The Hindu Tradition: Religious Beliefs and Healthcare Decisions
The Hindu Tradition: Religious Beliefs and Healthcare Decisions
The Hindu Tradition: Religious Beliefs and Healthcare Decisions
sive establishment of Muslim rule over virtually engaging in a dialogue with him or her on this
the whole of the Indian sub-continent and is point.
therefore referred to as the Muslim period of Most Hindus believe in reincarnation (punar
Indian history. This period is characterized by janma). From this belief follows a corollary
various modes of interaction between Hinduism belief in multiple lifetimes of existence in the
and Islam. past and the future (samsiira), lifetimes in which
By 1800 the British were well on their way to the quality of one's present life is determined by
achieving political control of the subcontinent. the quality of one's past life (especially moral
When they relinquished control in 1947, India life) as led in previous lifetimes (karma). It is
and Pakistan emerged as independent states. For thus possible to improve the quality of one's life
the most part, Pakistan was carved out of those over several lives and attain a better rebirth, but
parts of India that had Muslim majorities. the ultimate Hindu religious ideal aims at tran
Hinduism continues as the primary religion scending the process of the cycle of rebirths
of India, over 80% of whose citizens count as itself. The successful attainment of this goal is
Hindus. There are over a million Hindus in the called mok~a or mukti (liberation).
U.S.A., primarily as a result of Indian immigra Several ways of attaining mok~a are identified
tion. The Indian diaspora, as the spread of peo within the tradition. These methods are collec
ple of Indian origin through different parts of tively called yoga. The word is formed from a
the world is called, includes about 20 million root which means "to join"; hence any system of
Hindus. belief and practice which unites the seeker with
the ultimate reality (brahman) can be called
yoga. Such a union, when successfully effected,
BELIEFS RELATING TO HEAITII CARE involves liberation from samsiira and thus leads
to mok~a.
An important point to consider at the very out The importance of health in the context of
set, before specific beliefs of Hinduism which the practice of yoga is widely recognized, and a
may relate to health care are taken into account, famous maxim attributed to one of classical
is the nature of Hinduism itself as a belief sys India's most famous poets states that the body
tem. Hinduism is a broad-based and doctrinally should be viewed as the primary instrument for
tolerant religion with hardly any single and attaining mok~a. This maxim is put into practice
exclusive test of orthodoxy, with the result"that in Hatha Yoga, which takes the physical body as
diverse and even contradictory beliefs can be the starting point of yoga (as distinguished from
found co-existing within it. This diversity also the more usual practice of using the mind as the
encompasses the reality that "folk religion" and point of such departure, as in Raja Yoga). In the
the "religion of women folk" flourish freely West the term yoga has been almost exclusively
within Hinduism, without the doctrinal con identified with the physical form of yoga,
straints that these expressions of religion might because of its popular appeal as a way of secur
face in the Abrahamic religions, which attempt ing and maintaining physical and even mental
to "rationalize" 1 these dimensions of religion. By health. The Hindu religious tradition, however,
the same token, one must not presume to know associates the word yoga with the control of
what the beliefs and practices of a patient might the body as well as the mind, and Raja Yoga
be from the mere fact of his or her being a arguably associates it more with the mind than
Hindu. Because Hinduism lacks a standard defi the body.
nition, and practice tends to take precedence Some of these yogic techniques go back to
over theory, it is best to elicit the specific the Vedic period and may even have been part
"Hindu" religio,u.s life-pattern of the patient by of Harappan culture. In due course, however, a
c)
', .
ments or humors are present in a bio-system and traders, and (4) laborers (brahmatw,
alized as passing through the stages of life. that of the family in the pursuit of their dharma.
