Question:
We do interventions in birth and death, through IVF for birth and use of ventilators to delay death, though we don’t disturb the soul-journey perhaps, but what is our role in this process of interventions?
Rephrased: The facilitation that we do at the point of entry (conception or delivery) and at the time of exit, what should be our role in that; how much and till what limit should we intervene?
Discussion:
We should also look into the basic questions like can we delay anyone’s death, can we create someone’s life, can we change the course of suffering?
The social concept or understanding of death is such that we are not comfortable talking about it. Death is not something we are ready to invite. Death is not taken as a blessing. Talking about death is like talking about a bad event, it is equated to talking about suffering, and it is fearsome. So naturally, what we are afraid of we try and hide from it. Death is perceived as an enemy or a curse. The tendency is to save oneself from it. This is an instinctive behaviour; a foetus also tries to save itself when it is being aborted. This is the survival instinct. All this is because we do not understand the concept of death and so we think we can delay someone’s death.
The quest of spirituality is to know who am I, why am I, and what happens after my death. There are different schools of thoughts to answer these questions and these are called religions. Every religion has its own way of answering these questions.
When death is nearing, many people get indications or hints but not everyone has the ability to process them. Doctors can understand these indications through the status of the vital signs, though there have been cases where patients have made a U-turn and survived.
When the relatives are informed about the possibility of approaching death, the relatives say that they are ready to spend any amount of money but the doctor should try and save the patient. Saying and feeling this is considered to be a proof of their love for the patient. This kind of behaviour is considered to be normal and moral. On the contrary, if someone says that let the person pass away peacefully, that person will be considered to be abnormal and immoral. Sir’s own example was given where he was questioned by outsiders when he supported his mom’s decision to not feed her life anymore.
Some patients, even in old age, are ready to undergo any intervention to be able to stay alive. This is an indomitable urge to live (“Vijigishu” (विजिगीषु) in Sanskrit, or अभिनिवेश), to not die till I die. The social understanding is that a living body means life and a dead body means death. We forget that to be alive is not living. We get caught-up in fulfilment of our expectations and hope to postpone death, as if this strategy will help us overcome death for many years. What we don’t realise is that at some point a full-stop will come.
Analogy: A child starts going to school. As he grows up he continues in the same school and is happy in the familiarity of the ambience and the teachers and his friends. After a prolonged time he completes his education and now wonders what he has to do next. Since he is accustomed to his surroundings he looks for a job as a teacher in the same school. This person lives for himself. Similarly, we are given this body, we got educated, earned a livelihood, and raised a family and now we don’t feel like leaving the comforts of our body and surroundings. We forget that we have to move-on and beyond for an advanced course.
One who realizes spirituality will know when and where they have to stop. When-to-stop doesn’t mean to kill the body but to know that the body is existing for charity (परोपकार). When they start using the body (their physical existence) for the benefit of others, they start their advance education in their current body. It is not about serving the body (पोषण) but serving through the body (उपयोग), not for self, this is the concept of moksh. This moksha is not about salvation after death but part of purushartha; dharm, arth, kaam, moksh. Moksh in this context means to use this body for इदं न मम that is, for helping others. One who understands this understands the concept of death; to be free of any debts and not owing anything to anybody and helping others. We know that the body is governed by the mann which wants to go on living and entangles the body into prolonging life, though the body organs slowly starts weakening.
Spirituality looks at death as a moment of transformation. It is not the termination. Termination could mean not complete or abrupt end, but transformation means completion of this role and ready to move-on to the next role.
When someone we know starts showing the signs of approaching death and is ready to move beyond this body and mind, then we should help that chetana or consciousness to undertake its journey onward. To do this we must try to fulfil their pending wishes and desires (vasana and ichchha) to the best of our ability. Ideally, that person should also start working on not getting entangled in more desires and wishes and bring them to a zero in the remaining days. We should also not rekindle any new desires in that person (e.g. we’ll go abroad for treatment or you will live to see your grandchild).
