RECENTLY, problems that used to be considered the province of religion, such as educating the terminally ill and whether organ transplants should be performed, are now being taken up in the world of medicine.

This is especially pointed out by the fact that the medical profession, which until now was concerned solely with saving people from dying, now seriously considers the care of terminally-ill patients and how such patients can be gently brought to face their impending death.

Not wanting to grow old and die is probably the greatest desire of humankind since the realization that death is a condition of life. The fact that life is transient, that it consists of being born, growing old, becoming ill and finally dying as taught in Buddha-dharma in general, is apt to be forgotten because of the great strides made by medical technology going into the 21st century. Because of the limitations that have recently been realized, however, the fact that death cannot be escaped is recognized even in the world of medicine, and interest in religion and how it can help, has heightened.

The problem of the value and place of religion in our lives has been discussed very well from the side of religion, but I believe it is significant that such matters are now being taken up from the side of science (medical technology). I believe this is not only a splendid opportunity to explain the meaning and value of religion to society in general, but is also the proper time to speak about such matters.

I firmly believe that the Venerable Master’s teaching of “absolute ‘Buddha-centered power’” (zettai tariki) which overturns the traditional Pure Land teaching that laid so much stress on “Amida Buddha welcoming those on the verge of death to the Pure Land” (rinju raigo), and which opens the door for the salvation of all sentient beings by teaching that salvation takes place while “continuing to live in this world” (heizei gojo), is what will best respond to the religious quest of modern man.

As related in Part Two, the Venerable Master’s unique insight was emphasizing that we are included in the “rightly-established group (of those assured of birth in the Pure Land)” at the moment we receive shinjin, and that “salvation” begins in the present. I have already described this world so I will not go into details here. It results, however, in the great relief and reassurance of knowing that we will be born in the Pure Land without fail.

This is the world of, “All right if I live, and all right if I die.” It is the world of: I am a most fortunate person who lives within the “great salvation” of the Buddha while in this world, and regardless of when I die, will remain within that great salvific activity.

I believe it is this great realm of “All right if I live, and all right if I die,” in which we find ourselves as a result of the shinjin given to us by “Buddha-centered power,” that replies to the great expectation that the medical world has of the religious world.

The biggest problem that the medical world has about terminal care is the patient’s fear of dying—how to relieve the patient from anxiety about dying. I have already mentioned the story about Emperor Shih who founded the Ch’in dynasty, the most powerful person of his time. Because of his fear and anxiety about dying, he ordered his retainers to go as far as Japan in search of the elixir of life.

A nobleman during the Heian Period, Fujiwara Michinaga (966 - 1027 AD), who probably was then the most powerful man in Japan, boasted of his secular authority with the following words:

Like a full moon
That never wanes,
(My authority
Is unchallenged.)

In Eiga Monogatari (Tales of Prosperity), however, this same Michinaga is described on his death-bed as follows:

(Michinaga) wanted only to recite the Nembutsu in his death bed. He did not want to look at anything other than the Buddha, nor listen to anything other than the Buddha’s voice. He did not consider anything other than what would happen after his death. He wanted to see only Amida Buddha’s figure, hear only the Buddha’s words, and direct his thoughts to the Pure Land of Ultimate Joy. Holding the strings (from a portrait of Amida Buddha) in his hands, he lay with his head directed towards the north and his face towards the west...”

In order to escape his fear and anxiety regarding death, Michinaga desperately tried to turn his thoughts towards Amida Buddha. There is no difference today and yesterday among even those with power and riches, to seek relief from the fear and anxiety of death. Regardless of how much medical science and technology advances, that is an impossible request. In his book Waga Shoji-kan (My View of Life and Death), the religious scholar Hideo Kishimoto who, when confronted with death as a result of cancer, wrote:

The times when we become crazed with real desire to continue living come when we are sent into battle, become terminally ill, or at other times of real crisis. But that is limited to the short period while we are so confronted.

If we have the slightest chance of overriding that danger, however, and place all our hopes on that chance, that crazed desire will not arise.

In order for the true crazed desire to continue living to arise, there must be absolutely no chance that life will continue, as when there is no possibility that your execution will be stayed, the day you must leave on your kami-kaze flight has arrived, or your doctor informs you that your cancer has progressed too far for medical help.

When death appears before our very eyes and we are brought to the depths of despair—that is when we are suddenly and unexpectedly brought to a position of being crazed with the desire to continue living. And that is when attachment to life appears and true fear of death that cannot be described in words, arises.

I believe this sort of “crazed desire” to continue living that comes to everyone who becomes aware that his or her death is near, can only be resolved by the salvation of religion, in other words, the relief that comes from shinjin.

A woman who followed the Jodo-Shinshu teachings, who while aware that she was near death as a result of her illness, left the following words:

In our human world, there is are many above us when we look up, and many below us when we look down. Although half paralyzed, I have my right arm and I have my right leg. I have a tumor in my brain but I can see colors, hear sounds and sense differences in taste. I am fast getting to where even these will fade away, but I still have the Buddha, I have the Pure Land and I have the Great Compassion. How fortunate I am!

This truly is the “realm of salvation in the present” that is taught in Jodo-Shinshu. It is the world of “All right if I live, and all right if I die.”

I believe the words quoted above demonstrates how the Venerable Master’s teaching of Jodo- Shinshu best responds to the present world of medicine’s request of the world of religion, and shows Jodo-Shinshu’s true worth.