These are specified as those of (1) student, (2) Since this attitude may have a direct hearing on
householder, (3) hermit, and (4) renunciant a woman's physical and mental health, the prac
(brahmacO.r[, gr}tastha, vO.naprastha, sannyas[). titioner needs to be aware of this dimension of
According to the third, such an individual, living Hindu ethical practice.
in society, may pursue four valid goals of life. Along with the situated character of a human
These involve the pursuit of (1) righteousness, being, however, there is an equally clear recog
(2) wealth and power, (3) sensual and aesthetic nition of the ethics and morality of a human
pleasures, and (4) liberation (referred to as dhar being qua human being. Thus discussions of
ma, artha, kama, and mok~a). All these are to specific ethics conclude with considerations of
he done or attended to while living in the pres universal ethics, which is specially emphasized
ent age, called the Kaliyuga, which is the last of in a spiritual context. A famous text on yoga, the
the four ages that recur periodically at astro Yoga Sutra of Pataiijali, lays down the following
nomical time intervals (the previous three being ten moral rules as the starting point of his Yogic
krta, treta, and dvapara). system: non-violence, truthfulness, non-stealing,
The point of these four quadripartite classifi chastity, non-possession, purity, contentment,
cations is that in one respect ethics is specific to austerity, study, and faith in God. These have
one's vocation, age, gender, teleological disposi been compared to the Ten Commandments.
tion, and cosmo-temporal placement. Thus the As for medical ethics per se, the Hindu equiv
conduct appropriate to a priest (who may not alent of the Hippocratic oath runs as follows:
retaliate if attacked) is not appropriate for a war
rior (who may). Similarly, what is not appropri
ate conduct for a student (having sex) is appro If you want success in your practice, wealth and.
priate, even enjoined, for the householder, and fame, and heaven after your death, you must pray
so on. Hinduism pays more attention to these every day on rising and going to bed for the wel
specific duties and responsibilities than do many fare of all beings, especially of cows and brah
religious traditions. The minutiae of Talmudic mans, and you must strive with all your soul for
and Islamic law provide a useful parallel here. the health of the sick. You must not betray your
The term dharma is an important one in this patients, even at the cost of your own life ... You
context, especially when used to designate one's must not get drunk, or commit evil, or have evil
duties as flowing from one's vocation, age brack companions ... You must be pleasant of speech ...
et, gender, etc. Thus members of the priestly and thoughtful, always striving to improve your
class may forgo certain treatments involving the knowledge. 5
(
The central significance accorded the doctrine CLINICAL ISSUES
I of reincarnation in Hinduism is crucial for
assessing its position on genetics. Genetics Sex selection and selective abortion
essentially looks upon life as involving biological Prenatal sex selection has become a major issue
continuity; Hinduism looks upon life as involv in India: the ratio of women to men fell from
ing spiritual continuity, when "spiritual" is used 935:1000 in 1981 to 927:1000 in 1991.19
as an adjectival form of the word spirit or soul. Researchers are divided into two camps as to the
Hinduism possesses a concept, sariiskaras, which cause. One group blames cultural factors such as
corresponds in a spiritual sense to that of genes, preference for male children, need for dowry,
but sarhskaras are not biological but psychic in fear of widowhood, and so on.20 The other group
nature. And since the nature of reincarnation is blames socio-economic factors, 21 such as reliance
determined by one's karma, it might be permis on sons alone for old-age support in the absence
sible to argue that in Hinduism the genetic of a social security net, a view of sons as eco
endowment one obtains could be viewed as the nomic assets, and the like. Asian countries
outcome of one's karma. where both sons and daughters have begun
Several conclusions about genetics from the jointly supporting older parents have overcome
perspective of Hinduism may be drawn from gender imbalance. Education and economic
these observations. Hinduism would strongly opportunity seem to hold the key. 22
resist any form of genetic determinism as reduc
tive, as an attempt to explain the "higher" in Gene therapy and genetic screening
terms of the ''lower:' At most, it would admit These practices belong to the realm of preven
genes as only one factor among a complex of tive medicine and would be acceptable.
factors, some of which are decidedly spiritual,
that affect outcomes in life. At the same time, Cloning
Hinduism's emphasis on conscious decision The Abrahamic traditions tend to resist cloning;
making (an implication of its doctrine of the the Hindu approach is more accommodating.
four ends of life) and its disposition favoring Hindu religious imagination is familiar with ana
experimentation in general would encourage logues to cloning in its mythic lore.23 It would,
genetic engineering and experimentation. however, be opposed on moral principle to egois
However, Hinduism's insistence that the moral tic or spare-part cloning of other creatures.
compass never he abandoned implies that prop Cloning creates interesting issues for the doc
er ethical protocols must always be observed in trine of karma and the concept of a "soul," but
such endeavors. Chief among ethical considera although these ideas may complicate the discus
tions would be the question: To what extent do sion they do not negate the basic position.