The health industry is expanding because of the society’s prevalent fear of death and desire to live more. The doctors and medicines give us hope to live longer. This entangles our chetana to our body. Ideally, the mann should be removed from the body but the chetana is trapped in the body. What happens to the person on the ventilator? Probably they understand your emotions (bhavna). In that state they could be saying ‘let me go’. But we don’t have the means to hear this. People who have had near-death-experiences (NDE) say the journey ahead looked wonderful, not fearful. After their experience they tend to live a more meaningful life. Anita Moorjani’s book ‘Dying to be me’ elucidates this. We meet our soul groups when alive as well as after death.
Just before death the chetana finds the connection; the person goes into a state of delirium. They seem to see and speak to their near ones who are dead. In the near-death-time the person is in the living world as well as the world beyond death. This is when they get acclimatised before moving on. They can be in-between sleep and faintness (ग्लानि) and seem to be in delirium and not making sense because they are now connected to the other world too. They keep floating in and out. The real suffering at the time of death is of the body and mind but not the consciousness. Chetana does not suffer. The chetana is getting ready for the onwards journey. Unfortunately, if they suffer here, this suffering will not get transferred for karmic suffering. The suffering will get released here itself. We can try and reduce their physical pains at this time. If we ignore our role and let them suffer, we will accumulate our karma. When someone is about to pass away it is not about them but our karmic accumulation and cleansing. We tend to go down our memory lane and recollect our good and bad times with them. We also have social pressure to behave in a socially accepted normal way. We should forgive them and ourselves for whatever grudges we carry against them at this time.
At the time of death the psychology of the relatives around is also different and individual. Everyone acts according to their individual understanding. It is not in the interest of the patient that they behave. They behave in the interest of their own psycho/social/moral/theological needs. Their behaviour has nothing to do with the patient. When your behaviour is in the interest of the patient then you are spiritual. When it is about us, we are accumulating karma. What happens inside us at this moment is important; our opinion, emotions etc. What we do at the time of death of the relative is dependent on our concept of life and death.
What do we do at this time from spiritual perspective?
We should do what they want us to do. Our conscience (अंतःकरण) should be pure. It is not about that person; it is about us now. At that time we need to look into how we can purify our karma. We should sit next to them and pray to God to bless them with what is right for them (though God is already doing it, we don’t have to ask for it). At that point we cannot reduce our pain neither is the situation in our hand. We need to be calm and not suffer either. Pain is inevitable but suffering is a choice.
About interventions in birth:
Some believe that we should not donate organs as we then tinker with the suffering and karmic cleansing of that person who is getting those organs. The parallel is that we accumulate property and wealth in this lifetime but leave it behind for our children. By doing this are we not interfering with their destiny? (we are not earning only for our individual needs but beyond our needs). Our children are born with their own destiny so why tinker with it? How much are we doing for ourself and how much for others is the question. In that case, in spiritual perspective, there should be no banks and no insurance too.
The society is for the optimising of the spiritual advancement. The receiver of the donated organs might be able to fulfil a future next life curriculum because of the received donation.
When we impose any bond, our thoughts, our stubbornness, our concepts create our own karmic equation. When we abort a pregnancy due to abnormality, maybe that chetana will be reborn to us as a normal baby and later due to some accident become abnormal or handicapped. The chetana will serve its purpose anyhow. Like the Murphy’s Law: if anything has to go wrong it will. Our ‘prapta’ (प्राप्त) will eventually come to us. And we hoodwink ourselves into thinking that by terminating the abnormal foetus we did the unborn child a favour and eliminated their suffering. But, in fact, we tried to eliminate our own suffering. Similarly we fool ourselves when we force feed a person in delirium on the death bed by thinking we are doing the patient a favour or reducing their suffering.
