of caring for the sick, He also gives examples of good with himself ministering to those who are very ill, they are even considered to be repulsive to others.

The Buddha describes the properties that must be possessed by a good nurse. He must be able to deliver the drug, he should know what is beneficial to the patient and what is not. He should keep what not and give only what is beneficial to the patient. He must have compassion and generous, he should do his duty and a sense of service not only to reward (mettacitto gilanam upatthati no amisantaro). He should not feel disgusted with saliva, mucus, urine, faeces, wounds, etc.. He should be able to advise and encourage patients with noble ideas, the Dhamma talks (A.iii, 144).

It is noteworthy here that the nurses are not only expected to be efficient in treating the body by giving food and medicine, but is also expected to treat mental condition of patients. It is known that the kindness of the nurses and doctors are almost as effective as drugs for morale and recovery of a patient. When someone is seriously ill and feeling powerless, a kind word or an act becomes a source of comfort and hope. That's why loving kindness (metta) and compassion (karuna), which is also a noble feelings (brahmaviharas), considered as the properties were laudable in a nurse. The suttas adds another dimension to the nursing profession by incorporating spiritual elements in talks nurses. Sickness is when a person is facing the realities of life and it is a good opportunity to instill a sense of spiritual urgency, even in the most materialistic. Furthermore, a person who is ill must have a fear of death that is greater than when he was healthy. Ways best to calm this fear is to divert attention to the Dhamma. In supervision, nurses are expected to provide spiritual guidance to patients as a part and parcel of the duties of a nurse.

In the Anguttara Nikaya, the Buddha mentions three types of patients (Ai, 120). There are patients who do not recover if they get or do not get proper medical attention and nursing care; contained patients who recover do not care whether they get or do not get proper medical attention and nursing care; contained patients who will be cured only by medical and nursing care appropriate. Because of this third type of patient, then all the sick should be given the best treatment available, food is beneficial and appropriate care. As long as the patient is alive, everything possible should be done to cure.

Here, we are reminded of an event (MA.i, 203) where a mother who was very sick rabbit meat as requiring treatment. The son did not get rabbit meat in the public market, he looks for a rabbit. He managed to catch a rabbit but he hated to kill him while killing for the sake of his mother. He releases a rabbit and expecting mother recovered. Moral virtues simultaneously son with hopes to bring healing mother. Buddhist tradition seems to hold that the power of virtue in certain circumstances have healing properties that can work even in cases when treatment fails.

Chapter treatments in Vinaya Mahavagga (Vin.i, 199ff.) Suggests that the Buddha relaxed some minor disciplinary rules to suit the needs of sick monks. Despite the harsh discipline, the Buddha showed great sympathy and understanding to those who are sick. Health value has been fully realized and even recognized as the largest (arogyaparama labha, Dhp.204).

The Buddha taught that in order to heal, the patient should also work closely with physicians and nurses. A good patient should take and do what is beneficial to him. Even in eating foods that are beneficial though, he must know the exact amount. He should take prescription drugs without a hassle. He should honestly tell their diseases to nurses who are aware of the obligations. He should patiently endure the physical pain even when the pain is acute and excruciating (A.iii, 144).

The suttas show that the Buddha uses the power of determination and composure when he fell ill. He suffered excruciating pain when the sharp pieces of rock thrown by Devadatta Her legs poking him. He was in pain with full awareness and tranquility, and is not controlled by pain (Si, 27, 210). During his last illness, the Buddha also mindful withstand great physical pain, and with admirable courage he walked from Pava to Kusinara with his steadfast companion, Ananda, while resting in some places to reduce fatigue (D.ii, 128.134 ). Maha-Parinibbana Sutta also reports that the Buddha once hard to hide a dangerous disease and he Beluvagama healthy again (D.ii, 99).