any experiments in genetics involve wanton
destruction of human life, and to what extent do
they involve cruelty to other forms of life?
ne of the favorite myths of Hindu theologi egalitarian protocols, since life, as such, is of
O cal folklore-of how the god GaJ;lesa came
to possess an elephantine head-has to do with
equal value for all.25
Hinduism would favor procedures that
an organ transplant. Thus at one level there lengthen life span on two counts: its general
would he minimal subliminal resistance to the preference for longevity,26 and a general sense
procedure. that, the longer a person lives, the greater the
At another level, however, problems could likelihood that the person will become spiritual
arise. As the transplant usually involves organs ly disposed. 27
or tissue recovered from a recently deceased The karmic implications of a transplant are
person, considerations of ritual purity and prac significant, especially in light of stories that the
tice could come in the way of organ removal. transplantees develop a craving for the food
Certain Hindu practices, such as those of preference or other aspects of the life-style of
sroddh.a (a commemoration of the dead), involve the deceased owner of the transplanted organ.
a concept of a person migrating to another
world, a mental picture best imagined with all For donors
limbs intact. However, although the practice The donation is made either by the person or by
continues, this vision has paled and has been the family. There is real tension here between a
replaced by a more spiritual concept.24 sense of possession and compassion. There are
precedents for offering one's body parts while in
a state of moral elevation, as in the story of King
CLINICAL ISSUES Sivi, who willingly chopped off his limbs and
.) For recipients
gave them to a falcon as ransom for the life of a
dove. 28 In the absence of such compelling cir
One issue in transplantation would he that of cumstances, the permission of the donor may he
egalitarian transplant allocation procedures. secured in advance, as well as permission from
Every society, left to itself, tends to deviate in the family members, for family members could
the direction of its structural orientation, claim a legal right over the body of the depart
whether based on class, caste, wealth and so on. ed. Given Hindu social structures, it is best to
Resource allocation could then become biased obtain permission in advance when the donor
in these directions as well. Hence the need for may he able to take care of these objections.
(.
relationships, and here the role of the Guru in deal with and cure the mind would he deemed
the Hindu tradition becomes important.32 somewhat limiting in Hinduism. The shock of
The basic Hindu position, namely, that the a superior insight will he preferred to electric
self is more than merely a complex of hody shock and spiritual stimulation will be preferred
mind, is crucial to the discussion of mental to other forms.
health in Hinduism. This understanding enables One must also differentiate here between
its position to be distinguished from the yogic techniques, which carry one over one's
Buddhist, which views the person as a purely traumas to the other shore, and modern proce
psycho-physical organism, and also underscores dures that involve wading through the "muck,"
the fact that, in order to know the mind, one as it were, to reach the other shore.
must know more than the mind. Thus mental
health becomes part of spiritual health. Psychopharmacology
Although Hinduism at its most receptive admits
even of chemical means of attaining mok~a, 34
The key considerations in the Hindu Apprentice surgeons were taught by practicing
I approach to experimentation would be the incision on gourds; the puncturing and opening of
welfare of humanity and whether benefits out tumours on the bladders of animals filled with
weigh the costs. Hinduism generally favors blood and water; the piercing of hollow organs on
experimentation,36 and it has even been thick lotus stalks; probing on dried cucumbers
described as a spiritual laboratory. The evolu and worm-eaten wood; the application of caustics
tion of Hath.a Yoga and the various iisanas on pieces of meat; the giving of enemas on the
(physical postures) within it presupposes exten ends of water-melons; bandaging as practiced on a
sive experimentation. doll or clay figure. The stitching of wounds was
perfected on soft leather. 38
CLINICAL ISSUES
The surgical limits of sentimental benevo
In actual cases, however, the facts of the case lence are also recognized. The Su,Sruta Samhita
must be considered carefully. Willing participa recommends that if the "fetus is irreparably
tion in experimentation and research would be damaged or defective and the chances of normal
emphasized. Hinduism could, according to cer birth are nil ... the surgeon should not wait for
tain interpretations, be opposed to vivisection, as nature to take its course but should intervene by
for instance in the interpretation of Mahatma performing a craniotomic operation for the sur
Gandhi.37 However, its pluralism allows for other gical removal of the fetus:' 39
approaches, while moral aversion has sometimes
)
__ been accommodated by ingenious ways to teach
the practice of surgery.
