1)
CULTURE
Namaste: Greeting the Divine
The
Western handshake versus the Eastern anjali mudra: daily gestures that reveal
much about two distinct cultures
B
Y T H E E D I T O R
“S
HAKE HANDS AND COME OUT FIGHTING.” IT’S THE REFEREE’S final counsel to two
pugilists about to beat each other’s brains out with clenched fists. Even
outside the ring, a handshake can be a little off-putting. When one returns to
the West from an extended sojourn in India or elsewhere in Asia, the hand
suddenly thrust forward can seem more ominous than friendly, especially if the
hand offered is that of a stranger.
This
moment of intimidation has a history. According to some anthropologists, one
early manifestation of the handshake in the West arose in medieval Europe. More
than a few men approached others on the byways with daggers drawn for
self-defense. To fend off the fear of a foe’s foul foil, weapons would be
sheathed, and men would offer to each other open, visibly empty hands. It was a
kind of surety, a gesture of trust which said, “See, I am unarmed. So you may
safely let me approach.” Soon the gesture itself took on broad meaning, and
less lethal men on the street adopted the handshake as the proper way to greet
others.
In much
of the world today, people do not shake hands when they meet. They may hug
formally and kiss one another on the cheek, as in Eastern Europe and Arab
states. They may bow softly, eyes turned to the ground, as in Japan and China.
The Hawaiian greeting, termed honi, consists of placing the nostril gently
beside that of the person greeted, a sharing of breath, life and prana.
For
Hindus, of course, the greeting of choice is namaste. With both hands pressed
together and held near the heart, the head gently bowed, one says, “Namaste,”
or “Namaskara,” “Namaskaram” or “Namaskar” in the varied languages of the
subcontinent. It is both a spoken greeting and a gesture, a mantra and a mudra.
The prayerful hand position is a mudra called anjali, from the root anj, “to
adorn,” “honor,” “celebrate.” The hands held in union signify the oneness of an
apparently dual cosmos, the bringing together of spirit and matter, or the self
meeting the Self. In Sanskrit namas means “bow,” “obeisance,” “reverential
salutation.” It comes from the root nam, which carries meanings of bending,
humbly submitting and becoming silent; te means “to you.” Thus namaste means “I
bow to you.”
Namaste
has become a veritable icon of Indianness. Indeed, there must be an Indian law
that requires every travel brochure, calendar and poster to include an image of
someone with palms pressed together, conveying to the world India’s
hospitality, spirituality and graceful consciousness. And there can be subtle ways
of enhancing the gesture, as in the West one might shake another’s hand too
strongly, to impress and overpower them, or too briefly, indicating the
withholding of genuine welcome. In the case of namaste, a deeper veneration is
sometimes expressed by bringing the fingers of the clasped palms to the
forehead, where they touch the brow, the site of the mystic third eye. A third
form of namaste brings the palms completely above the head, a gesture said to
focus consciousness in the subtle space just above the brahma-randhra, the
aperture in the crown chakra. This form is so full of reverence it is reserved
for God and the holiest of satgurus.
It is
always interesting and often revealing to muse about the everyday cultural
traits and habits that evolve in each nation and community. For instance, a saw
for cutting lumber, if designed in the USA, is made in such a way that the
carpenter leans into the saw, cutting away from his body. But in Japan saws are
engineered so that the cutting takes place as the carpenter draws the saw
toward himself. A small detail, but it yields a big difference. One is a thrust
of power, the other provides more control in the cut, requiring surprisingly
less effort. Each has its place in the global toolbox. Each speaks—like the handshake
and namaste greeting—of an underlying perception of man’s relationship with
things.
In the
West we are more outgoing, forceful, externalized. Phone and web companies tell
us, “Reach out and touch somebody.” We are unabashedly acquisitive, defining
our progress in life by how much we have—how much wealth, influence, stored-up
knowledge, status or whatever. Every culture exhibits such traits to some
extent, but in the East, Mother is there to remind us, “Reach in and touch the
Self.” Here we are taught to be more introspective, more concerned with the
quality of things than their quantity, more attuned with the interior dimension
of life, where things are not the thing. So there you have it, the whole of
Eastern and Western culture summed up in the handshake, which reaches out
horizontally to greet another, and namaste, which reaches in vertically to
acknowledge that, in truth, there is no other.
As a
test of how these two greetings differ, imagine you are magically confronted
with the Divine. God walks up to you on the street, like George Burns in the
movie “O God!” What do you do? Reach out to shake His/Her hand? Probably not.
Though suitable between man and man, it’s an unseemly expression between man
and God. We never shake hands with God. I mean, what if your palms are
sweating? So, you namaste instead. The reason it feels natural to namaste
before God is that it is, in its very essence, a spiritual gesture, not a
worldly one. By a handshake we acknowledge our equality with others. We reveal
our humanity. We convey how strong we are, how nervous, how aggressive or
passive. There is a bold physicality to it. For these and other reasons, Popes
never shake hands. Kings never shake hands. Even mothers don’t shake hands with
their own children.
Namaste
is cosmically different. Kings do namaste. Satgurus namaste and mothers namaste
to their own family. We all namaste before God, a holy man or holy place. The
namaste gesture bespeaks our inner valuing of the sacredness of all. It
betokens our intuition that all souls are divine. It reminds us in quite a
graphic manner, and with insistent repetition, that we can see God everywhere
and in every human being we meet. It is saying, silently, “I see the Deity in
us both, and bow before It. I acknowledge the holiness of even this mundane
meeting. I cannot separate that which is spiritual in us from that which is
human and ordinary.”
And
while we are singing the praises of namaste, it should be observed how
efficient a gesture it is in an age of mass communication. A politician, or
performer can greet fifty thousand people with a single namaste, and they can
return the honor instantly. In such a situation a handshake is unthinkable and
a mere waving of one hand is somehow frivolous. Recently, many non-Hindus,
especially celebrities, are adopting namaste to avoid transmission of contact
diseases.
