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Cultural Approaches to Pediatric Palliative Care in Central Massachusetts: Buddhism

This subject guide is a collaborative project with the Children's Medical Center Pediatric Palliative Care Team, the Lamar Soutter Library, and Interpreter Services.



          *There are 3 major Buddhist traditions:  Theravada, Mahayana, and Tibetan


  • The main goal is to reach spiritual enlightenment through meditation and conscious living
  • Personal insight replaces belief in God with complete study of the laws of cause and effect (Karma)

Daily practices

  • May include meditation or chanting according to the form of Buddhism the Buddhist follows

Dying and death

  • All rituals at death are aimed at promoting human rebirth in the next life, as well as preventing lower forms of rebirth taking place
  • May wish prayers/chanting to take place
  • Person’s state of mind at moment of death believed to influence rebirth, so they will want to be calm and peaceful
  • Person may not want medication while dying if it affects  clarity of mind
  • Imperative that a Buddhist representative be notified well in advance to see that appropriate person presides over the car of a dying person
  • Unexpected death or death of small child may necessitate special rituals
  • Traditionally, there is a 3-5 day period when the body is not disturbed following death

Facilitating practices

  • Allow for quiet time to observe practices
  • Ensure calm and peaceful environment and comfort, especially for dying person


  • May be vegetarian, may avoid stimulants (coffee, alcohol, tobacco)


  • Illness is a result of karma (law of cause and effect), therefore an inevitable consequence of actions in this or a previous life
  • Health is holistic (connect between mind and body); mental cures are important
  • Healing and recovery promoted by awakening to wisdom of  Buddha, which is spiritual peace and freedom from anxiety
  • Do not believe in healing through faith
  • No restrictions on blood or blood products, surgical procedures, organ donation, autopsy
  • Medications acceptable if in great discomfort as long as they do not affect state of mind

Holy days and festivals

  • While some celebrations are common to all Buddhists, many are unique to particular schools

Pregnancy and birth

  • Artificial insemination, sterility testing and birth control acceptable
  • Buddhists do not condone taking a life; circumstances of patient determine whether abortion acceptable


Rituals or ceremonies

  • There is a monthly atonement ceremony on the full moon. The major rituals are around baby blessings, lay and monk ordination, marriage and death.

Spiritual instruments, social structure, and symbols

  • Incense burning, flower and fruit offerings, altars/images/statues of Buddha and ancestors, prayer beads, chant boxes
  • Ordained spiritual community involves full ordination for women and men
  • No institutionally organized hierarchical structure
  • Buddha images, lotus, swastika-looking symbol (which represents peace)

 Reproduced by permission from George Handzo, BCC at 

 Dictionary of Patients' Spiritual & Cultural Values for Health Care Professionals was developed by the Pastoral Care Leadership and Practice Group of HealthCare Chaplaincy, New York, NY. (Revision and update of earlier work by the Rev. Susan Wintz, BCC and the Rev. Earl Cooper, BCC)