ABSTRACT
This chapter describes ethical issues in the clinical course of a Burmese monk, Venerable U Sacca Vamsa, who suffered a stroke while he was living in the United States. Primary issues in the case concerned who should make decisions and whether to withdraw care. The case posed difficult ethical issues due to both uncertainty about his wishes and a lack of understanding of his cultural and religious background by healthcare providers. Different understandings of the situation by medical professionals, Western lay Buddhists, and Asian Buddhists led to ethical conflict about both his care and the disposal of his remains. This case identifies the need for monks in the United States to have durable powers of attorney that name healthcare decision-makers, and to communicate their wishes with lay people in advance. While there is an existing body of literature on Buddhism and bioethics, it should include discussion of how Buddhism will contribute to healthcare ethics at a clinical level in America.
