‘Extremis’ is a documentary on the tough decisions that family members have to make in extremely difficult situations, near moments of potential death of their loved ones. Medical personnel are also shown to face much challenge when explaining the impact of their choices. When patients are unconscious and without 100% certainty of recovery, should they recommend attaching them to life-support or not?
A family member remarks, ‘If I have to make that decision for myself, take me off. And if I breathe on my own, then that’s fine, that’s God’s will. If I don’t breath on my own, fine, then that’s God’s will. Because I believe in prayer, but I believe in nature taking its course too.’ The subject of faith aside in this case, how do we know if one should be put on or taken off life-support in the first and second place? And how do we know if to pray and hope for a miracle or to just let things be?
When Pure Land Buddhists face such dilemmas, and if after much discussions, are truly uncertain, there should be swift and sincere prayers for what best to do. Whether there is use of life-support or not, there should also be swift and clear guidance with support-chanting before the patient, to urge sincere mindfulness of Amituofo (Amitabha Buddha), so as to connect swiftly to him to reach his Pure Land. If it is such that healing is possible, there will be swift healing too. This would be the meaningful thing to do.
A doctor comments, ‘Every day, people with very poor neurologic prognoses are attached permanently to machines [due to family members wanting to try everything]… [W]e’re keeping it alive when it’s not really the person.’ Of course, the condition is not truly permanent, as the patients eventually still die, even if in vegetative states. However, will the patients be in great(er) suffering if they live on in this way?
If life-support clearly creates much pain that distracts from mindfulness of Buddha, while not offering real hope for recovery, it ought not be given. Yet, as above, if already on life-support, which offers some extra precious time, there should be the same swift and clear guidance with support-chanting to relieve suffering. The mind is not the brain itself, while as long as the body is alive, even if vegetative, the consciousness is still within, able to be guided to reach Pure Land. If the consciousness is not present, the body will surely and shortly die, with or without a machine.
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