As a rule Hindus would like to see the body pre the rite of cremation for themselves (via an effi
served for the last rites of cremation. However, gy) at the time of their initiation into formal
erations of justice or benevolence would he The ceremonies for the departed ancestors,
SPECIAL CONCERNS
considered sinful. s3
5. A. L. Basham, The Wonder That Was India (New 19. By contrast, in Nepal, another Hindu-majority country,
Delhi: Rupa & Co., 1999: 3rd rev. ed., 1967), 500. women outnumber men.
6. P. V. Kane, History ofDharma.Siistra, 2nd ed. (Poona: 20. See R. Mutharayappa, M. K. Choe, F. Arnold, and T.
Bhandarkar Oriental Research Institute, 1973), vol. 3, K. Roy, Son Preference and Its Effect on Fertility in
816-817. India (Honolulu: East-West Center, 1997); E. Bumiller,
7. A. S. Altekar, The Position of Women in Hindu Journey Among the Women ofIndia (New York:
Civilization (Delhi: Motilal Banarsidass, 1995), 206- Fawcett Columbine, 1990), 104.
207.
Hinduism," in Homosexuality and World Religi'!ns, ed. 24. On the question of karma as it relates to this point see
Arlene Swidler (Valley Forge: Trinity Press Murray Milner, Jr., "Hindu Eschatology and the Indian
12. S. Radhakrishnan, The Hindu View ofLife (New 25. See Manus~ (VIII.104).
Abortion and the Moral Status of the Unborn," in ence to a SUlra above ninety (SUdro'pi c1aSaml.m gatalf,
Harold G. Coward et al., Hindu Ethics: Purity, 11.137) .. ;• (Agrawala, India as Described, 29).
Abortion. and Euthanasia (Albany: State University of Moreover, "'long life was thought to be the boon of a
14. William A. Young, The World's Religions and 27. See Patrick Olivelle, The Asrama System: The History
Contemporary Issues (Englewood Cliffs, NJ.: Prentice and Hermeneutics of a Religious Institution (New York:
Hall, 1995), 127. M.A. Warren, Gendercide: The Oxford University Press, 1993).
(_
14 THE HINDU TRADmoN: RELIGIOUS BELIEFS AND HEALTHCARE DECISIONS
!.
" ''
28. The incident occurs in the Ar111Jyaparva in the
Mahabharata. The context is as follows: Indra has
assumed the form of a hawk, and Agni (Fire) has.
42. See Arvind Sharma, Classical Hindu Thought: An
Introduction (Delhi: Oxford University Press, 2000),
chap. 11.
assumed the form of a dove. The hawk wants to
devour the dove as its natural food, but the dove has 43. Bhagavadgl,ta VIIl.5.
sought refuge in the lap of King Sivi, whose virtue is
being tested by the two gods. In the end, the king 44. Prakash N. Desai, Health and Medicine in the Hindu
ends up first offering his own flesh in lieu of the dove, Tradition (New York: Crossroad, 1989), 31-32.
and, finally, his entire body, rather than abandon
someone who has sought shelter with him. 45. So also in Buddhism; see Bimala Churn Law, Concepts
ofBuddhism (Leiden: Kern Institute, 1937), 93.
29. Herbert Benson, 1he Relaxation Response (New York:
Morrow, 1976). 46. Barbara Stoler Miller, Yoga: Discipline ofFreedom
(Berkeley: University of California Press, 1995), 47-49.
30. Heinrich Zimmer, M)1hs and Symbols in Indian Art
and Civilization, ed. Joseph Campbell (New York: 47. M. K. Gandhi, Hindu Dhanna (Ahmedabad: Navajivan
Harper & Row, 1946); Heinrich Zimmer, Philosophies Publishing House, 1958), 192-197.
ofIndia, ed. Joseph Campbell (Princeton, N.J.:
Princeton University Press, 1969). 48. Katherine K. Young, "Euthanasia: Traditional Hindu
i
Views and the Contemporary Debate," in Coward et al, !