There
are other, more mystical meanings behind namaste. The nerve currents of the
body converge in the feet, the solar plexus and the hands. Psychic energy
leaves the body at these junctures. To “ground” that energy and balance the
flow of prana streaming through the nerve system, yogis cross their legs in the
lotus posture, and bring their hands together. The anjali mudra acts like a
simple yogic asana, balancing and harmonizing our energies, keeping us
centered, inwardly poised and mentally protected. It closes our aura, shielding
us psychically. It keeps us from becoming too externalized, thus we remain
close to our intuitive nature, our superconsciousness.
We asked
a number of Hindus for their insights into namaste, what it means and why we do
it. Here are a few responses:
“Namaste
elevates one’s consciousness, reminding one that all beings, all existence is
holy, is God. It draws the individual inward for a moment, inspires reflection
on the deeper realities, softening the interface between people. It would be
difficult to offend or feel animosity toward anyone that you greet as God.”
“I have
a poster that says it well: ‘Namaste! I honor the place in you in which the
entire universe dwells. I honor the place in you which is of love, of truth, of
light and peace. When you are in that place in you, and I am in that place in
me, we are one!’ ”
“Namaste
is a gesture of friendship and kindness, also of thanks or special recognition.
Mystically it is called namaskara mudra in the Agamic puja, and it centers
one’s energy within the spine.”
“I’ve
heard it means, ‘I salute God within you.’ The true namaste gesture is
accompanied by bowing the head and shoulders slightly. This is a gesture that
lessens our sense of ego and self-centeredness, requiring some humility to do
it well—whereas shaking hands can be quite an arrogant event.”
“Touching
the hands together puts you in touch with your center, your soul. Namaste puts
you forward as a soul, not an outer personality.”
“The
gesture has a subtle effect on the aura and nerve system. Bringing focused
attention and a collection of one’s forces, so to speak. It also protects
against unnecessary psychic connections which are fostered by shaking hands.
This might be called a form of purity also—protecting one’s energies.”
“This
form of acknowledgement is so lovely, so graceful. Just look at two people in
namaste and you will see so much human beauty and refinement.”
2)
How Hindu Dharma Addresses 25 Controversial Medical Issues Frequently Encountered by Physicians
INDU MEDICINE, KNOWN AS AYURVEDA, OR
THE “SCIENCE OF LIFE,” has a highly developed system of practical ethics
derived from the Hindu principles of nonhurtfulness, the sanctity of all life,
the existence of the soul separate from the body and a willingness to accept
life’s circumstances as defined by one’s karma and dharma.
In
1999, HINDUISM TODAY was approached by the Texas Medical Association to help
them revise and expand a book on medical issues called Faith of Our Patients.
When it was first published in 1978, the book dealt with the Catholic,
Protestant and Jewish views of 14 “problem areas” most frequently encountered
by physicians, including autopsy, abortion, artificial insemination,
prolongation of life and organ transplants. The association had recently
expanded its list and sought to include the views of Hinduism and Buddhism to
accommodate increased religious diversity among their patients.
Responding
to their request, HINDUISM TODAY enlisted the help of Swami Bua of New York;
Swami Satchidananda of the Integral Yoga Institute; Swami Ranganathananda,
president of the Ramakrishna Mission; Swami Chidananda Saraswati (Muniji);
Swami Omkarananda; Swami Pragyanand; Swami Tejomayananda of Chinmaya Mission;
Satguru Sivaya Subramuniyaswami, founder of HINDUISM TODAY, and his successor,
Satguru Bodhinatha Veylanswami. We also consulted with Dr. Virendra Sodhi, a
gifted ayurvedic and allopathic doctor in Washington, and Cromwell Crawford of
the University of Hawaii, an Indian-born specialist in Hindu medical ethics.
The assembled responses below represent the broad consensus of this group, with
occasional differing opinions, though the precise wording has been crafted by
HINDUISM TODAY.
Fortunately,
as pointed out by Professor Crawford, the ancient codifiers of ayurveda,
Sushruta and Charaka, carefully considered and documented the ethics of their
profession and its medical procedures. They did so within the context of a
Hindu view of man, which, as Swami Ranganathanananda put it, “is that his
essential, real nature is the atman or Self, which is immortal, self-luminous,
the source of all power, joy and glory. Everything that helps in the
manifestation of the divinity of the soul is beneficial and moral, and
everything that obstructs this inner unfoldment is harmful and immoral.”
With
this over-arching principle in mind, it was the aim of the ayurvedic physician
in ancient India (and remains so today) to preserve the well-being of the
community through maintaining health and removing the threats to life of humans
and non-humans. The ancient healers held that pathogenesis, the development of
disease, is not caused randomly or simplistically by external agents through
infection or injury. Rather, the development of any disease is also an
expression of karma: the results of one’s past actions. It is hoped that this
compilation of Hindu medical ethics will provide a spiritual view of the
medical concerns faced by all Hindus, one that will balance the prevailing
humanistic view by presenting a traditional Hindu perspective from which to
evaluate the important matters of healing, life, death and the beyond.
Matters of Birth
Hindus consider children a gift from
God. Conception, development and birth of a child are sacred events, honored by
a ceremony, or samskara, marking these rites of passage. Today’s medical
technology has developed many means for conceiving children. Hindus have a
general unwillingness to interfere with nature and a special aversion to
abortion, based on the belief in reincarnation and the sanctity of marriage.
Conception
From
the Hindu point of view, conception connects a soul from the next world to this
world, and the state of mind at the moment of conception—including the purity
and spiritual intent of both partners—is a major factor in determining who is
born into the family. Prospective parents often offer prayers at temples,
perform spiritual disciplines and visit saints for their advice and blessings
in their effort to conceive a worthy child. In Western thinking, no emphasis is
placed on the state of mind of the parents at conception, and there is little
understanding of the ways parents can affect the “quality” of the souls born to
them.
Birth Control
While
revering conception as a divine act, Hindus have little hesitation to practice
birth control, and there are remedies specified in ayurveda both for
facilitating and preventing conception. As Swami Bua reminded, restraint and
moderation are important: “Hindu scriptures explain how to beget a child. They
specify the days, time and methods. That means they would have known also how
not to beget a child! But willful control of conception by external means was
not advocated. The preferred control was through restraint, as wasting of life
seeds was considered unhealthy and unethical. Birth control now is highlighted
as a prime duty of every citizen to society and nation. But one fears that
these open discussions are licensing society towards promiscuity, since weak
minds take the shortest route to pleasures, however fleeting they may be,
unmindful of consequences.”
