Critical Importance of the Moment of Death

69) Seeking Guidance from Spiritual Advisors

The Pure Land practitioner should take medicine when he falls ill and his condition is not desperate, but he must persevere in reciting the Buddha's name. When his condition is hopeless, he may refuse further medication. A well-known Elder Master, gravely ill, responded with the following gatha, when his disciples sought his approval to send for a physician:

The Honored Amitabha Buddha 
Is the foremost king of physicians. 
If we forget this and fail to heed Him, 
We are indeed deluded! 
One utterance of the Buddha's name 
Is the wonderful panacea, 
If we forget this and fail to take it, 
We are truly and greatly mistaken!

We must remember that when death is impending, the practitioner should let go of everything around him, including his own body and mind, and concentrate singlemindedly on reciting the Buddha's name, earnestly seeking rebirth in the Pure Land. By so doing, if his life span has come to an end, he will surely achieve rebirth there. On the other hand, if his life span is not yet over, even though he seeks rebirth, his condition will improve, thanks to his sincere and steadfast mind (as part of his bad karma will have been dissipated in the process). Acting otherwise, he will forfeit rebirth in the Pure Land if his lifespan has come to an end (as he was only seeking recovery, not rebirth). If his lifespan is not yet over, he will aggravate his illness through worry and fear.

When they fall gravely ill, some Pure Land practitioners are not encouraged to practice Buddha Recitation, as their family members lack understanding of Buddhism. On the other hand, their kin spare no time or effort seeking out all kinds of charlatans and quacks. Some families even go to such lengths as making offerings to various deities in the hope of obtaining a quick cure. Thus, the patient not only does not receive the benefit of "supportive recitation," his mind is divided and disturbed. He cannot, therefore, be reborn in the Pure Land. The entire process is sometimes motivated by a sense of filial obligation or the desire for a good name, aimed at neighbors and friends. Little do they know that the Buddhas and sages are not deceived, and that a filial, sincere mind does not depend on external factors! Such behavior only makes the wise smile in pity.

When the patient is gravely ill but still conscious, his close family members should invite good spiritual advisors to preach the Dharma and enlighten him. If no monk or nun can be found, a knowledgeable lay person should be invited over to comfort the patient and preach the Dharma to him. The spiritual advisor should remind and enjoin the patient's relatives to be compassionate and ensure that everything is conducted according to the Way, so that the patient may enjoy the benefit of rebirth in the Pure Land.

In general, the spiritual advisor should follow the guidelines set out below.

Remind the patient of the sufferings of the Saha World and the joys of the Pure Land, so that he may develop a mind of devotion and attraction to the Pure Land. The good advisor should also enumerate and praise the patient's good deeds, merits and virtues in cultivation. This will make him happy and free of doubts, certain that when the time comes to die, he will, thanks to his good deeds, be reborn in the Pure Land.

If the patient has any doubts, the advisor should, depending on the circumstances, explain the Three Points of Doubt and the Four Narrow Passes discussed earlier. A critical detail to bear in mind here: the dying person should be reminded to eliminate all regret over wealth and property, as well as attachment to close family and relatives.

If the patient has a will, so much the better, but if not, the advisor should counsel against all inquiries in this regard. He should also advise everyone to refrain from useless chitchat that could rekindle the patient's love-attachment to the world, which is detrimental to rebirth in the Pure Land.

When relatives and friends come to visit, they should be discouraged from standing before the patient, inquiring about his health in a sad, piteous way. If they come out of true concern, they should merely stand on the side, reciting the Buddha's name aloud for a moment. If, lacking understanding of the Dharma, the visitors act conventionally [crying, etc.], they are in effect pushing the dying person into the ocean of suffering -- a most regrettable occurrence indeed!


The patient should be counselled to practice charity and give away his personal effects to the needy. Or, better still, in accordance with the Ksitigarbha (Earth Store Bodhisattva) Sutra, he should use the proceeds from the sale of his personal possessions to purchase Buddhist images or sutras for free distribution.[82] All this helps the patient increase his stock of merits and eliminate bad karma, thus facilitating rebirth in the Pure Land.

The good advisor should keep these general guidelines in mind, but be ready to improvise according to the situation.