31. Ian Stevenson, Cases of the Reincarnation Type Hindu Ethics, 92££. 11
I
(Charlottesville: University Press of Vrrginia, 1975). I,
49. Wilhelm Halbfass, India and Europe: An Essay in
32. See Sudhir Kakar, The Analyst and the Mystic: Understanding (Albany: State University of New York
Psychoanalytic Reflections on Religion and Mysticism Press, 1988), 12-13.
(London: Pali Text Society, 1960), vol. 1, 609-610. Press, 1923), 664.
34. Ainslie T. Embree, ed., Alberuni's India Translated by 51. ':Apastamba attributes the first enunciation of the
Edward C. Sachau (New York: W. W. Norton & Co., Sradha Rites to Manu" (Agrawala, India as Described,
1971), part 2, 189. 3).
35. Ibid, part l, 80. 52. Paul David Numrich, The Buddhist Tradition:
Religious Beliefs and Healthcare DeciSions (Chicago:
36. David M. Knipe, Hinduism: Experiments in the Sacred Park Ridge Center for the Study of Health, Faith, and
(San Francisco: HarperSanFrancisco, 1991). Ethics, 2001), 11.
37. M. K. Gandhi, My Religion (Alunedabad: Navajivan 53. Manusrm;ti X.126; but see also Agrawala, India as
Publishing House, 1955), 81. Described, 28.
38. Benjamin Walker, The Hindu World (New York: 54. David Godman, ed., The Teachings of Sri Ramana
Frederick A. Praeger, 1968), vol. 2, 455. Maharshi (New York: Arkana, 1985), 139.
39. Crawford, Dilemmas, 32. 55. Bhagavadgita XVII.7-9; see W. Douglas P. Hill, The
Bhagavadg°i.ta, 196-197.
40. Sunil K. Pandya, "On Dying and Death: Lessons From
the Indian Tradition," Dilip 28, no. 1 (2002): 23-28.
co .
Bhagavadgl,ta, 2nd ed. (Madras: Oxford University
Press, 1973; 1st ed., 1928), 134-135 .
Agrawala, V. S. India as Described by PW],ini. Varanasi: Kakar, Sudhir. The Anal,yst and the Mystic: Psychoanalytic
Prithvi Prakashan, 1970. Reflections on Religion and Mysticism. New Delhi:
Viking, 1991.
Altekar, A. S. The Position of Women in Hindu Civilization.
Delhi: Motilal Banarsidass, 1995. Kane, P. V. History ofDharmaSiistra. 5 vols. Poona:
Bhandarkar Oriental Research Institute, 1968-1977.
Basham, A. L. The Wonder That Was India. New Delhi:
Rupa & Co., 1999. Knipe. David M. Hinduism: Experiments in the Sacred.
San Francisco: HarperSanFrancisco, 1991.
Benson, Herbert. The Relaxation Response. New York:
Morrow, 1976. Law, Bimal Churn. Concepts ofBuddhism. Leiden: Kem
Institute, 1937.
Bhagavadg'itii.
Malalasekera, G. P. Dictionary ofPali Proper Names.
Bumiller, E. May You Be the Mother of a Thousand Sons: London: Pali Text Society, 1960.
A Journey Among the Women ofIndia. New York:
Fawcett Columbine, 1990. Manusmi;ti.
Coward, Harold G., et al. Hindu Ethics: Purity, Abortion. Miller, Barbara Stoler. Yoga: Discipline ofFreedom.
and Euthairasia. Albany: State University of New Berkeley: University of California Press, 1995.
York Press, 1989.
Milner, Murray, Jr. "Hindu Eschatology and the Indian
Crawford, S. Cromwell. Dilemmas ofLife and Death. Caste System: An Example of Structural Reversal:'
Albany: State University of New York Press, 1995. The Journal, of Asian Studies 52, no. 2 (May 1993):
298-319.
Desai, Prakash N. Heal,th and Medicine in the Hindu
~
Tradition. New York: Crossroad, 1989. Mutharayappa, R.; M. K. Choe; F. Arnold; and T. K. Roy. \.!}
Son Preference and Its Effect on Fertility in India.
Embree, Ainslie T., ed. Alberuni's India Transl.ated by Honolulu: East-West Center, 1997.