Sterility Testing
While
ostensibly harmless, sterility tests can cause serious social and emotional
difficulty if one is deemed sterile, including inability to find a spouse,
cancellation of proposals and the ruin of marriages once it is known who is to
blame for the lack of children. “This should not be resorted to as a routine
test,” cautioned Swami Bua. “Doubting the manliness of a man and femininity of
a woman is degrading them. What will happen to those who fail the test? Will
anybody come forward to marry them? Even though procreation is the main aim of
a marriage, it is not the only aim. After a reasonable time following the
marriage, if there has been no conception, and if a mature couple desire to get
tested with a view to take corrective action, it may be done.” Dr. Sodhi
pointed out that while ayurveda has no tests for sterility, the likelihood of
children is one of the major considerations when evaluating a couple’s
astrology prior to marriage.
Artificial Insemination
Fertilization
of the egg by mechanical introduction of sperm is universally acceptable when
the sperm is provided by the woman’s husband. But questions arise with donated
sperm from another man. Because conception creates a psychic bond between a man
and a woman, even if they don’t meet physically, fertilization in this manner
may have a similar karma as adultery. “In Sanatana Dharma initiation into
married life is sanctified by sacred sacramental rites,” Swami Tejomayananda
observed. “The offspring of such a union is blessed and protected by the holy mantras
and rites. If there is some defect or obstruction in either partner, artificial
insemination may be resorted to, but with the husband’s sperm only. If the
procedure succeeds, it may be taken as the will of the Lord for that couple.
Use of seeds from the sperm banks or from any living person other than the
husband is not proper. It will amount to bearing a child outside holy wedlock.”
However, as Professor Crawford pointed out, the Manu Dharma Shastra did allow a
woman to conceive a child by another man, usually her husband’s brother. Swami
Bua referenced this tradition also: “The Rig Veda and Atharva Veda prescribe
the procedure called niyoga to enable a childless widow or the wife of an
impotent man to raise progeny with his consent. But even with this, the
attitude of an average Hindu woman considers the one who has given her a child
as her respectful husband.” Satguru Bodhinatha Veylanswami observed that one
has to consider the likely negative impact of artificial insemination on a
marriage. The husband would not be the child’s true father, resulting in a weak
relationship with the child and even with the wife who required another man to
conceive.
In Vitro Fertilization
Even
with present-day technology, the creation of “test-tube babies”—the fertilization
of the egg outside the womb and its subsequent placement in the womb—is
expensive and unreliable. As with artificial insemination, it is acceptable if
the egg and sperm are from the husband and wife. Like other medical advances,
in vitro fertilization introduces unknown factors that may bring unintended
consequences, not necessarily positive or conducive to spiritual progress,
which is life’s real purpose. Hindus regard the natural way of things as
endowed with God’s infinite intelligence and often ask, “Are humans wise enough
to tinker with the cosmic order of life?”
Abortion
Hindu
scripture and tradition clearly prohibit abortion, except to save the life of
the mother. It is considered an act against rita (universal order) and ahimsa
(noninjury). In the words of Swami Omkarananda, “Imagine, through millions of
abortions around the world, day in and day out, how many wonderful scientific
and spiritual geniuses—doctors, men of excellence of every kind, sages, saints,
benefactors of mankind, builders of a better culture and civilization—are
destroyed even before they can take a breath of fresh air here on Earth!” Hindu
ethics also do not justify aborting a fetus because of actual or potential
deformity or mental retardation, for each birth, normal or not, is revered as
having a divine purpose to be understood, not manipulated. Nevertheless,
abortion is performed today by Hindus in India and elsewhere—particularly
selective termination of female fetuses following ultrasound examination.
Professor Crawford called that practice “a perverted use of modern science, a
scarcely concealed form of female infanticide.” Sivaya Subramuniyaswami
summarized in sutra 34 of Living with Siva, “Followers know abortion is, by
Vedic injunction, a sinful act against dharma fraught with karmic
repercussions. Scripture only allows it to prevent the mother’s death, for it
is a greater sin for a child to kill the mother.” “In the modern context,”
Swami Tejomayananda advised, “attention must be focused on the prevention of
pregnancy by educating and creating awareness in the parents.” Abortion, should
it occur, creates a karma to be faced in the future, but is not regarded as an
unforgivable “sin.” A penance could mitigate the karma, such as adopting a baby
who might otherwise have been aborted if no home was provided.
Selective Termination of Multiple Fetuses
Multiple
births are rare, except when a couple is undergoing fertility treatments, which
may result in multiple fetuses, creating a potentially dangerous condition for
the mother. Under the principle that abortion is allowed to save the mother’s
life, Dr. Sodhi offered that selective abortion is acceptable when a specific
pregnancy poses such a threat. It is an unfortunate choice to have to make, and
hopefully future technology will reliably produce only one fetus.
Pain-Relief Drugs for Newborns
Pain
relief for children should be carefully chosen to not form, or lay the seeds
for, a future addiction. Swami Bua counseled, “Some people think that the pains
of a newborn baby are the consequences of its previous birth and that we should
allow the baby to experience and sustain them so that remnants of the previous
birth are left behind. But we should also realize that God has brought this
baby to our hands expecting us to comfort it and protect it and help it to grow
as a healthy and worthy human being. It is the duty of the parents and the
people nearby to do whatever is possible to relieve the baby of any pain.”
“According to ayurveda,” Dr. Sodhi added, “the baby has as sensitive a nervous
system as an adult, just not as developed. So pain medicine is okay, if
necessary. Morphine was used for thousands of years in the form of opium,
applied on the baby’s skin for pain relief.”
Circumcision
Hindus
consider the practice of circumcision for males unnecessary and do not practice
it. Doctors should be alerted to Hindu views on this often-standard procedure.
A circumcised Hindu boy could face ridicule and discrimination. Rarely, the
procedure is required as a medical necessity for an adult, but kept secret.
Other Medical Concerns
Our reflections move on to ethical
considerations regarding organ transplants, blood transfusions, faith healing
and dietary laws.
