Abortion, Personhood, and Buddhism

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In November, 2011, Mississippi voters soundly defeated a proposed amendment to the state constitution, which many had expected to pass. It would have determined that human life (personhood) begins at conception. While passage would have created a legal nightmare of challenges and counterchallenges, the amendment captured an idea of great importance.


Shortly before the vote, I reprinted here an important article from the fascinating literature of Buddhist bioethics. The bibliography is amazing.


Because of latest Santorum dust-up -- his wanting to 'throw up' on the First Amendment, I'm reprinting it now. 


Because there have been many hundreds of pageviews for this article, I've turned on the comments so you can share your views if you like. 

Buddhism and Medical Ethics: A Bibliographic Introduction

James J. Hughes
MacLean Center for Clinical Medical Ethics

Damien Keown
Goldsmiths, University of London

Published in the Journal of Buddhist Ethics, Volume Two, 1995

ABORTION

Buddhism, like all religious and secular philosophies, focuses on two central questions concerning abortion: (a) when does the embryo or fetus acquire the property which makes termination of pregnancy "killing"?; and (b) is termination of a pregnancy, before or after this point, ever justifiable?

While there was a minority tradition in classical Hindu embryology that held that incarnation does not occur till as late as the seventh month (Lipner, 1989), most Buddhist commentators have adopted classical Hindu teachings that the transmigration of consciousness occurs at conception, and therefore that all abortion incurs the karmic burden of killing. Before modern embryology, however, in both Buddhist countries and the West, ideas about conception were scientifically inaccurate, and often associated the beginning of life with events in the third or fourth month of pregnancy (for a discussion of traditional Tibetan embryology, see Dhonden, 1980 and Lecso,1987).

Another problem in early Buddhists' embryology is their assumption that the transmigration of consciousness is sudden rather than gradual. Based on the findings of modern neuro-embryology Buddhists today might maintain that the fetus does not fully embody all five skandhas and the illusion of personhood until after birth; this is the argument developed by most Western ethicists to defend abortion (Tooley, 1984; Flower, 1985; Bennett, 1989). If the fetus is not yet a fully embodied person, then the karmic consequences of abortion would be even less than the killing of animals, which Buddhism teaches do have moral status. This neurological interpretation of the skandhas may be more consistent with Western Buddhism, which often sees the doctrine of rebirth as peripheral or interprets rebirth metaphorically rather than literally (Batchelor, 1992; King, 1994).

The second question is whether abortion always generates bad karma, or in Western terms, is it ever "justified." This relates to the debate about whether Buddhist ethics are absolutist, utilitarian or "virtuist," i.e. seeing the good in the development of personal qualities. The absolutist would hold that bad karma is incurred from any act of murder, whatever the justifications. The utilitarian would argue that murder can be a compassionate act with positive karmic consequences, taking into account factors such as the health of the fetus or mother, the population crisis, and the readiness of the parents to raise a child.

A virtue-oriented Buddhist would argue that the attitude and motivations of the pregnant woman and her collaborators would determine the ethics of an abortion. Along this line, Tworkov (1992) argues that the karmic skilfulness of an abortion is related to whether the person became pregnant and made her decision to abort without serious mindfulness. From this perspective, aborting a fetus conceived without an effort at contraception would be more karmically significant than an abortion necessitated in spite of contraception.

The much discussed Japanese tolerance for, and ritualization of, abortion appears to combine both utilitarian and virtue approaches. The Japanese believe that abortion is a "sorrowful necessity," and Buddhist temples sell rituals and statues intended to represent parents' apologies to the aborted, and wishes for a more propitious rebirth. The Japanese have reached these accommodations consensually, with little debate, and without discussion of the rights of women or the unborn (LaFleur, 1990, 1992).

The Theravaadin commentator Buddhaghosa appears to have combined all three views. He held that killing produces karma jointly through the mental effort and intensity of the desire to kill, and the virtue of the victim (Florida, 1991). Since killing big animals required more effort, and was therefore worse than killing small animals, the karma of feticide would be less than murder of adults, and less in earlier stages of pregnancy. On the other hand, for Buddhaghosa, the karma of feticide would be greater than that of killing villains in self-defence.

Buddhists have thus far given little thought to the third important question, the connection between morality and law, specifically how, and on what grounds, the state should regulate abortion. Some Buddhists have adopted the stance of many moderates in the West: abortion is murder of a person, but women should have that choice (for instance, Imamura, 1984 and Lecso, 1987). Since most Buddhists have no problem with laws to discourage and punish murder in general, implicit in this position is that murder is either justifiable when it conflicts with bodily autonomy or, since few Buddhists would imprison butchers, that fetuses are closer in status to animals. Clearly there is much room for clarification of the 

relationship between religious ethics and law in pluralistic societies.