It seems that those who have higher mental development able to withstand disease, at least in certain conditions. Once Nakulapita visited the Buddha in old age, and the Master advised him to remain mentally healthy even though the body is weak (S.iii, 1). There are physical and mental pain (vedana DVE Kayika cetasika ca ca). When a person has a physical pain, if he becomes anxious and adding inner pain as well, then it's like being shot with two arrows (S.iv, 208). Someone who develop spiritually capable of keeping the mind healthy balanced with spiritual development. Because a spiritual arahatta fully developed, he was able to only experience physical pain with no inner pain (so Ekam vedanam vediyati kayikam na cetasikam, S.iv, 209).

A number of sutta recommends reading the elements of enlightenment (Bojjhanga) in order to cure physical ailments. On two occasions, when the Elders Mahakassapa and Mahamoggallana were ill, the Buddha recited the elements of enlightenment and reported that the monks are back healthy (Sv 0.79 to 80). It may be noted that all the monks in question is arahatta, they have developed the elements of full enlightenment. Bojjhanga Samyutta also told that at one time the Buddha was ill, he asked Cunda to recite the elements of enlightenment (Sv, 81). The Buddha was pleased with the reading and it is said that he regained health. On another occasion, when the monk Girimananda ill (Av, 109), the Buddha told Ananda that if the sermon on the ten-consciousness (dasa sañña) delivered to him, he might be healthy. Ten consciousness is awareness of impermanence, not-self, body dirtiness, bad consequences (of the body), annihilation (the pleasures of lust), detachment, cessation, disillusionment with the entire worldly impermanence all the objects, and mindfulness of breathing. Ananda learned the discourse of the Buddha, repeated the sermon to Girimananda, and reported that Girimananda be healed.

Once upon a time, the Buddha heard that a newly ordained monk who was seriously ill, he was not well known among members of the monks. The Buddha visited. When he saw the Buddha approaching, he moved on his bed and tried to stand, but the Buddha cautioned not to rise. Once seated, the Buddha asks health, whether the pain is reduced or not reduced. The monk replied that he was very sick and weak, that the pain is increasing and not decreasing. The Buddha then asked if he had a sense of hesitation or remorse. The monk replied that he had a lot of doubt and regret. The Buddha then asked if he blamed himself for any offense. He said no. Then the Buddha asked him why he was sorry if he was not guilty of any offense. The monk replied that the Buddha did not preach the doctrine for the purity of virtue, but a detachment from lust (ragaviragatthaya). Feeling happy, the Buddha said 'Sadhu ... Sadhu 'in praise.

Then the Buddha spoke to the monk's teachings. He explained that these feelings are impermanent, unsatisfactory and without a nucleus, then they should not be considered as "I" and "mine". Understanding of their true nature, good students become attached to feelings. Currently Dhamma explanation is given, the vision of the truth (dhammacakkhu) occurs on the monk, and he realized that whatever nature arising must have had a sinking properties. In other words, he became a sotapanna, a stream-entry.

According Sotapattisamyutta Anathapindika was once very ill, and the Venerable Sariputta visited upon request him (Sv, 380). On being told that the pain is severe and increasing Sariputta Anathapindika reminded of the goodness-n-his own good. Sariputta explains that ordinary beings, who do not have faith in the Buddha, Dhamma and Sangha and do not maintain good habits, will feel sorrow for the destruction of the body. But Anathapindika have unshakable faith in the Buddha, Dhamma and Sangha, and has maintained good moral habits. Sariputta told him that when these noble qualities are mindfully, the pain will subside.

Furthermore, Sariputta suggests that ordinary people reach a state of sorrow over the destruction of the body because they have not developed the Noble Eightfold Path. But instead Anathapindika has developed the Noble Eightfold Path. When attention is paid to them and noble qualities understood, the pain will subside. Told that the pain subsided and Anathapindika recovered from the disease. Furthermore, Anathapindika get out of bed and serve Sariputta with food provided by himself.

Sotapattisamyutta recorded another occasion when Anathapindika ill (Sv, 385). Venerable Ananda was called to the bed and he gave a sermon. Ananda explains that ordinary people who do not have faith in the Buddha, Dhamma and Sangha as well as having immoral habits will experience anxiety and fear when death is imminent. But the followers of both the firm had confidence in the Buddha, Dhamma and Sangha and to develop moral habits will not experience anxiety and fear of death. Furthermore Anathapindika recognizes unshakable faith in the Buddha, Dhamma, and Sangha, and stated that he is endowed with virtue unsullied. Ananda said that it is indeed a great achievement that Anathapindika have shown the fruit of stream-attainment. However, it is not reported whether Anathapindika recovered instantly.

