By Traci Cumbay
Put any two people in a room together, and they impact each other in ways subtle and obvious. They observe each other. They breathe the same air. One talks, the other listens. And if one falls to the floor suddenly? Surely the other will jump to offer aid.
That’s all well and good when a fellow human is within sight. One of the premier tenets of Buddhism is that any person anywhere is affecting everyone everywhere through actions large and small. That idea, that interconnectedness, is a little more difficult to absorb but is the impetus for the social justice activism that has been an important aspect of Buddhism all along.
“First, I need to stress that we’re talking about 2,500 years of tradition here and a very diverse religion that migrated to the United States and added further layers of diversity,” said Rev. Dr. Daijaku Kinst, Hanyu Professor of Buddhist Chaplaincy at Institute of Buddhist Studies, Graduate Theological Union. “That said, the teaching of interconnectedness and the idea that every being deserves care and respect are fundamental.
“If you see the world as an expression of interconnectedness and each person of equal value, then when you’re faced with inequity, you’re going to act.”
Suffering, whether because of an acute harm or a systemic injury, constitutes a chief concern for Buddhists.
“Buddhism was essentially founded over the issue of how to overcome the experience of suffering, and the Buddha himself was often compared to a doctor,” said Nathan Michon, a Fulbright Scholar currently in Japan studying the rise in Buddhist chaplaincy and caregiving, with a healthcare focus. “The overall emphasis within Buddhism on overcoming suffering has always related deeply to caring for the sick and needy.”
And although that care may mean sitting with someone to provide comfort, it often encompasses issues of much greater scale.
“Because we’re all interconnected moment by moment, doing something systemic to address suffering is fundamental,” Kinst said. “All beings are not different from me but related in a system. When you think systemically, you see that a person is suffering and put your effort into changing the system that causes suffering in addition to comforting the individual.”
An important aspect of that pursuit is approaching it with heart and head. In Buddhist theology, compassion without wisdom won’t get you far, and those twin virtues are compared to bird’s wings—a bird can’t fly with only one wing. Applied to alleviating suffering, compassion and wisdom are taken as motivation for looking deeply into what people need and tailoring one’s efforts to those needs.
“With only wisdom, you won’t make a difference in the world, but with only compassion, the help you provide might be unwanted or damaging,” Michon said. “There is an emphasis on not just helping those in need, but helping in ways that are truly helpful for that specific individual.”
Or helpful regarding a specific issue, when you apply that approach on a larger scale.
“You’re looking for the causes and conditions to address suffering,” Kinst explained. “If I don’t pay attention to racism and poverty and other systemic issues, I’m not seeing the world as it is.”
"What Happens to Another Happens to Me"
Michon notes that Buddhism’s steps to reducing suffering—the four noble truths—have been treated in the West as philosophical; elsewhere they are taken as practical advice for acknowledging, understanding, and acting to alleviate suffering.
“This is essentially a constantly repeated cycle to deal with issues of suffering, big and small, short-term and long-term,” he said. A budding activist may start by caring for one individual, applying each of the steps outline in the four noble truths, and then work outward, repeating the process again and again.
Michon points also to loving-kindness—one of the four Brahma-viharas (virtues and meditation practices) that enable a person to reach the “abode of the gods”—as a motivation toward healthcare activism: “Loving-kindness is described as treating all living beings as if they were your only child and caring for all no matter who they are.”
Along those same lines, Kinst notes that this care may extend selflessly on a broad scale.
“In the Mahayana tradition,” she said, “there’s a focus on the bodhisattva—someone who is dedicated to awakening for all beings. The way of bodhisattva is the way of service. You see the suffering of the world and respond. You place yourself at the end of the line and want all beings to be free of suffering before yourself.”
At present, Kinst stressed that end-of-life care has received tremendous attention among Buddhist activists. American healthcare has become focused on “save save save,” she said, rather than on the reality that people die. Approaching this issue means more than advocating for adequate, compassionate (and realistic) hospice care but examining how pharmaceutical and technology companies are driving end-of-life decisions. Issues like whether Medicare approves a drug impact standards of care—and countless lives.
As for any healthcare issue, approaching end-of-life care from a Buddhist perspective arises out of the appreciation of interconnectedness.
“If you understand you’re your own unique self and interconnected,” Kinst said, “you can better see the need to care for all. Which isn’t just Buddhist but also something Martin Luther King, Jr., stressed: What happens to another happens to me.”
Traci Cumbay is a writer and editor, and a valued contributor to Faith in Healthcare
Faith and Healthcare Notes
PHARMA 101: A PRIMER Public Citizen last week released an important overview of the pharmaceutical industry, which includes such insights as:
The Industry is Huge: “The global market for pharmaceuticals reached $1.2 trillion in 2018. Just one product—AbbVie’s Humira—had almost the same amount of sales that year as Southwest Airlines.”
The Industry is Taxpayer-Subsidized: “At its core, the brand-name business model is simple. The pharmaceutical industry uses government-funded research to help develop products that are protected by government-granted monopolies to sell to the government and other purchasers for exorbitant profits.”
The Industry is Ridiculously Profitable: “Prescription drugs are not expensive because they are costly to produce, or because of R&D investments. A recent analysis found that prescription drug corporations receive 163 percent of their global research and development costs from just the revenue generated by overcharging Americans for prescription drugs compared to citizens of other countries . . . Retail prescription drug spending, on a per capita basis, has nearly quadrupled since 1990, increasing from $266 to $1025
The Industry’s Products are Usually Not Innovative: “Overly broad U.S. government patent standards and interpretations enable drug corporations to construct “thickets” of patents around their product and engage in patent evergreening to prevent generic competition. Between 2005 and 2015, over 75 percent of drugs associated with new patents were already on the market, meaning most pharmaceutical patents support older medicines rather than groundbreaking new ones.”