Monthly Archive for February, 2007

Death, Dying and Religion: Buddhism

In the 1996 census there were 199,812 Buddhists living in Australia (ABS, 1996). Fourteen percent of Buddhists in Australia are Australian born (Adam & Hughes, 1996). The majority of Buddhists have come from Asia, particularly Vietnam, Cambodia and Laos with the single largest ethnic group of Buddhists being those from Vietnam. Chinese Buddhists also comprise a large proportion of Australian Buddhists, coming from many countries including Singapore, Hong Kong, Malaysia, Taiwan and the Peoples Republic of China. A smaller group of Buddhists of the Theravada traditions have come from Sri Lanka, Burma and Thailand and there is also a number of Tibetan Buddhists. BuddhaNet, an Australian Internet Buddhist information service has a list of 167 Buddhist societies operating in Australia.

1. General Beliefs
Buddhism was founded on the Indian subcontinent around 560BC. Its founder was an Indian prince, Siddartha Gautama, who renounced his wealthy life after encountering sickness, death and the suffering experienced by his people. Through meditation, Guatama discovered the four noble truths. That the nature of existence is suffering, the cause of which is karma, produced by our deluded thoughts, actions and ignorance keeping us trapped in samsara (the cycle of death and rebirth). The cessation of these causes of suffering results in permanent peace (nirvana) and the path to cessation (the eightfold path) is to develop true understanding of the interdependent nature of all phenomena and to conduct ourselves in a way which is compassionate rather than harmful to others (Gyatsho, 1965). The components of the eightfold path are: Right View, Right Intention, Right Speech, Right Action, Right Livelihood, Right Effort, Right Mindfulness, and Right Concentration.

The cessation of all suffering is the goal of Buddhists spiritual practice. Meditation is an important component 0f this practice, although some traditions give it higher importance than others. While there are many forms of meditation, the main purpose is to train the mind, bringing it under control, clearing it of impurities, and opening it to wisdom, awareness and observation. This training then influences how we live our daily life. In general a Buddhist is trying to live with correct understanding and correct moral action. The tenet of the “middle way” or moderation in everything is also an important part Buddhist philosophy and practice.

Known as Buddha after attaining enlightenment, Guatama’s teachings (Dharma) were passed down orally. By emphasising different aspects of the original teachings different lineages have developed. These different lineages spread to other countries, where the existing cultures influenced the form of practice and the aspects that were taught. Buddhism now consists of two main schools. Theravada, or Hinayana, emphasises the monastic tradition and holds that the path to Nirvana, is an individual pursuit. This tradition predominates in Sri Lanka, Burma, Thailand, Laos and Cambodia. Mahayana, the more liberal tradition, holds that the belief of its followers will in time encompass the whole of humanity and lead to its salvation. This tradition predominates in China, Taiwan, Korea, Vietnam, Bhutan and Nepal. There are also major schools within this stream, such as the Vajrayana tradition found in Tibet and the Zen tradition of Japan (Klein, 1991).

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Health Faith Spirituality

Since the Buddha turned the first wheel of dharma in India in 2500 years ago his teachings have spread to many other countries where various traditions have developed. This has been partly due to which of the Buddha’s teachings were emphasised in that country and what aspects of the local culture influenced the way the teachings were put into practice.

One of the fundamental teachings of the Buddha that we find in all Buddhist traditions however, is the teaching on the Four Noble Truths which many of you may be familiar with. These truths are that

  1. There is suffering,
  2. That karma, ignorance and negative emotions are the causes of suffering,
  3. That there can be a complete cessation of suffering and
  4. That the path to cessation is through the cessation of the causes karma, ignorance and negative emotions.

In the first truth - the truth of suffering - sickness, old age and death are all included as types of sufferings that we will experience during our life.

We are encouraged in our practice of Buddhism to see sickness of any kind as a normal thing to happen rather than seeing perfect health as normal and sickness as life gone wrong. As ordinary beings ie unenlightened beings, we are under the control of ignorance, negative emotions and karma and therefore it is natural that we will experience sickness just as it is natural for us to experience old age and death.

We are born with the potential to experience many forms of illness, pain or injury - and this potential ripens when we meet the appropriate conditions eg spending time with someone who has a cold just at the time we are stressed, tired and have less resistance than usual. We probably all have the potential to be injured in eg a car accident but for most of us it hasn’t happened yet because we were not the one immediately behind the car that stopped suddenly and unexpectedly.

So this is the first understanding we can develop from the teaching on the 4 Noble Truths - that sickness is a normal thing to happen to us.

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Karuna’s Christmas Craft Group

The Karuna Christmas Craft Group has begun work once again. This dedicated group meets every Thursday in a relaxed and friendly environment in a nearby volunteers home. Together they create decorations and gifts to be sold at our annual Christmas Craft Market later in the year.

The group commences at 10am and finishes at 3pm, but you are welcome to arrive and leave at times which suit you. There is no need to book and it is free, so come along, bring your lunch and willingness to share and learn. You are guaranteed a great time!

If you want to be a part of this fantastic group, but are unable to make it to these sessions, then you are more than welcome to create your own hand-made craft decorations and gifts at home to give to Karuna. If you would like to be a part of this group, or for more information, call Stephanie on 07 3632 8300 or email stephanie@karuna.org.au.

A Submission to the Queensland Health Systems Review

Thank you for the opportunity to comment on palliative care service arrangements with Queensland Health.

Karuna Hospice Service provides specialist hospice-in-the-home services to people who live in a geographic area that stretches from 10 kms south of the Brisbane River to the Glass House Mountains. The area includes Redcliffe and Bribie Island. The western boundaries run from Corinda, to Mt Nebo and Woodford. During 2004-5 we provided care for 268 new patients and their families as well as 419 bereaved carers in this geographic area.

Karuna is part of a home hospice consortium that also provides services to the Sunshine Coast (Cittimani Hospice Service) and Gympie (Little Haven). The consortium provides free high level palliative care to dying people and their families from a funding base made up of government funding, community fundraising and donations. Our model includes:

  • Advanced practice palliative care nurses with 24 hour on call service
  • Collaborative care with palliative care medical Consultants and GP’s
  • Counsellors for terminally ill patients and their families (this frequently includes children of dying parents)
  • Spiritual care
  • Trained volunteers who provide in-home respite care and social support
  • Loan of home nursing equipment
  • A 12 month bereavement support program for people with normal grieving
  • Psychological services for people with abnormal and complex grief
  • Carer Education

The above services are all provided free to the client family.

In addition Karuna provides

  • Education to other health professionals
  • Education to the community.
  • Psycho-social and spiritual support to people with needs related to dying and loss but who do not need admission to home hospice care.

Our services assist between 58% to 75% of patients to die at home, depending upon the availability of visiting GP’s. These figures are well above the national average for home deaths.

Karuna works collaboratively with hospital based palliative care teams at Royal Brisbane Hospital, The Prince Charles Hospital, Redcliffe, Princess Alexandra, and Mater hospitals. We are a major referral point for the Wesley and Holy Spirit Hospitals, and Greenslopes for patients who live on the north side of Brisbane. We also enjoy a collegiate relationship with Mt Olivet who provide in-patient hospice services and consulting to the domiciliary services.

In addition, Karuna is contracted to manage the state-wide Palliative Care Information Service (PCIS) which is a 1800 telephone information and referral service. PCIS maintains an extensive data base of palliative care and other health and support networks across the state.

We would like to offer comments on a number of issues confronting palliative care services under the headings of structure, funding, collaborative partnerships and workforce before concluding with some suggestions for the future.

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