The Buddha suggested that a monk should not detract from the power and determination for spiritual progress, even when he was sick (A.iv, 335). Possible that the illness will get worse, and before that happens, spiritual development should be implemented as much as possible. After recovering from the illness, one should also not be negligent, because if disease recurrence, the possibility of a higher spiritual attainment will be reduced.

The Buddhist method of ministering to the sick, as is evident from the above texts, not only affirms the importance of proper treatment and care, but also the mind of the patient to good thoughts. It seems that there is a belief that the attention on topics related to teaching, especially the reminder about the virtues that have been developed by someone, have healing properties. In the case of the Buddha and the arahatta, recitation of the bojjhangas has restored health. In the case of the monk who was probably not Girimananda arahatta early in the illness, the ten perceptions that restored his health. Anathapindika is a sotapanna and conversation about the special properties of an instrument for his speedy recovery. Maybe when someone reminded inner traits that have been obtained, the excitement came to mind. The excitement thus may be able to change a person's body chemistry in a positive and healthy manner.

Here we are reminded of the same events told in Papañcasudani (MA.i, 78). A monk bitten by a snake when she was listening to the Dhamma. He ignored the snake bites and keep listening to the Dharma. Venom spread and became very ill. He then reflected on the sanctity of the act of virtue he has done since his ordination. When he realized the nature of the spotless, joy and satisfaction exceptional appear in them. Healthy physiological changes act as an anti-venom and he was healed instantly. These events seem to show that at the time was seriously ill, attention was focused on one's spiritual nature, the incredible excitement in the mind, and the factors that promote health to be active in the body, perhaps by way of hormones restore health. Maybe that's how the high berspiritual individuals get health back when appropriate suttas read.

In the Pali canon there are many instances of giving advice to the terminally ill. Speaking about death to a terminally ill patient is an unpleasant subject. Instead, the reality of death and the possibility of death must be accepted immediately without pretense and the patient is prepared to face death with confidence and poise.

The advice given by Nakulamata to Nakulapita very helpful in terms of dealing with this (A.iii 0.295 to 98). Once Nakulapita Nakulamata serious and his wife noticed that he was nervous and anxious. She advised him thus: "Please, sir, do not face death with anxiety.'s Death is a painful thing for someone who is agitated. Buddha despise death anxiety. Perhaps you are worried that I will not be able to support the family after your death. Kindly do not think so. I was able to spin and weave, and I will be able to raise children if you are not in the world anymore. Perhaps you are worried that I would get married again after the death of you. Kindly do not think so. Both of us live holy lives according to the rules noble householders. then Do not worry about it. Perhaps you are worried that I will neglect attention to the Buddha and the Sangha. Kindly do not think so. I will be more faithful to the Buddha and the Sangha after your death. Perhaps you are worried that I'm going to ignore the behavior guidelines. Kindly do not have any doubts on this matter. I was one of those who fully practice the moral habits made ​​for the layman, and if you want, please ask the Buddha about it. Maybe you fear that I have not achieved inner peace. Please do not think so. I was one of those who have earned as much inner peace that can be achieved by a householder. If you have any doubt about this, the Buddha was in Bhesakalavana, ask him. Maybe you think that I have not reached proficiency in the teaching of the Buddha, that I am not free from doubt and confusion without relying on others. If you want clarity on this, ask the Buddha. But please do not face death with anxiety, because it is very painful and prohibited by the Buddha. " Reported that after Nakulapita advised by Nakulamata, he regained his health, the disease disappeared and never relapse. Later, the whole incident was narrated to the Buddha, he praised Nakulamata wise advice.