Some scholars (such as Ling, 1969, and LaFleur, 1992) have looked beyond the strictly ethical concerns with abortion to examine the cultural aspects of the question. From this perspective it is sometimes pointed out that Buddhism is not "pro-natalist," i.e. does not hold that reproduction is a religious duty - quite the reverse in fact - and does not advocate "family values," at least in the sense that Confucianism did. Buddhist skepticism about family and reproduction was a central cause of Confucian and Shinto persecution. The Sinhalese embrace of contraception and abortion was so enthusiastic in the 1960s, compared to Sri Lanka's Muslims, Catholics and Hindus, that racialist monks began to argue that Buddhists had an obligation to "race-religion-nation" to reproduce.

BIBLIOGRAPHY

BUDDHISM AND MEDICINE

Birnbaum, Raoul

1979. The Healing Buddha. Boulder,Co: Shambhala.

Clifford, Terry

1984. Tibetan Buddhist Medicine: the Diamond Healing. York Beach, Maine: Samuel Weiser.

Demieville, P.

1985. Buddhism and Healing: Demieville's article 'Byoo' from Hooboogirin, translated by Mark Tatz. Lanhan, Md:University Press of America.

Dhonden, Dr. Yeshe

1986. Health Through Balance: An Introduction to Tibetan Medicine. Ithaca: Snow Lion.

Duncan, A. S., G. R. Dunstan, and R. B. Welbourn.

1981. "Buddhism", Dictionary of Medical Ethics. London: Darton, Longman and Todd.

Fenner, Edward Todd.

1982. Rasayana Siddhi: Medicine and Alchemy in the Buddhist Tantras. Ann Arbor, Mich: University Microfilms International.

Haldar, J. R.

1977. Medical Science in Pali Literature. Indian Museum Monographs, 10. Calcutta: Indian Museum.

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1992. Development of Public Health in Buddhism. Varanasi: Indological Book House.

Jaqqi, Q. P.

1987. "India" (Medical Ethics of). In Encyclopedia of Bioethics, ed. W. Reich, London: Macmillan, 906-11.

Majupu, Trilok Chandra.

1989. Religious and useful plants of Nepal and India: medicinal plants and flowers as mentioned in religious myths and legends of Hinduism and Buddhism. Lashkar (Gwalior): M.Gupta.

Massin, Christopher.

1982. La medicine Tibetaine. Paris: Editions de la Maisnie.

Meulendbeld, G. Jan (ed.).

1991. Medical Literature from India, Sri Lanka and Tibet. Leiden: E.J. Brill.

Mitra, J.

1985. A Critical Appraisal of Ayurvedic Materials in Buddhist Literature (with special reference to Tripitaka). Varanasi: The Jyotirlok Prakashan.

Ohnuki-Tierney, Emiko

1984. Illness and Culture in Contemporary Japan. Cambridge: Cambridge University Press.

Rechung Rinpoche, Ven.

1976. Tibetan Medicine: Illustrated in Original Texts. Berkeley: University of California Press.

Redmond, Geoffrey P.

1992. "Concepts of Disease in Buddhism," in Buddhist Studies Present and Future, ed. Ananda W.P. Guruge, Paris: The Permanent Delegation of Sri Lanka to Unesco, 143-159.

Soni, R. L.

1976. "Buddhism in Relation to the Profession of Medicine" in Religion and Medicine, ed. D. W. Millard, Vol.3. London: SCM Press, 135-51.

Unschuld, P.U.

1979. Medical Ethics in Imperial China. A Study in Historical Anthropology. Berkeley: University of California Press.

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1987. "General Historical Survey" (of Asian Medical Ethics) in Encyclopedia of Bioethics, ed. W.Reich, London: Macmillan, 901-6.

Umezawa, K.

1988. "Medical Ethics in Japan," Biomedicine and Pharmacotherapy 42:169-172.

Zysk, K. G.

1991. Asceticism and Healing in Ancient India: Medicine in the Buddhist Monastery. Oxford: Oxford University Press.

BUDDHISM AND MEDICAL ETHICS

Beauchamp, Tom L. and James F. Childress

1989. Principles of Biomedical Ethics, Third ed. Oxford: Oxford University Press.

Epstein, Mark.

1993. "Awakening with Prozac: Pharmaceuticals and Practice." Tricycle Fall:30-34.

Florida, R. E.

1994. "Buddhism and the Four Principles". In Principles of Health Care Ethics, ed. R. Gillon and A. Lloyd, Chichester: John Wiley & Sons, 105-16.

Jones, Ken.

