THE SPIRITUAL NEEDS OF THE DYING:
A BUDDHIST VIEW
by: Ven. Pende Hawter
discussing the spiritual needs of the dying from the Buddhist
perspective, we firstly need to look at several key points,
an understanding of the shortness and preciousness of life.
what can help ourselves and others at the same time of death.
what goes on after death.
Buddhist concept of mind.
order to gain an understanding of the shortness and preciousness
of life and how to make it meaningful we need to reflect on
the fact that death is certain and that the time of death is
uncertain. These points may seem obvious but we rarely stop
to consider the truth of them.
example, when we consider that death is certain we can reflect
on several points:
there is no possible way to escape death (nobody ever has),
life has a definite, inflexible limit and each moment brings
us closer to the end of this life, and
death comes in a moment and it's time is unexpected (and even
while alive we devote very little of our life to spiritual practice).
reflecting on the fact that the time of death in uncertain we
can analyse this further by recognising that:
the duration of our lifespan is uncertain - young people can
die before old people, the healthy before the sick, etc.
there are many causes and circumstances that lead to death but
few that favour the sustenance of life - in fact even the things
that sustain life and make it comfortable can kill us e.g. food,
our house, our car.
the weakness and fragility of our body contributes to life's
body can be easily destroyed by disease or accident.
on these points can help us to realise that life is short and
precious and that there is no time to lose. It is good to remind
ourselves of these points each day. It can be very helpful when
first getting up each day to say to ourselves "today may
be the last day of my life, let me live it therefore by making
it as meaningful as possible, being of benefit to others, etc.".
can also be very helpful to consider how we would react if we
were told, for example, that we only had 3 or 6 months to live,
to ask ourselves questions like:
I ready to die?
unfinished business do I have?
do I want to do or achieve in the time I have left?
my priorities change?
can help me at the time of death?
as somebody put it "Live each day as though it were your
last and one day you'll be right!"
other critical point is to consider what will help us at the
time of death. Reflection here reveals that:
worldly possessions such as wealth, position or money can't
relatives and friends can neither prevent death nor go with
even our own precious body is of no help to us and we have to
leave it behind.
ultimately the only thing that can help us is the state of our
mind, the state of our mental or spiritual development.
and the mind
is this so? The Buddhist belief is that every action of body,
speech and mind that we create lays down a subtle imprint in
our mind which has the potential to ripen as future happiness
or suffering, depending on whether the action was positive or
negative. These imprints remain in the mind until they ripen
or until they are purified or cleansed by spiritual practices.
This process in known as the law of karma.
mind itself is formless, shapeless, colourless, genderless,
and has the ability to know or cognize all phenomena. It's basic
nature is luminous and knowing. The mind also has different
levels - gross, subtle, and very subtle. The very subtle mind
is very clear and is usually only experienced at the time of
death or during advanced meditation practices. The imprints
of our actions (karmic imprints) are stored in the very subtle
intermediate state and rebirth
the time of death, the body and mind go through a process of
dissolution, where the 25 psycho-physical constituents that
we are comprised of gradually absorb and lose their ability
to function.  This process of dissolution is associated with
external and internal signs. This process continues even after
the breathing ceases, for up to 3 days.
this process the mind becomes more and more subtle and clear
until it eventually reaches the point of the 'clear light of
death', where it is said to be approximately 9 times more clear
than in the normal waking state. At this point the mind separates
from the body, taking with it all of the subtle imprints from
that life and previous ones.
very subtle mind or consciousness and the very subtle wind upon
which it rides then arises into an intermediate state (bardo)
being which has a subtle (non-physical) body that can move through
solid objects, travel anywhere just by thinking of that place,
and so on. The intermediate state being stays in that state
for up to 7 weeks, by which time a suitable place of rebirth
is usually found. This place of rebirth is determined by the
force of karma, whereby the intermediate state being dies and
the consciousness is propelled without control towards the place
of rebirth. The consciousness enters the fertilized egg at or
near the moment of conception and the new life begins.
in this whole process is the state of mind at the time of death,
because it is this that determines the situation a person will
be reborn into. If the mind is calm and peaceful and imbued
with positive thoughts at the time of death, this will augur
well for a happy rebirth. However, if the mind is in a state
of anger or has strong desire or is fearful etc, this will predispose
to an unhappy or lower type of rebirth.
mind that arises at the time of death is usually the one that
the person is most habituated to. People tend to die in character,
although this is not always so. So in the Buddhist tradition
it is emphasised strongly that the time to prepare for death
is now, because if we develop and gain control over our mind
now and create many positive causes we will have a calm and
controlled mind at the time of death and be free of fear. In
effect, our whole life is a preparation for death and it is
said that the mark of a spiritual practitioner is to have no
regrets at the time of death. As a friend of mine said recently
on hearing about these concepts, "Perhaps it's time I started
swotting for the finals!"