Organ Transplants
Hindus
generally believe that the recipient of a major organ, such as the heart, lung,
liver or kidney, takes on some of the karmas of the donor. Evidence of this can
be found in documented cases where the organ recipients took on the interests,
emotions, food preferences, etc., of the donor, especially after a heart transplant.
Transplants apparently create psychic connections with the donor, whether
living or dead. Also, the fact that part of a deceased donor’s physical body
still “lives” may interfere with his reincarnation pattern, keeping him close
to the physical plane and to the recipient. Swami Tejomayananda offered, “The
Hindu way of life is to accept the inevitable, to go through the karma, exhaust
it and be free to take on new life to evolve further spiritually.” Swami Bua
voiced a different view: “Let us encourage and support the scientists and
medical men and women who are working with pure intentions towards a painless,
diseaseless society. We should only guard against unscrupulous traders in human
organs.” Swami Chidanand Saraswati opined that it is “important to donate
organs” in the Hindu spirit of giving and sacrifice. Dr. Sodhi offered: “Some
transplants, such as the cornea, are okay, but not the heart, which is the seat
of the soul according to ayurveda. If the quality of life is going to be very
good after the transplant, I might not have a problem, but if they have to be
on harsh drugs all the time, maybe transplanting is not the best idea.” Swami
Satchidananda chided, “What are we doing by transplanting organs?” By replacing
organs in a body that is clearly dying, we are not allowing the soul to fulfill
its karma in this life by dying at the proper time and getting a new body. The
trend of science seems to want to keep the soul indefinitely in the same old
body with repaired parts. This is not the correct thing to do.”
Blood Donations/Transfusions
“In
early times there were some hesitations, on the basis of caste and religion,
for blood transfusion,” observed Swami Bua; “but now, considering the necessity
of blood transfusion during any surgery, people are accepting it.” Blood
transfusions differ from organ donations in that the recipient’s body soon
completely replaces the foreign blood.
Religious or Faith Healings
Hindus
make use of all means of healing, be they medical, astrological or
metaphysical. The latter includes mantras and yoga, seeking the guidance of a
guru and performing temple ceremonies for the direct blessing and intervention
of God, Gods and devas. “A Hindu has an ardent faith in the powers of prayers
and in the Supreme God,” said Swami Bua, “The patient will go to the
doctor—ayurvedic or allopathic—all the while praying to God for recovery.”
Swami Pragyanand noted, “Healing with mantras was very popular in ancient
times. Even now it is being practiced for various ailments.” Swami Tejomayananda
added, “In healing by prayers, Divine Grace comes in. If the karma is nearing
exhaustion, or it is only a weak karma, or the healing will help the person in
his spiritual pursuit, or if the Higher Power has some work to be done through
the person, then a cure may be effected.” Dr. Sodhi added, “In ayurveda,
specific pujas, or ceremonies to the Gods, are sometimes prescribed for
patients.”
Dietary Ethics
Vegetarianism
is a central aspect of Hinduism, and of even broader import is the ayurvedic
wisdom that health is directly dependent upon diet. A Hindu vegetarian who is
hospitalized will need to coordinate with care-givers to be served proper food
unless he can have family or friends bring his meals. The ayurvedic prerogative
is: when healthy, eat a diet that prevents disease and enhances spiritual life.
When ill, a drastic change in diet may be the best cure, as seen in the
improvement of heart patients put on a vegetarian diet. “The scriptures
recognize that food has a great influence on the mind,” shared Swami
Tejomayananda, “‘When food is pure, mind is pure,’ state the Upanishads.
Mothers prepare food with love in the heart for the children. These positive
vibrations are absorbed, and the persons who partake of the food imbibe them.
Eating is an act of worship.”
End-of-Life Issues
Hindus regard death as a most
exalted human experience, the migration of the soul from one dimension of
consciousness to another, a transition we have all experienced many times.
Death is not to be feared, neither unnecessarily accelerated nor relentlessly
delayed. In considering the following end-of-life issues, the Hindu seeks to
preserve the natural timing of death, while humanely comforting and being
present for the patient in a spiritual environment.
Assisted Suicide
Hindu
philosophy does not support assisted suicide, which is deliberately causing the
death of a patient at the patient’s own request by drugs, overdose of
painkillers or other lethal means. In extreme circumstances of unbearable agony
where others turn to euthanasia or mercy killing, Hindus know the sufferer may
refuse food and water.
Suicide
Hindus
believe that life is sacred—God’s grace—and therefore it is not ours to end.
Suicide only postpones and intensifies the karma one seeks escape from,
requiring several lives to return to the evolutionary point that existed at the
moment of suicide; thus it is a spiritual step backwards. In cases of terminal
illness, under strict community regulation, tradition does allow prayopavesha,
self-willed religious death by fasting. Sivaya Subramuniyaswami taught, “The
Vedic rishis gave the anguished embodied soul a way to systematically, nobly
and acceptably, even to loved ones, release itself from embodiment through
fasting. The person making such a decision declares it publicly, which allows
for community regulation and distinguishes the act from suicide committed
privately in traumatic emotional states of anguish and despair. Ancient
lawgivers cited various stipulations for prayopavesha: inability to perform
normal bodily purification, death appears imminent, or the condition is so bad
that life’s pleasures are nil. The gradual nature of prayopavesha is the key
factor in distinguishing it from sudden suicide, for it allows time for the individual
to settle all differences with others, to ponder life and draw close to God.”
It also gives the person time to reflect and reconsider his decision.
Prolongation of Life
Ayurveda
classifies disease as either sadhya, those that can be effectively treated and
cured, or asadhya, those that cannot. It further classifies untreatable
diseases as those which can be managed for an acceptable quality of life, such
as diabetes, and those which cannot, such as terminal cancer. If treatment
cannot provide the patient a quality life, then it is considered better to give
no treatment beyond palliative measures.
The Right to Die
It
is the law in many parts of America that a hospital must do everything it can
to keep a patient alive as long as possible, no matter what his state of
consciousness, or the prognosis for a useful existence. If the patient’s
financial resources are exhausted, then the state must pay. To avoid being kept
alive against his own wishes, he must make a “living will” in advance, to
specify under what conditions he declines further treatment, and assign a
person to make that decision for him if he cannot. A living will can preserve
the resources of a family, avoiding costly and ineffective heroic treatment.