70) Conducting "Supportive Recitation"

Family members and relatives of a dying patient should remain calm, without weeping or lamenting, from the time he becomes gravely ill until his last moments. Some people, while not crying, still show sorrow and emotion on their faces. This, too, should be avoided, because, at this juncture, the dying person has reached the crossroads which separate the living from the dead, and the mundane from the transcendental. The critical importance and danger of this moment can be compared to standing under a sword -- his fate is determined by a hair's breadth![83]

At this time, the most important thing is to practice supportive recitation. Even though a person may have set his mind on rebirth in the Pure Land, if family members weep and lament, thus arousing deep-seated feelings of love-attachment, he will certainly sink into the cycle of Birth and Death, wasting all his efforts in cultivation!

When a patient on the verge of death wishes to bathe, dress in different garments, or change his position or sleeping quarters, we may comply, while exercising caution and acting in a gentle, careful manner at all times. If the patient refuses, or cannot give his consent because he has become mute, we certainly should not go against his wishes. This is because the patient on the verge of death is generally in great physical pain. If he is forced to move, bathe or change clothing, he may experience even greater pain. There are numerous cases of cultivators who had sought rebirth in the Pure Land but failed to achieve this goal because their relatives moved them around, disturbing them and destroying their right thought. This unfortunate development occurs very often.

There are also cases of individuals who might have achieved rebirth in the higher realms. However, out of ignorance, others made them suffer physically (by rearranging the positions of their hands and feet, for instance), making them irritated and angry. Because of this one thought of anger, they immediately sank into the evil realms. As an extreme example, King Ajatasatru[84] had earned numerous merits and blessings through cultivation. However, at the time of death, one of his attendants dozed off and inadvertently dropped a paper fan onto the king's face. He became so furious that he expired on the spot -- to be reborn, it is said, as a python! This example should serve as a warning to us all.

At the time of death, the cultivator himself should either lie down or sit up, according to what comes naturally, without forcing himself. If he feels weak and can only lie down, forcing himself to sit up, for appearances' sake, is dangerous and should be discouraged. Likewise, even though, according to Pure Land tradition, he should lie on his right side facing west, if, because of pain, he can only lie on his back or on his left side facing east, he should act naturally and not force himself. The patient and his family should understand all this and act accordingly.

Supportive recitation by family members or Dharma friends is most necessary when a patient is on the verge of death. This is because, at that time, he is weak in body and mind and no longer master of himself. In such trying circumstances, not only is it difficult for those who have not cultivated in daily life to focus on Amitabha Buddha, even individuals who have regularly recited the Buddha's name may find it difficult to do so in all earnestness -- unless there is supportive recitation.[85]

Such recitation should closely follow the guidelines set out below.

Respectfully place a standing Amitabha Buddha statue in front of the patient, so that he can see it clearly. Place some fresh flowers in a vase and burn light incense with a soft fragrance. This will help the patient develop right thought. A reminder: the incense should not be overpowering, to avoid choking the patient and everyone around.

Those who come to practice supportive recitation should take turns ... It should be remembered that the patient, in his weakened state, requires a lot of fresh air to breathe. If too many persons come and go or participate in the recitation session, the patient may have difficulty breathing and become agitated, resulting in more harm than benefit. Therefore, participants should consult their watches and silently take turns reciting, so that recitation can continue uninterrupted. They should not call to one another aloud. Each session should last about an hour.

According to Elder Master Yin Kuang, the short recitation form (Amitabha Buddha) should be used, so that the patient can easily register the name in his Alaya consciousness, at a time when both his mind and body are very weak. However, according to another Elder Master, we should ask the patient and use the form he prefers (short or long), to conform to his everyday practice. In this way, the patient can silently recite along with the supportive recitation party. To go counter to his likes and habits may destroy his right thought and create an offense on our part. Furthermore, we should not practice supportive recitation in too loud a voice, as we will expend too much energy and be unable to keep on for very long. On the other hand, neither should we recite in too low a voice, lest the patient, in his weakened state, be unable to register the words.

Generally speaking, recitation should not be too loud or too low, too slow or too fast. Each utterance should be clear and distinct so that it can pass through the ear and penetrate deep into the patient's Alaya consciousness. One caveat: if the patient is too weak [or is in a coma], he will not be able to hear "external" recitation. In such a case, we should recite into the patient's ear.[86] This helps the patient keep his mind clear and steady.

With regard to percussion instruments, it is generally better to use the small hand bell, instead of the wooden fish gong with its bass tone. The hand bell, with its clear, limpid sound, can help the patient develop a pure and calm mind. However, this may not apply in all cases. For instance, an Elder Master once taught, "It is best to recite the Buddha's name by itself without musical accompaniment, but since each person's preferences are different, it is better to ask the patient in advance. If some details do not suit him, we should adapt to the circumstances and not be inflexible."

The above are some pointers to keep in mind with regard to supportive recitation.