Sotapattisamyutta contains valuable advice to people ill (Sv, 408). Once Mahanama Sakyan asked the Buddha how a prudent layperson should advise other wise layman who is terminally ill. It should be noted here that the counselor and the patient are both prudent lay Buddhists. The Buddha gave a whole discourse on how this is done. First, lay people should calm wise wise layman who is terminally ill with four beliefs: "Relax friend, you have an unshakable faith in the Buddha, Dhamma and Sangha, that the Buddha was fully enlightened, well-expounded Dhamma, and Sangha bertata good order. You also have to develop prudent measures that help concentration unsullied. " So after entertaining patients with four convictions, he should ask him whether he has the desire / attachment to any of the parents. If he says yes, it should be pointed out that death will surely come if he has an attachment to their parents or not. Thus, it would be better to stop the attachment. Furthermore, if he says he has decided attachment to his parents, he should be asked whether he has the desire / attachment to his wife and children. For the same reason, he had to be convinced to stop the attachment anyway. Furthermore, he should be asked whether he has an attachment to worldly desires. If he says yes, he must be convinced that the spiritual desires are higher than human desires, and should be encouraged to achieve spiritual desires. Furthermore, he slowly led up the scale of spiritual and when he reached the highest heaven of consciousness, attention shifted to the world of Brahma. If he said he had completed the achievement of world Brahma, he should be advised that even Brahma world are impermanent and rebirth. So, it's better to aspire cessation of rebirth. If he can concentrate his mind on the cessation of rebirth, the Buddha said there is no difference between him and the monk who has attained liberation.

No doubt that this advice is the highest form of advice that can be provided by people who are more advanced to terminally ill people who have the same spiritual high. Preaching is very clear that the patient must be as advanced as the current entry, because the four-confidence or comfort factors mentioned at the beginning of the sermon is similar to the properties of a stream-entry.

Cittasamyutta contains an interesting event of the death of a lay follower who has developed his inner (S.iv, 302). Citta the householder was not a born again (anagami, A.iii, 451). When he was seriously ill, a group of deities invited Citta to set his mind to become king of the whole universe (cakkavattiraja) because of his virtue. He refused, saying that it too is impermanent. While lying on his bed, he advised that surrounds relatives about the importance of developing confidence in the Buddha, Dhamma and Sangha, and about the importance of charity, eventually he died.

According Sotapattisamyutta the Buddha visited Dighavu laypeople who was gravely ill near death in her bed (Sv, 344). The teacher advised him to appoint his attention on the firm belief would the noble Triple Gem and determined that he was awarded with the behavior of unsullied virtue. Dighavu replied that it is the properties of a feeder stream that had been found on him. Furthermore, the Buddha advised him to bertetap the virtues and developing six properties that help towards an understanding, that awareness of the impermanence of all elements of the object, the dissatisfaction of all impermanence, without a point of dissatisfaction, awareness of the disappearances, release and termination. Dighayu replied that these qualities are also found in him, but he worried that his father would be upset when he died. Furthermore father, Jotipala, advised him not to worry over it, and see what the Buddha says. The Buddha, having advised and Dighavu soon died. Later, the Buddha states that Dighavu died as a non return.

Dhananjani Brahmin was a tax collector who was right, he extorted the king and the general public (M.ii 0.184 to 96). Venerable Sariputta met him and advised him of the consequences of the life that is not true. Soon after Dhananjani ill, Sariputta summoned by him. After being told about his health, Dhananjani told Sariputta that he had an unbearable headache. Furthermore Sariputta talked to him, slowly guiding his attention away from the lower realms to a higher extent Brahma. After distracting the verge of death of patients to the Brahma, Sariputta went on to explain the way to the attainment of the Brahma, the full development brahmaviharas - universal love, compassion, sympathy and equanimity - to cover all directions. Sariputta went and soon Dhananjani died. It was reported that he was reborn in the Brahma. Later, when the matter was related to the Buddha, he found fault Dhananjani Sariputta for not guiding the spiritual path further.