Spiritual Needs of the Dying
considering the spiritual needs of the dying, the basic principle
is to do whatever you can do to help the person die with a calm
and peaceful mind, with spiritual/positive thoughts uppermost.
This is because it is believed that the state of mind at the
time of death is vitally important and plays an important role
in determining what will happen to the person after death.
whether we are a doctor or nurse relieving pain and other distressing
symptoms and reassuring the family, a counsellor helping to
resolve emotional issues, a minister of religion offering spiritual
counsel, or a volunteer who offers companionship and support
for the dying person and their loved ones, we are all contributing
significantly towards obtaining this calm and peaceful state
this basic principle, there are several ways we can categorise
people which will help to determine the type of spiritual support
that they need, namely:
the person conscious or unconscious?
conscious, you can do the practices with them or get them
to do them
unconscious, you have to do the practices for them
the person have specific religious beliefs or not?
religious, remind them of their religious practices
not religious, encourage them to have positive thoughts, or
remind them of positive things they have done
a person with a spiritual faith it is beneficial to have spiritual
objects around them e.g. an altar, a rosary, photos of their
spiritual teacher, or to play spiritual music, or to burn incense,
and so on - whatever reminds them of their spiritual practice.
It is good also to talk to them about their spiritual practices,
recite prayers with them and so forth. For an unconscious person
it is said to be good to recite prayers, mantras etc into their
a person does not have a spiritual faith, it is helpful to remind
them of positive things they have done in their life, or of
positive qualities such as love and compassion and kindness.
is important to avoid religious activities that are inappropriate
or unwanted by the dying person. Someone standing at the end
of the bed reciting prayers may be an annoyance, and I have
seen a case of an attempted deathbed salvation which greatly
angered the dying person.
basic aim is to avoid any objects or people that generate strong
attachment or anger in the mind of the dying person. From the
spiritual viewpoint it is desirable to avoid loud shows of emotion
in the presence of the dying person. We have to remind ourselves
that the dying process is of great spiritual importance and
we don't want to disturb the mind of the dying person, which
is in an increasingly clear and subtle state. We have to do
whatever we can to allow the person to die in a calm/happy/peaceful
state of mind.
for sick and dying people
those who have advanced illness but are still conscious there
are a number of simple meditation techniques or visualisations
that can be very helpful.
those who are anxious or fearful of dying, teaching them relaxation
or guiding them through a simple relaxation technique can be
very beneficial. I will usually leave them a relaxation tape
that they can use any time of day or night, whenever the need
arises. When appropriate, touch, massage, reflexology and similar
techniques can also be very soothing and stress-relieving, especially
as the person may be somewhat starved of touch due to the fears
and awkwardness of people who visit them.
simple meditation technique that is very effective is awareness
of the breath. The person becomes aware of the movement of the
breath inwards and outwards at the level of the nostrils, breathing
naturally and easily, not forcing or exaggerating the breath.
At the same time, any thoughts that arise are let go of, constantly
bringing the mind back to the breath. This technique, although
simple, can generate very calm states of mind and relieve anxiety.
the awareness of breath is then combined with the recitation
of certain words or mantras or prayer it becomes very powerful.