1989. The Social Face of Buddhism: An Approach to Political Activism. Boston: Wisdom Publications.

Kabat-Zinn, Jon.

1990. Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain and Illness. New York: Dell.

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1994. Wherever You Go, There You Are: Mindfulness Meditation in Everyday Life. Westport, Conn.: Hyperion.

Keown, Damien.

1995. Buddhism & Bioethics. London and New York: Macmillan/St. Martins Press.

Kitagawa, J.

1987. "Medical Ethics of Japan through the Nineteenth Century," in Encyclopedia of Bioethics, ed. W.Reich, London: Macmillan, 922-924.

Leland, Charmiere.

1995. "Bear Bile and Musk," International Journal of Alternative and Complementary Medicine 13:16-17.

Lindbeck, Violette.

1984. "Thailand: Buddhism meets the Western Model," The Hastings Center Report 14:24-26.

Mettanando, Bhikkhu.

1991. "Buddhist Ethics in the Practice of Medicine" in Buddhist Ethics and Modern Society: An International Symposium, ed.C.Wei-hsun Fu and S. A. Wawrytko, New York, etc: Greenwood Press, 195-213.

Nakasone, R. Y.

1990. Ethics of Enlightenment. Fremont, Ca: Dharma Cloud Publishers.

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1994. "Buddhism". Encyclopedia of Bioethics. London: Macmillan.

Ratanakul, P.

1986. Bioethics, an introduction to the ethics of medicine and life sciences. Bangkok: Mahidol University.

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1988. "Bioethics in Thailand: The Struggle for Buddhist Solutions," Journal of Medicine and Philosophy13:301-12.

---.1990. "Thailand: refining cultural values." The Hastings Center Report 20:25-27.

Sizemore, Russell and Donald Swearer, eds.

1990. Ethics, Wealth and Salvation: A Study of Buddhist Social Ethics. Columbia SC: University of South Carolina Press.

Taniguchi, S.

1987a. "A Study of Biomedical Ethics from a Buddhist Perspective". MA Thesis, Berkeley: Graduate Theological Union and the Institute of Buddhist Studies.

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1987b. "Biomedical Ethics from a Buddhist Perspective". Pacific World New Series 3 Fall:75-83.

Umezawa, K.

1988. "Medical Ethics in Japan," Biomedicine and Pharmacotherapy 42:169-172.

BUDDHIST APPROACHES TO PERSONHOOD

Chaube, D. B.

1991. Mind-Body Relation in Indian Philosophy. Varanasi: Tara Book Agency.

Collins, Steven.

1982. Selfless Persons: Imagery and Thought in Theravada Buddhism. Cambridge: Cambridge University Press.

Harvey, P.

1987a. "The Buddhist Perspective on Respect for Persons". Buddhist Studies Review 4:31-46.

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1987b. "A Note and Response to 'The Buddhist Perspective on Respect for Persons'". Buddhist Studies Review4:97-103.

Klein, A.

1987. "Finding a Self: Buddhist and Feminist Perspectives" in Shaping New Vision: Gender and Values in American Culture, ed. C. Atkinson, C. Buchana, and M. Miles, Ann Arbor: UMI Research Press.

Koyeli, G. D.

1987. "Individual Autonomy in Traditional Indian Thought," Journal of Indian Philosophy 15:99-107.

MEDICAL ETHICISTS ON PERSONHOOD

Fletcher, Joseph.

1979. Humanhood: Essays in Biomedical Ethics. Buffalo: Prometheus Books.

Gervais, Karen.

1986. Redefining Death. New Haven: Yale University Press.

Lizza, John P.

1993. "Persons and death: what's metaphysically wrong with our current statutory definition of death?" Journal of Medicine & Philosophy 18:351-74.

More, Max.

1993. "The Diachronic Self: Identity, Continuity, Transformation" (Unpublished dissertation thesis, available at gopher://gopher.etext.org:70/00/Politics/ Extropy.Institute/more.03049*

Nelkin, Dorothy.

1983. "The Politics of Personhood," Milbank Quarterly 61(1):101-12.

Tooley, Michael.

1984. Abortion and Infanticide. Oxford: Oxford University Press.

PARFIT'S DECONSTRUCTION OF PERSONHOOD

Gruzalski, B.

1986a. "Parfit's impact on utilitarianism," Ethics 96:760-83.

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1986b. Symposium on Reasons and Persons. Ethics 96:832-72.

Kuczewski, Mark G.

1994. "Whose Will Is It Anyway? A Discussion of Advance Directives, Personal Identity and Consensus in Medical Ethics," Bioethics, 8(1):27-48.

Parfit, Derek.