Hindus accept the natural timing of life and of death, and do not strain to
gain a few months of struggle-filled life at great effort and expense.
Do-Not-Resuscitate Orders
Part
of a living will deals with “Do-not-resuscitate” orders. These instructions
tell the doctors when they should not use cardiopulmonary resuscitation (CPR)
or other measures to revive a person if his heart or breathing has stopped.
Again, the decision centers around the likely quality of a life so revived. A
drowning or heart-attack victim may, after resuscitation, go on to a full
recovery. But for terminally ill patients, resuscitation may only delay the
inevitable, prolong the suffering and interfere with the natural timing of
death. Sivaya Subramuniysawami counseled, “To make heroic medical attempts that
interfere with the process of the patient’s departure is a grave
responsibility, similar to not letting a traveler board a plane flight he has a
reservation for, to keep him stranded in the airport with a profusion of tears
and useless conversation. To prolong life in the debilitated physical body past
the point that the natural will of the person has sustained is to incarcerate,
to jail, to place that person in prison. The prison is the hospital. The guards
are the life-support machines and the tranquilizing drugs.”
Removal of Life Support
A
critical and closely related issue any living will should address is the
removal of life support. Modern machines can keep patients alive when they are
unable to breathe or take nourishment, and when organs cease to function,
including the heart. Life-support patients may be in near-normal consciousness,
semi-conscious, comatose or brain dead, with no brain wave activity at all.
Even common kidney dialysis machines and ventilators qualify as life support,
for if turned off patients would die. A much discussed issue is whether turning
off a life support machine is killing the patient or letting him die. The issue
is further complicated by rapidly advancing technology whereby ever more
seriously ill or injured patients can be kept alive.
In
Dr. Sodhi’s opinion, removal of life support would be justified in a case where
there is no brain-wave activity, for “according to ayurveda, that person is
dead. Sustaining his condition is more like the torture of the soul, and
ayurveda prohibits it.” While ancient Hindu medicine did not anticipate many of
the abilities of today’s complex machines, it did discuss the issue of
nourishment, which is a part of any life-support system. Hindu scripture allows
for the termination of food and water at the request of a terminally ill
patient who chooses a self-willed death by fasting. The patient can specify in
advance in his living will under what conditions nourishment, hydration or
other life support should be withheld. Knowing his intentions would alleviate the
karmic burden of the doctors and family. The ideal, as Sivaya Subramuniyaswami
counseled his devotees, is to not be put on a life support machine in the first
place when there is little chance of recovery.
Preparation for Death
“With
our strong conviction that all our actions in the present life will be the
cause for the effects in our future life,” noted Swami Bua, “a wise Hindu
facing death goes into introspection of all his deeds during the present life
and sincerely tries to make amends for the wrong deeds. Wherever it is beyond
correction, he repents and wholeheartedly prays for forgiveness in the form of
chanting mantras. He plans to visit holy places and temples, health permitting.
When and if he becomes immobile due to physical conditions, and the indications
are that he is nearing his end, his children assemble around him and give him
holy water from the Ganges. They sing bhajanas and chant mantras, often in a
24-hour-a-day vigil.” Sivaya Subramuniyaswami wrote: “Blessed with the
knowledge of impending transition, we settle affairs and take refuge in japa,
worship, scripture and yoga—seeking the highest realizations as we consciously,
joyously release the world. Our soul never dies; only the physical body dies.
We simply step out of the physical body and are in our astral body, going on in
the mind as usual. For Hindus, death is nobly referred to as mahaprasthana,
‘the great journey.’ The awareness, will, memory and intelligence which we
think of as ourselves continue to exist in the soul body. We approach death as
a sadhana, as a spiritual opportunity. To leave the body in the right frame of
mind, in the right consciousness, through the highest possible chakra, is a key
to spiritual progress.”
Pain Control
Hindus
regard pain management as an important duty of care-givers. “If an individual
opts to undergo the pains, he or she should be left alone,” Swami Bua advised.
“Otherwise, it is the duty of the people around to help reduce his suffering.
If a person is relieved of pain, his thoughts become sublime, with gratitude
and the feelings of amity, affection and love. Nobody should be allowed to die
with feelings of bitterness, feelings of wanting or feelings of unfulfilled
duties. We should do everything possible to keep the dying person comfortable till
his end, which is determined by Him.” Opiates and other drugs have been used
for this purpose in Hindu medicine for thousands of years, according to Dr.
Sodhi. However, he explained, “Practitioners try not to administer so much
pain-killer as to alter or cause loss of consciousness.” Excessive pain-killers
can dull awareness and inhibit a conscious transition, which is the Hindu
ideal.
Definition of Death
“When
the physical body dies, this automatically severs the silver cord that connects
the astral and physical bodies,” Sivaya Subramuniyaswami explained.
Metaphysically, this is the point of death. Physically, death can be defined as
the cessation of breath, heartbeat and brainwave activity, in that order. Even
then, it may be possible to revive a person, and the patient may report a
“near-death experience” of beginning the transition to the next world but being
pulled back. Decay of the body is the definitive sign of death.
Autopsies
Autopsies
are the examination of a dead body to learn the cause of death. Hindus believe
that autopsies are disturbing to the still-aware soul which has just separated
from the body and should therefore be avoided unless required by law.
Similarly, embalming, which replaces the blood with a preservative fluid, is
ill-advised.
Use of the Body After Death
In
ancient times, doctors around the world used dead bodies to understand anatomy
and practice surgery. In India, the bodies used for this purpose were those
unclaimed by relatives or friends. According to Swami Bua, “In the Vedic Age,
dissection and mutilation of body were considered detrimental to the
fulfillment of life. Yet, if we consider that once the spirit leaves the body,
the lifeless body has no karmic obligations, then it may be okay.” Swami
Pragyanand pointed out that autopsy and dissection were practiced by Sushruta,
an early pioneer of ayurveda. Swami Tejomayananda offered, “The body of the
deceased is treated with reverence. The feelings and sentiments of the family
also do not favor dissection. People have some fear that the astral body may be
hurt by these intrusions or some harm may come to the family.” Sivaya
Subramuniyaswami similarly held that what happens to the dead physical body is
disturbing to the soul, and did not advise his devotees to donate their bodies
to science.