Just to say "Let...go...let...go..." in time with
the in and out breaths can be soothing and relaxing. A person
with a spiritual belief can use a prayer or mantra with the
breath. For example, one lady whom I was visiting who was an
ex-Catholic nun chose the prayer "not mine, Lord, but thy
will be done". She shortened this by reciting "Not
my will" on the in-breath and "but yours" on
the out-breath, repeating this over and over again.
beauty of this technique is that 1) it can be done for short
periods of time and requires little concentration, which is
often reduced by the effects of disease and medication, 2) it
helps to calm the mind and reduce anxiety, 3) it utilizes and
strengthens the person's spiritual refuge, 4) it does not require
anything other than the breath.
both a religious and a non-religious person a white light 'healing'
meditation can bring a lot of comfort and benefit. The person
visualizes a brilliant ball of white light above their head,
with the light streaming down through their bodies, removing
sickness, pain, fear, anxiety and filling the body with blissful
healing light energy. Depending on the person's belief system,
they can see the light as being in the nature of Jesus, or Buddha
or some other spiritual figure, or they can just visualise it
as a source of universal healing energy. This meditation combines
very well with the breath awareness technique and is also good
to have on tape to leave with the person, to be used whenever
needed day or night. When a person is close to death they can
also be encouraged to let go into the light, into the heart
of Jesus or Buddha seated above their head, whatever is appropriate
for that person.
use of guided imagery or gentle music can also be soothing and
relaxing and help the person to have a calm and peaceful mind
as they approach death.
person in pain can also be guided through a pain meditation,
a technique whereby the pain is explored in detail, often leading
to a reduction or eradication of the pain.  A very profound
meditative technique is to actually use the illness or pain
as a way of developing compassion. For those who can use this
technique the results can be very great. The person is encouraged
to think that "by me experiencing this cancer/AIDS/pain
etc, may all other beings in the world be free of this, and
may they have good health, happiness and long life". The
person uses their sickness or pain as a way of opening their
heart to others who are in a similar situation. People who have
used this technique have often gone from being totally caught
up in their own misery to a state of open-heartedness and peace.
even more advanced technique is the meditation on "taking
and giving on the breath" as described in the Tibetan Buddhist
scriptures. In this meditation, one visualises taking on the
suffering of all other living beings (or this could be restricted
to those with cancer or AIDS etc) in the form of black smoke,
which is taken in on the in-breath. Then on the out-breath all
of our health and happiness and all positive qualities are sent
out to other living beings in the form of white light, and we
visualise them receiving everything that they want. At our heart
we visualise a black rock of selfishness, and as the black smoke
is inhaled we visualise it hitting the black rock and smashing
it completely, thus eradicating all trace of selfishness from
meditation is a profound method for developing compassion quickly
but there will only be a minority of patients who will be able
to use this method. The usual way to progress in these meditations
is to start with small problems such as a headache or tiredness
etc, then gradually train our minds to transform bigger and
aim of all these methods is to help the dying person die with
a calm, happy and positive mind. Anything that we can do to
achieve this will benefit the person, whether that be good nursing
care and pain relief, massage, the presence of a loving family,
or whatever. It is said that the best thing we can bring to
a dying person is our own quiet and peaceful mind.
this way we will help the dying person make the transition from
this life to the next as smooth and as meaningful as possible,
recognising the vital spiritual importance of this transition.
wish is that this short paper may in some way be of benefit
to those who read it and reflect on it, and hence to the sick
or suffering people that you serve.
revised August 1995
Francesca and Chogyam Trungpa, The Tibetan Book of the Dead:
The Great Liberation Through Hearing in the Bardo, Shambala,
Boulder and London 1975.
the new translation by Robert A.F. Thurman, Aquarian Press,
Philip, The Wheel of Life and Death, Doubleday, New York, 1989.
Rinbochay and Jeffrey Hopkins, Death, Intermediate State and
Rebirth in Tibetan Buddhism, Rider & Co, London,1979.
Stephen, Healing Into Life and Death, Anchor Press/Doubleday,
New York, 1987.
Stephen, Who Dies, Anchor Press/Doubleday, New York, 1982.
Vicki, Reincarnation: The Boy Lama, Bloomsbury, London, 1988
Vicki, Reborn in the West: The Reincarnation Masters, Bloomsbury,
Glenn H., Death and Dying: The Tibetan Tradition, Arkana, London,
Rinpoche, The Tibetan Book of Living and Dying, Rider, London,
see "Death, Intermediate State and Rebirth" by Lati
Rinbochay and Jeffrey Hopkins or my paper on "Death and
Dying in the Tibetan Buddhist Tradition" for full details
of this process.
for full details of this technique, refer to "You Can Conquer
Cancer" by Ian Gawler, pp 177-180 or to my paper "Relaxation
Therapy and Meditation in Pain Control".