When we deal with the death moment of other or the birth moment of some consciousness, basically we are into our karmic accumulation. What type of karmic accumulation we do is more important. The sanatan Dharma says that during pregnancy if you follow the garbh-sanskar, it will take care of itself, clear the ‘sanchit’. It is a possibility that the mother through garbh-sanskar can remove the abnormalities of the foetus and a normal child is born. We might try to reduce the delivery pains by doing a C-section but the mother has to endure whatever pains were in her destiny, either during or after delivery. Any external intervention can confuse the entity which wants to enter this life. One who tries to break the cocoon is not helping the caterpillar but obstructing its possibility of becoming a butterfly (can’t fly), similarly an unnecessary C-section is not helping the baby but impeding its growth (latches later). Even deciding the time of birth is interfering. Birth and death are natural and we tinker with nature with our interventions. When life is there, we must facilitate the quality of life and we must look into how we can save or reduce the pain. People pre-decide the time and place of birth according to astrology (MedicoAstrology) is also intervening on the life of the chetana about to be born and we acquire karma. When we acquire life next time, be sure somebody else is going to take decisions on our behalf as our current deeds are being stored. As we sow so shall we reap. If we’ve caused suffering to someone then it will have to be re-payed by our suffering only. Somebody will take the role of giving that suffering to us, not necessarily the same entity, as we live in a cluster. The suffering that will be given to us will not be a punishment but to cleanse us.
Next topic:
A Jain couple took the decision of santhara* for their 5 year old child suffering from brain tumour after consulting their gurus. The time difference in santhara and the death of the child was only five hours, so the issue is whether she really fasted? Despite the feeding, the child would’ve survived only a few more hours because the illness was incurable. People are raising moralistic issue about the case. The parents who could see the death coming only stopped feeding the life. They did not decide to let her die; they decided that this child was anyway not going to survive. The indications of imminent death were observed by the doctors as well as the saintly gurus. Parents agreeing to it meant that they were permitting their child to go. Parents are the spiritual guardian not only the biological guardians of the child. And if they can really vouch for the santhara, the child will get the benefit of the santhara, that’s the religious dictate. The act of santhara was seeking their voluntary permission to allow the child to go. The saint did not let them become superstitious by trying unreasonable tactics to keep the child alive. The media projected this event as if the parents subjected their child to death but that was not the case as death was imminent.
The saints themselves practice this. When their disease gets aggressive they stop feeding their body so that their body is dedicated to the organisms surviving on the body. Allowing their body to be the food for the bacteria and virus is a supreme sacrifice. They are not the body but the chetana. They carried this body, now this body doesn’t carry the consciousness or is not able to carry the consciousness, so let it feed those who can get fed on it. Other religions offer the dead body as food to the birds and animals.
Take-aways:
Try to fulfil the wishes of the patient on the death-bed but don’t accumulate your karma at that point.
Your death determines how you live. Yes, in that moment of transformation all this accumulation of life is transferred. The last karmas are very important and carry weight. The karmas at the death moment will decide their further journey, irrespective of how they have lived their whole life.
The role of the relatives or the patient is being discussed above and not that of the doctors because the doctors are bound by oath to do their best for the patients.
When you know it is the end and still you don’t show it to the world that it is the end, and you keep doing what is appropriate at that moment; this is your moment of karma shuddhi.
There are some common statements to be said at the death-moment: I am sorry. I love you. I miss you. I seek forgiveness. I forgive you. This makes the death peaceful. This is the observation at the palliative care centres too. But the relatives at that time are not willing to say this and bid farewell. They want the patient to live longer.
In palliative care centres effort is made to gather all the near and dear ones of the patient because it is not known who will be needed by the patient.
“My body is not able anymore to carry my consciousness”: we learn two things from this. My body is not me and my body is no longer capable so it will be easier to embrace death because death is a transformation. Yes, It is transformation when you feel life is completed. If you feel life is terminated then there is no transformation. In the case of santhara they made life complete to create the possibility of transformation.
Dharm arth kaam moksh: we’ll have to keep a designated time for the moksh. Yes, the time starts when for the first time you get a lifestyle problem/illness or when you are in you fifties. This is a wake-up call. By then most of your responsibilities are over.
Who is the intervention being done for is important: we should be aware of this: is it for our benefit or the benefit of the patient.
Death is a moment of transformation and our awareness of it will determine our onward journey.
PS:
In the context of Jainism, “santhara” (also known as sallekhana) is a spiritual practice of voluntary fasting to death. It involves gradually reducing food and water intake to the point of death, considered a way to purify the soul and destroy karma. It is not considered suicide by Jain scholars because it’s not driven by passion or the use of harmful substances.