Sutta shows that people who have no right livelihood can also be guided toward a rebirth happier with the provision of advice at a crucial time before dying. It is doubtful whether any offenders can be guided toward rebirth in nature happy. Perhaps the good qualities Dhananjani exceed bad deeds (Dhp.173) and maybe that's why a arahatta be guided toward rebirth in the happy realm at death.

It can be inferred from the facts reported in the sutta (M.ii, 185). When Sariputta himself was to travel far in Dakkhinapata, he inquired about the health of the Buddha from a monk who came from Rajagaha, at the same deliberate Sariputta inquired about Dhananjani spirit spiritual quest. Chances are that Dhananjani is a staunch supporter of the Sangha as his first wife, a woman who has conviction, is still alive. His second wife is a woman who has no convictions. When Sariputta heard that Dhananjani was negligent he was worried, and decided to talk to Dhananjani if there is a chance to meet him.

Another important noteworthy in this discourse is the Venerable Sariputta start preaching from the low natural birth, and one by one up to the top as far as the Brahma. Perhaps he started from the Hell-Fire because Dhananjani has dropped to that level. Sariputta had helped him remember the good deeds before, and has also drawn attention to the Dhamma discourses related, and maybe preaching Dhamma by Sariputta had given him only a few days before he fell ill. So to draw attention to the hidden spiritual potential in them, Sariputta can help achieve rebirth Dhananjani happy with his advice at the last minute.

Here we are reminded of the events of the young Mattakundali (DhpA.i, 26). As he was lying on his bed, the Blessed and Mattakundali appear to be very excited, excitement was aroused faith in the Buddha. Soon after, he was reborn in heaven.

A sutta in Sotapattisamyutta (Sv, 386) explains that the common man on the brink of death to see that he had no faith in the noble Buddha, Dhamma and Sangha, and he lived an immoral life, the death of the great fear and anxiety will appear in it. But a person who has a firm belief in the noble Triple Gem, and whose behavior is not tarnished, will not experience such fear and anxiety. Seems to be the guilty conscience causes suffering at death. If fear and anxiety at this crucial moment, the rebirth of nature must take place in a balanced and appropriate to the experience suffering.

Fitting here to record a conversation between a Sakya Mahanama and the Buddha on the fate of a person who met with sudden death (Sv, 369). Mahanama tells the Buddha that when he came to the monastery a quiet atmosphere and is associated with pious monks who have noble qualities, he felt quite calm and has self-control. But when he went to Kapilavatthu busy streets that have busy traffic, it has the feeling of fear that he will experience sudden death from a traffic accident. The Buddha assured him that a man who has developed a moral virtues and lead a righteous life need not entertain such fears. He explained the situation with a parable. If a pot of butter oil broke after drowning in the water, chips pot will sink into the river, but the butter oil will appear on the surface. In the same way, the body will be destroyed, but unsullied mind will arise as butter oil.

Suttas like Sankharuppatti, (M.iii, 99) Kukkuravatika (Mi, 387) and Tevijja (In, 235) emphasizes the same idea. Rebirth usually depends on the thoughts that most often appears during life. If anyone has any thoughts and temperament that matches the animals, such as dogs or buffalo in the Sutta Kukkuravatika, it's likely someone will be born among these animals, between living creatures that have a similar character. Conversely, if someone is getting the thoughts and characters, which can be equated with Brahma, the development of noble feelings such as love and compassion, he has a good chance of being born among the Brahma. So prepare for death really be done while living. Although the time of death comes rebirth guided in thought to be higher, one needs to prepare for the match with confidence and understanding of human virtues - that is meant to have faith in the Buddha, Dhamma and Sangha - and the development of moral habits. If someone does not have merit, guiding thought patterns towards higher levels during hours of death will be difficult. But, however difficult and effective coaching, the monk invited the dying person is a Buddhist custom of chanting in the hope that some will help patients develop confidence and improve his thoughts to a higher spiritual level.

We are reminded here that according to the Vinaya (iii, 8), several Buddha before such a release does not end Vessabhu long, often instruct their disciples to look into their minds with telepathic powers and guiding their thought patterns: "Think Thus, do not think so, look at this, do not watch it, stop it, develop it, "etc.. Perhaps the Buddha and his disciples famous technique used to guide thought patterns amenable adherents at the time of death.



