Paper 06

Contemporary debates on euthanasia and end-of-life care often focus on patient autonomy and the relief of physical suffering. In contrast, Theravāda Buddhism evaluates a “good death” primarily in terms of the quality of consciousness and volition (cetanā) associated with the dying process.

This study aims to examine the concept of a good death from an Abhidhamma perspective and explores its ethical implications for contemporary debates on euthanasia and end-of-life care. Employing qualitative doctrinal and textual analysis of the Pāḷi Canon, Abhidhamma texts, commentarial literature, and relevant contemporary scholarship, the study focuses particularly on the near-death cognitive process (maraṇāsanna-vīthi), volition (cetanā), and death consciousness (cuti-citta). The findings indicate that an Abhidhamma conception of a good death is not determined primarily by external biological circumstances but by a wholesome and steady state of mind supported by ethical conduct, mindfulness, and mental cultivation. From this perspective, active euthanasia remains ethically problematic because it intentionally causes death, even when motivated by compassion. By contrast, withholding or withdrawing futile treatment may be ethically distinguishable from intentionally causing death when the intention is to allow the underlying illness to take its natural course. Palliative care is likewise compatible with Buddhist compassion when its primary purpose is the relief of suffering rather than the intentional termination of life. The findings of this research may also inform healthcare professionals about Buddhist values and beliefs to provide culturally relevant end-of-life care for Buddhist families.