1984. Reasons and Persons. Oxford: Oxford University Press.

BUDDHISM AND ABORTION

Florida, R.

1991. "Buddhist Approaches to Abortion," Asian Philosophy 1:39-50.

Imamura, Ryo.

1984. "The Shin Buddhist Stance on Abortion." Buddhist Peace Fellowship Newsletter 6:6-7.

Jones, K.

1989. The Social Face of Buddhism. London: Wisdom Publications.

Lecso, P. A.

1987. "A Buddhist View of Abortion," Journal of Religion and Health 26:214-18.

Stott, D.

1985. A Circle of Protection for the Unborn. Bristol: Ganesha Press.

Tworkov, H.

1992. "Anti-abortion/pro-choice: taking both sides," Tricycle Spring:60-69.

KEY WESTERN WRITINGS ON ABORTION

Bennett, Michael.

1989. "Personhood from a Neuroscientific Perspective" in Abortion Rights and Fetal Personhood, eds. Edd Doer and James Prescott. Long Beach, California: Centerline Press, 83-86.

Flower, Michael J.

1985. "Neuromaturation of the human fetus," Journal of Medicine and Philosophy 10:237-251.

Luker, K.

1984. Abortion and the Politics of Motherhood. Berkeley: University of California Press.

Tooley, Michael.

1984. Abortion and Infanticide. Oxford: Oxford University Press.

WRITINGS ON EMBRYOLOGY, REBIRTH AND KARMA

"Abortion" in Encyclopaedia of Buddhism.Batchelor, Stephen.

1992. "Rebirth: A Case for Buddhist Agnosticism," Tricycle Fall:16-23.

Dhonden, Y.

1980. "Embryology in Tibetan Medicine" in Tibetan Medicine. Dharamsala: Library of Tibetan Works and Archives.

King, Winston.

1994. "A Buddhist Ethics Without Karmic Rebirth?" Journal of Buddhist Ethics 1:33-44.

Lipner, J. J.

1989. "The Classical Hindu View on Abortion and the Moral Status of the Unborn." In Hindu Ethics, ed. H. G. Coward, J. J. Lipner, and K. K. Young, Albany, New York: State University of New York Press, 41-69.

McDermott, James Paul

1984. Development in the Early Buddhist Concept of Kamma/Karma. New Delhi: Munshiram Manoharlal.

O'Flaherty, W. D., ed.

1980. Karma and Rebirth in Classical Indian Traditions. Berkeley: University of California Press.

Saksena, B.

1935. "Pali Bhuunahan," Bulletin of the School of Oriental and African Studies 8:713-14.

JAPAN AND ABORTION

Brooks, Anne Page.

1981. "Mizuko Kuyoo and Japanese Buddhism," Japanese Journal of Religious Studies 8:119-47.

Eiki, H., and T. Dosho.

1987. "Indebtedness and comfort: the undercurrents of mizuko kuyoo in contemporary Japan," Japanese Journal of Religious Studies 14:305-20.

LaFleur, W. A.

1990. "Contestation and Confrontation: The Morality of Abortion in Japan," Philosophy East and West 40:529-42.

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1992. Liquid Life: Abortion and Buddhism in Japan. Princeton: Princeton University Press.

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1995a. "The Cult of Jizo: Abortion Practices in Japan and What They Can Teach the West," TricycleSummer:41-44.

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1995b. "Silences and Censures: Abortion, History, and Buddhism in Japan. A Rejoinder to George Tanabe,"Japanese Journal of Religious Studies 22/1-2:185-196.

Miura, D.

1983. The Forgotten Child. Henley-on-Thames, England: Aidan Ellis.

Rand, Yvonne, Sensei.

1994. "The Buddha's Way and Abortion - Loss, Grief and Resolution." Mind Moon Circle Autumn:5-8 (also available electronically, filename jizo.zip, original site coombs.anu.edu.au).

Smith, B.

1988. "Buddhism and Abortion in Contemporary Japan: Mizuko Kuyoo and the Confrontation with Death,"Japanese Journal of Religious Studies 15:3-24.

Werblowsky, Z.

1984 "Mizuko Kuyoo; Notulae on the most important 'New Religion' of Japan," Japanese Journal of Religious Studies 18:295-354.

Young, R. F.

1989. "Abortion, Grief and Consolation: Prolegomenon to a Christian Response to Mizuko Kuyoo," Japanese Christian Quarterly (Tokyo) 55:31-39.

BUDDHISM ON SEXUALITY AND CONTRACEPTION

Ling, T.

1969. "Buddhist Factors in Population Growth and Control," Population Studies 23:53-60.

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1980. "Buddhist Values and Development Problems: A Case Study of Sri Lanka," World Development 8:577-586.