Questions that may arise is how effectively the spiritual guidance by death if the patient is not aware. The truth is what is important here is that we really do not know the condition of the patient at the time of death spiritually. The doctor and the audience may conclude that the patient is unaware because it does not react to the surroundings and the questions put to him. Five senses may be partly or totally does not work, but no one thought to make sure the function is active or not. We certainly do not know the special potentials of what is in his mind when death. Chances are that the mind is most active at this important time. Perhaps at this moment a person has the inner struggle hard, live strong desire that comes from familiarity and protested strongly against death.

Our guess is when someone is very afraid of the face of death, the desire for life to be strong. Fear of death is very big on the guilt of a great moment, the fear that a person has a good chance of scatter as a human life, an opportunity that could be good for spiritual development. On the other hand, if someone has used the opportunity of human life as well to the spiritual, a person can face inevitable death with serenity, pleasure and fulfillment. Rebirth of the spiritual potential seems to fit with a person named kamma in Buddhist terminology.

Very accurate to conclude this essay with the thought of what we should do when we visit patients by death. Normal attitude we are sorrow and sympathy, but Buddhism considers one have negative thoughts at this moment. My opinion would be more help for the patient and for the patient's death by anyone, if we radiate thoughts of metta, love him. Because the patient's mind is working towards possible death at this pivotal moment, not obscured by the limitations of the encumbered by bodily functions, the possibility that a person's inner self will be more sensitive and receptive to spiritual thought waves around it. If sorrow and sighing produce negative thought waves, then people will die may have been affected. But if good thoughts about love emitted, so thoughts can serve as a tranquilizer inner eliminate suffering and death emergency came and thought someone could enveloped in a warm blanket, calm and protect.





Abbreviation that are used the Translate Article refer to the Edition found in the Pali Text Society, Oxford. 

A ........... Anguttara Nikaya
D ............Digha Nikaya
Dhp ....... Dhammapada
DhpA ..... Dhammapada Atthakatha
M ........... Majjhima Nikaya
MA ......... Majjhima Nikaya Atthakatha
S ........... Samyutta Nikaya
Vin ......... Vinaya Pitaka 


About the the Author

Lily de Silva, Ph.D. was educated at the University of Ceylon, Peradeniya, where she received a B.A. with First Class Honors in Pali and the Woodward Prize for Pali and, in 1967, a Ph.D. She taught at the University for many years and served as Chair of the Department of Pali and Buddhist Studies until her retirement in 1994. Dr. de Silva was the editor of the Digha Nikaya Atthakatha Tika (Subcommentary to the Digha Nikaya), published by the Pali Text Society in three volumes, and has long been a regular contributor to Buddhist scholarly and popular journals.

Buddhist publications by Lily de Silva

• The Buddhist Attitude Towards Nature, by Lily de Silva (from Buddhist Perspectives on the Ecocrisis (BPS Wheel Publication No. 346), edited by Klass Sandell; 1987; 50k/12pp.)
• "Giving in the Pali Canon," by Lily de Silva, in Dana: The Practice of Giving, edited by Bhikkhu Bodhi (BPS Wheel Publication No. 367/369; 1990; 114k/38pp.)
• Ministering to the Sick and Terminally Ill, by Lily de Silva (BPS Bodhi Leaves No. 132; 1993; 34k/11pp.)
• Nibbana As Living Experience/The Buddha and The Arahant: Two Studies from the Pali Canon by Lily de Silva (BPS Wheel Publication No. 407/408; 1996; 119k/28pp.)

• One Foot in the World: Buddhist Approaches to Present-day Problems, by Lily de Silva (BPS Wheel Publication No. 337/338; 1986; 106k/35pp.)
• Radical Therapy: Buddhist Precepts in the Modern World by Lily de Silva (BPS Bodhi Leaf Publication No. 123; 1991; 27k/8pp.)
• The Self-made Private Prison by Lily de Silva (BPS Bodhi Leaves No. 120; 1990; 33k/9pp.)