Burial and Cremation Practices
Cremation,
ideally held within 24 hours, is the traditional Hindu system of disposing of
dead bodies. It has the benefit of releasing the soul most quickly from any
lingering attachment to the earth plane. Should it be necessary to preserve the
body a few days to allow time for distant relatives to arrive, refrigeration or
use of dry ice is recommended, rather than embalming. Hindus do not bury their
dead, except infant children and godly saints.
E D
U C A T I O N A L I N S I G H T P A R T I I
A Health-Care Providers’ Handbook on Hindu Patients
Excerpts from a new booklet by Queensland Health, Australia
SKILLED MEDICAL GROUP IN AUSTRALIA
has produced an impressively accurate and comprehensive 24-page booklet that is
packed with vital, insightful information for health care providers. Put
together in 2011 by the Queensland Health Multicultural Services (multicultural@health.qld.gov.au), it is entitled Health Care Providers’ Handbook on
Hindu Patients.
The first half of the booklet, guidelines for health services, covers a wide
gamut of subjects: including communication issues, religious observances,
dietary needs, astrological beliefs, decision making, traditional medicines and
remedies, medicines of animal origin, maternity services, home visits,
rehabilitation and end of life issues. The second half is devoted to Hindu
beliefs that relate to health care. It includes cogent sections on food, karma,
holy days, fasting, abortion and more. The text as written is in a terse
summary form meant for easy access by care givers and we share it unedited,
believing that its sensitive wisdom will guide health-care providers all over
the world looking after the needs of Hindu patients. On the advisory committee,
ensuring depth and authenticity, was a host of persons of Indian origin: Shyam
Das, Kermeen Kansara, Vinita Khushal, Balaji Motamarri, Rajni Nair, Pt. Sanat
Pandey, Surendra Prasad, Sarva-Daman Singh and Krimesh Shukla.
Introduction
Queensland
is a culturally and religiously diverse state—in 2006 nearly one in five Queenslanders
(17.9 per cent) was born overseas, 7.8 per cent of the population spoke a
language other than English at home, and more than 129,000 people followed a
religion other than Christianity. Between 2001 and 2006, one of the fastest
growing religions in Queensland was Hinduism. Figures from the 2006 census show
there are more than 14,000 Hindus living in Queensland [total population 4.5
million]. This figure is now likely to be higher, as between 2007–08 and
2009–10, permanent migration to Australia from Southern Asia (which includes
India, Sri Lanka, Bangladesh and Nepal) was second only to permanent migration
from Europe. The increasing cultural, linguistic and religious diversity in the
Queensland population means that to be safe, health services need to be
culturally appropriate and responsive. Research indicates a strong link between
low cultural competence and poor quality health outcomes, and significant
risks.
Personal level of adherence
Hinduism
is the world’s oldest living faith and third largest religion. It is practiced
in many countries around the world, including by large populations in Southern
and Southeast Asia, Europe, Africa, North America and Australia.
There is
much diversity in the beliefs and practices of Hindus, with hundreds of diverse
sects and no central doctrinal authority. As Hinduism grants individuals
complete freedom to practice his or her religion as they choose, there are
personal and cultural variations that make it difficult to provide definitive
rules and regulations that apply to all Hindu patients. Because of these
personal variations, it is important that health care providers consult the
patient about their personal level of religious observance and practice.
However,
Hindu patients should not be regarded as a “special” group that require
additional attention from health care providers. Due to the common Hindu
beliefs of karma (the belief that every action has a consequence which is
experienced in this or future lives) and reincarnation, Hindu patients may
display acceptance of difficult circumstances and be inclined to comply with
the instructions of health care providers.
Section I: Religious Observance
Hinduism
grants individuals complete freedom to practice his or her religion as they
choose. As a result, it is important that health care providers discuss
religious observance needs with each patient. Some topics that health care
providers may wish to discuss with their patients include prayer and
meditation, bathing and cleanliness, dietary needs and astrological beliefs.
Prayer and Meditation
- Prayer and meditation are important to many Hindus.
- There are no set times for prayers; however, most Hindus prefer to pray in the morning.
- Prayer can take place in any location, including in bed or in hospital prayer rooms.
- Hindu patients may wish to have religious statues or icons close by when in hospital.
Bathing and Cleanliness
- The concept of purity is important to Hindu life, and some Hindus may be quite meticulous about bathing and cleanliness.
- Most Hindus have a ritual of cleanliness and prayer each morning which includes brushing the teeth immediately upon waking, followed by bathing, prayer and then eating.
- A delay in eating to follow this ritual should not be interpreted as a refusal to eat.
- Washing of hands prior to eating is important as many Hindus eat with their hands.
- Washing with running water is important to Hindus and most will prefer a shower rather than a bath.
- Women may be considered impure or unclean when menstruating or following childbirth.
Dietary Needs
- Many Hindus are strict vegetarians, abstaining from all meat, fish and eggs. Vegetarian Hindus do consume dairy products.
- Hindus who choose to follow a vegetarian diet do so because of a belief in nonviolence which extends to animals, and a belief that nonvegetarian food impedes spiritual development.
- Some Hindus choose to eat meat and do not follow a vegetarian diet.
- Most nonvegetarian Hindus do not eat beef or pork, as cows are considered sacred and pigs are considered unclean.
- Many nonvegetarian Hindus may choose to abstain from eating meat on particular days of the week. For example, a strict vegetarian diet may be observed on Mondays.
- Some strict vegetarian Hindus will not eat from plates or use utensils that have previously been used to serve meat.
- Most Hindus will eat only with the right hand. Some may not eat food which has been passed to them with the left hand.
- Fasting is common for Hindus and can vary from complete abstinence to only avoiding certain types of foods.
- Fasting on a particular day of the week is also a common practice.
Astrological beliefs
- Many Hindus hold strong astrological beliefs and may believe the movement of the planets has a strong influence on health and wellbeing.