Edward C. Sachau. New York: W. W. Norton & Co.,
1971. Numrich, Paul David. The Buddhist Tradition: Religious
Beliefs and Heal,thcare Decisions. Chicago: Park
_ _ _, ed. The Hindu Tradition. New York: Random Ridge Center for the Study of Health, Faith, and
House, 1972. Ethics, 2001.
Gandhi, M. K. My Religion. Ahmedabad: Navajivan Olivelle, Patrick. The Asrama System: The History and
Publishing House, 1955. Hermeneutics ofa Religious Institution. New York:
Oxford University Press, 1993.
_ _ _.. Hindu Dharma. Ahmedabad: Navajivan
Publishing House, 1958. - - - · The Early U~. New York: Oxford
University Press, 1998.
Godman, David, ed. The Teachings of Sri Ramana
Maharshi. New York: Arkana, 1985. Pandya, Sunil K. "On Dying and Death: Lessons From the
Indian Tradition:' Di1ip 28, no. 1 (2002): 23-28.
Halbfass, Wilhelm. India and Europe: An Essay in
Understanding. Albany: State University of New York Radhakrishnan, S. The Hindu View ofLife. New Delhi:
Press, 1988. Indus, 1993.
Hassan, R. Ethnicity, Culture, and Fertility. Singapore: Sen, A. "Population and Gender Equity?' The Nation 271,
Chopmen, 1980. no. 4 (24-31July2000): 16-18.
Hill, W. Douglas P. The Bhagavculgi-ta. Second edition. Sharma, Arvind. Classical Hindu Thought: An
Madras: Oxford University Press, 1973. Introduction. Delhi: Oxford University Press, 2000.
(
16
THE HINDU TRADmoN: RELIGIOUS BELIEFS ANP HEALTHCARE DECISIONS
- - - · · "Hinduism and Qoning." Ecumenism 142 (June
2001): 27-29.
eligious beliefs provide meaning for people substitute for discussion of patients' own reli
R confronting illness and seeking health, par
ticularly during times of crisis. Increasingly,
gious views on clinical issues. Rather, they
should be used to supplement information com
healthcare workers face the challenge of provid ing directly from patients and families, and used
ing appropriate care and services to people of dif as a primary source only when such firsthand
ferent religious backgrounds. Unfortunately, information is not available.
many healthcare workers are unfamiliar with the We hope that these booklets will help practi
religious beliefs and moral positions of traditions tioners see that religious backgrounds and beliefs
other than their own. This booklet is one of a play a part in the way patients deal with pain, ill
series that aims to provide accessible and practi ness, and the decisions that arise in the course of
cal information about the values and beliefs of treatment. Greater understanding of religious tra
different religious traditions. It should assist ditions on the part of care providers, we believe,
nurses, physicians, chaplains, social workers, and will increase the quality of care received by the
administrators in their decision making and care patient.
giving. It can also serve as a reference for believ
ers who desire to learn more about their own tra
ditions.
Each booklet gives an introduction to the his
tory of the tradition, including its perspectives on
health and illness. Each also covers the tradi
tion's positions on a variety of clinical issues,
with attention to the points at which moral
()
dilemmas often arise in the clinical setting. Final
ly, each booklet offers information on special
concerns relevant to the particular tradition.
The editors have tried to be succinct, objec
tive, and informative. Wherever possible, we have
included the tradition's positions as reflected in
official statements by a governing or other formal
body, or by reference to positions formulated by
authorities within the tradition. Bear in mind
that within any religious tradition, there may be
more than one denomination or sect that holds
@
views in opposition to mainstream positions, or THE PARK RIDGE CENTER
fOR THt STUDY OF Hf.Al.TH. FAITH, AND ETHICS
groups that maintain different emphases.
aJ5\\estT~A\m.Je •Suite 203•Park Ridge, Illinois 60068-4202
The editors also recognize that the beliefs and
values of individuals within a tradition may vary
from the so-called official positions of their tradi The Park Ridge Center explores and
tion. In fact, some traditions leave moral deci enhances the interaction of health, faith,
and ethics through research, education, and
sions about clinical issues to individual
consultation to improve the lives of
conscience. We would therefore caution the read individuals and communities.
er against generalizing too readily.
The guidelines in these booklets should not © 2002 The Park Ridge Center. All rights reserved.