- Patients may wish to schedule appointments or surgeries according to these beliefs.
Decision-making
Hinduism
views the needs of the individual in the greater context of family, culture and
environment. As a result, family members, especially elders, can have a strong
influence on decision-making related to health matters, including informed
consent. Hindus may wish for family members to be responsible for making
treatment decisions.
Administration of medicines
Traditional Medicines and Remedies
Hindus
may use a variety of ayurvedic medicines, home remedies and spiritual remedies,
often in conjunction with Australian medicine. It is important for health care
providers to be aware of their patient’s preferences. Ayurveda is a holistic
system of medicine practiced by many Hindus around the world. It is a highly
valued and respected health science in India. Ayurveda is practiced by many
Hindus in Australia, and ayurvedic medicines are regulated by the Therapeutic
Goods Administration (TGA). As a discipline, ayurveda sits alongside
Traditional Chinese Medicine in the TGA classification of complementary
medicines.
Based on
ayurvedic principles, Hindus believe that all illnesses, whether physical or
mental, have a biological, psychological and spiritual element. Ayurveda seeks
to maintain a balance between the body’s three elemental energies (humors).
Good and bad health is related to the level of balance of these three energies.
Many Hindus also use traditional home remedies which are based on ayurvedic
medicine and are easily available from Indian grocery stores.
One of
the most common Hindu spiritual remedies is vibhuti, or holy ash. Vibhuti is
commonly used in Hindu religious worship and is believed to contain protective,
purifying and healing properties when applied on the skin (particularly on the
forehead), consumed in small quantities, or carried on the person in a small
packet.
Medicines of Animal Origin
Some
medicines may not be suitable for Hindu patients because they are derived from
cows, pigs or other animals. The Queensland Health Guideline on
Medicines/Pharmaceutical Products of Animal Origin states that health care
providers should inform patients about the origins of their proposed medication
if it is derived from animals and no suitable synthetic alternative exists.
Patients should be encouraged to make informed decisions regarding their
treatment.
Oral Hygiene
- Oral hygiene is very important to most Hindus, especially those who practice ayurvedic principles.
- Many Hindus prefer to brush their teeth immediately after waking in the morning and some may also scrape their tongue with a metal tongue scraper. This is done to avoid the ingestion of impurities that may have built up in the mouth during sleep.
- Hindu patients may also wish to brush their teeth immediately after waking from general anesthesia or surgery for the same reason.
- Health care providers should explain the benefits of also brushing the teeth after eating.
- Many Hindus use home remedies for oral hygiene and health purposes, including chewing mint leaves, cloves or fennel seeds.
- Oral health examinations and treatments are usually not regarded as invasive by Hindu patients.
Maternity Services
- A small number of Hindu ceremonies accompany pregnancy and childbirth.
- While most of these ceremonies are completed in private, there are some which may be completed while the mother and infant are in hospital care.
- After childbirth, a Hindu father may wish to perform the jatakarma ceremony to welcome the infant into the world. As part of the ceremony, the father touches and smells the infant and whispers mantras (religious verses) into the infant’s ears.
- Another rite which is performed shortly after birth involves drawing a small dot (often in the shape of an Om) behind the infant’s ear. The Om symbol may also be placed on a chain around the infant’s neck or placed in the cot.
- A family member may also wish to write the Om symbol on the infant’s tongue with jaggery (unrefined whole cane sugar) dipped in ghee or honey.
- Health care providers should advise parents that feeding honey to infants below the age of 12 months is not recommended in Australia due to the risk of infant botulism.
- The sixth day after birth is considered the most auspicious in a person’s life. On this day, a fragile white cotton thread is ceremoniously tied around the infant’s wrist, ankle or neck. A pen and blank piece of paper may also be placed in the infant’s cot, as it is believed that on this day Saraswati (Goddess of Learning) charts the child’s future.
- Some Hindus may wish to bury the umbilical cord on the sixth day after birth. If there are clinical reasons for not providing the umbilical cord to the parents, this should be explained.
- The naming ceremony (namakarana) usually occurs at the infant’s home after birth.
- Depending on family customs, the ceremony may be delayed if the infant requires extended hospital care.
- Some Hindu women may wish to express colostrum before feeding their baby for the first time.
- Health professionals should inform women of the benefits of feeding their infant colostrum.
Community health services
Home Visits
- Hindus may prefer for shoes to be removed when entering a home.
- If this is not possible for Workplace Health and Safety reasons, alternatives should be explored (e.g., wearing plastic shoe covers).
- Health care providers should avoid taking meat products into the homes of vegetarian Hindus.
Rehabilitation Issues
- Self care practices involving eating or drinking are ideally performed with the right hand.
- Health care providers should be aware that where a patient has lost the ability to use their right hand, sensitivity may be required.
- Similarly, loss of function in the left hand may affect the patient’s comfort with bathing and washing habits.
Visiting Arrangements
- Visiting the sick is an important responsibility for Hindus.
- Hindu patients may have large numbers of visitors, including those from outside their immediate family.
- Health care providers should discuss with the patient, or their family, the impact a large number of visitors may have on rest or care requirements, and other patients.
- Patients may wish for family members to stay in the hospital overnight. This should be accommodated if possible.
Care of Family and Older Persons
- Hinduism encourages family members to take a role in the care of family members.
- Hinduism especially emphasizes respect for all older people, with children having a special responsibility towards their parents.
- It is considered a family obligation to care for the elderly and the sick.
- Health care providers should take this into account when developing care plans or suggesting nursing or residential care.
End of life issues
- The sanctity of life is central to Hindu teachings.
- Hindus believe that all living beings possess a soul which passes through successive cycles of birth and rebirth.
- Hindu patients may wish to die at home, as this has particular religious significance.
- The patient’s eldest son is expected to be present before, during and after death, even if the son is a small child.
- Other family members may wish to be present and to participate in the care of the patient.
- Family members may request that patients not be told about a terminal diagnosis directly.
- A Hindu patient may wish for a pandit (priest) to be present to perform certain rituals, including: tying a sacred thread around the neck or wrist, placing a few drops of water from the River Ganges into the patient’s mouth, placing a sacred tulsi leaf (holy basil) in the patient’s mouth.
- A Hindu patient, especially a Hare Krishna follower, may wear sacred tulsi beads (a string of small wooden prayer beads) around their neck. It is important that these be on the body at the time of death.
- If it is necessary to remove these beads, they should be retied around the wrist (preferably right).
- Patients may wish to read or recite religious chants and prayers. However, some patients may prefer to listen on a personal media player or small radio.
- Hindu chaplaincy services are available in many Queensland Health facilities.
Deceased Patients
- A deceased Hindu’s body is usually washed by close family members, with the eldest son taking a leading role.
- The family may wish to light a small lamp or burn incense near the body.
- If possible, all jewelry, sacred threads and religious objects should be left in place.
- Health care providers should advise family members if it is necessary to remove these items.
- The deceased patient’s family may have a preference for the position of the body after death.
- Hindus are usually cremated as soon as possible after death.
Autopsy
- Hindus generally regard autopsies as unacceptable. However, autopsy is permitted if required under Queensland statutory laws .
- Hindus are usually cremated as soon as possible after death, and autopsy may affect this practice.
- Health care providers should consult with the family of a deceased Hindu patient before proceeding with an autopsy.
Section II: Hindu Beliefs Affecting
Health Care
Food beliefs
Hindu
dietary practices can vary depending on the individual’s beliefs and customs.
Most Hindus do not eat beef or pork and many follow a vegetarian diet. Fasting
is common among Hindus, but there are no set rules, and the decision to fast is
up to the individual. Many Hindus follow ayurvedic dietary practices. Under
this system, certain foods are classified as hot or cold and can adversely or
positively affect health conditions and emotions. The classification of foods
as hot or cold is unrelated to temperature. Hot foods are generally those foods
which are salty, sour or high in animal protein, while cold foods are generally
sweet or bitter. Some strict Hindus do not consume garlic or onion, as the
properties of these foods disturb spiritual practices such as meditation.
Karma
- A central belief of Hinduism is the doctrine of karma, the law of cause and effect.
- Hindus believe that every thought, word and action accumulates karma, which can affect current and future lives.
- Hindus believe in reincarnation. Actions from a past life can affect events in the current life, including health and well-being.
- Health care providers should be aware that a strong belief in karma can affect decision-making regarding health care.
Holy days
Hindus
do not observe a specific day of worship, although some days of the week may be
associated with particular Deities. Hindus do observe a number of holy days and
festivals which can have an impact on health care due to associated fasts. Most
Hindu holy days are based on the lunar calendar, and the dates can vary from
year to year. Some festivals can occur over an extended period, with
celebrations lasting for days or weeks.
Fasting
Fasting
is an integral part of Hinduism and is seen as a means of purifying the body
and the soul, encouraging self-discipline and gaining emotional balance.
Fasting may be practiced on specific days of the week, during festivals or on
holy days, or in conjunction with special prayers. It is not considered obligatory
for a Hindu patient to fast during hospitalization. However, some patients may
wish to fast while in hospital. There is no specified way to fast, but
individuals may choose to abstain completely from all food and drink or only
abstain from certain foods.
Dress
While
there is no religious requirement for modest dress, many Hindus choose to dress
modestly and may be reluctant to be examined by health care providers of the
opposite sex. Hindu women may wear a sacred thread or gold chain around their
necks, and Hindu men and boys may wear a sacred thread across the chest. These
items should not be removed during examination. If it is necessary to remove an
item, permission should be sought prior to removal .
Hare
Krishna followers, and some other Hindus, may wear sacred tulsi beads around
the neck. If it is necessary to remove these beads, they should be retied
around the wrist (preferably right). In addition, some jewelry worn by Hindus
may have a sacred meaning, and patients should be consulted before removal.
Mental health and/or cognitive Dysfunction
Hindus
believe that all illnesses, whether physical or mental, have a biological,
psychological and spiritual element. Treatments which do not address all three
causes may not be considered effective by a Hindu patient.
Many
Hindus attach a stigma to mental illness and cognitive dysfunction. Many have a
strong belief in the concept of the evil eye and may believe this to be a cause
of mental illness. In addition, all illness, including mental illness, may be
seen as the result of karma from this life or a previous life.
Transplants and Organ Donation
Hinduism
supports the donation and transplantation of organs. The decision to donate or
receive organs is left to the individual.
Contraception
There
is no official Hindu position on contraception.
Abortion
Beliefs
about abortion may vary depending on cultural or religious interpretations.
Many Hindus believe that the moment of conception marks the rebirth of an
individual, which may make abortion unacceptable, except in emergencies.
Assisted Reproductive Technologies
There
is no official Hindu position on assisted reproductive technologies.
Pain Management
Hinduism
encourages the acceptance of pain and suffering as part of the consequences of
karma. It is not seen as a punishment, but as a natural consequence of past
negative behavior and is often seen as an opportunity to progress spiritually.
This may affect triaging or the monitoring of pain levels as Hindu patients may
not be forthcoming about pain and may prefer to accept it as a means of
progressing spiritually. However, this behavior may be less prevalent in
Australia, especially among young people.
Death and Dying
Hindus
believe that the time of death is determined by one’s destiny and accept death
and illness as part of life. As a result, treatment is not required to be
provided to a Hindu patient if it merely prolongs the final stages of a
terminal illness. Under these circumstances, it is permitted to disconnect life
supporting systems. However, suicide and euthanasia are forbidden in Hinduism.
Web Resources
The
booklet, in its fullness (including a list of appropriate Hindu vegetarian
foods at the back), can be seen here:
A
religious calendar that includes Hindu holy days may be found at:
Health
Care Providers’ Handbook on Hindu Patients is licensed under a Creative Commons
Attribution, Non-Commercial, Share Alike 2.5 Australia licence. To view a copy
of this license, visit:
Om Tat Sat
(My humble salutations to Sadguru Sri Sivaya Subramuniyaswami
ji, Satguru Bodhianatha Velayanswami ji, Hinduism
Today for the collection)
(The Blog is reverently for all the seekers of truth,
lovers of wisdom and to share the Hindu Dharma with others on the
spiritual path and also this is purely a non-commercial blog)
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