Conventional attitudes on human life and death, of which we were so sure based on our own experience and observation, have been totally upended by the issues of brain death and organ transplantation, forcing us to rethink the meaning of these fundamental concepts. The question of whether or not to recognize brain death as constituting the death of the individual involves more than a mere change of the medical criteria for recognizing death—it challenges us to answer what it means to be alive and what it means to be dead. The question of whether or not to proceed with organ transplantation is not simply a matter of surgical equipment and technique—it challenges us to answer what it means to receive a human body and what it means for me as an individual to live. The issues of brain death and organ transplantation are not limited to the question of death or survival, but involve our entire sense of values.
         The progress of modern science and technology is the result of sustained efforts to realize the humanistic goal of increasing human happiness and the quality of human life. However, what humanity has obtained through that effort has not always been happiness. It has become quite clear to everyone today that science and technology has both bright and dark sides. The knowledge and technology that we have gained has brought us to the distressful point where we are faced with having to determine for ourselves the meaning of our existence. Foolish though this may seem, this challenge may be seen as humanity’s task, charging us to transcend the level of karmic consciousness and strive toward the realm of truth. However, this invites the immediate retort, “What does it mean to ‘strive toward the realm of truth’? Are you saying that we should forgo saving the lives of people whose lives could potentially be saved? Should we abandon the technological advances that make it possible now to save those who in the past could not be saved?” The issues of brain death and organ transplantation that now face us are the most striking expressions of science and technology, which stand at the forefront of humanity’s historical development. They penetrate to the heart of the question of existence, and thus lie solidly within the province of religion.
         That which has form eventually perishes; that which has life eventually dies. The human body, as a living organism, ultimately reaches the point where it’s death as an organism can be medically determined, and this determination is entrusted by society to those in the medical field who are professionally qualified to do so. However, it is not for doctors alone to define what constitutes life and what constitutes death. Human beings are not simply expressions of nature that emerge like shoots from the ground, but are the product of the world formed through the action of human thought and creativity. The existence of an individual is not only the existence of that individual alone but also the existence of everyone in his or her world. All living things eventually die, but humans don’t simply return to the earth—they return to the greater world that their thoughts and the thoughts of the people around them have together created. Thus the issues of brain death and organ transplantation, insofar as they are issues relating to the existence of particular human beings, are necessarily issues that are deeply influenced by the nature of human reality as something formed through the thoughts of individual humans and (at the very least) their family and relatives. For this reason, only when those individuals and their families recognize brain death as biological death, and only when they agree to organ donation, does brain death truly become death and organ removal become possible. This, of course, presupposes that objective mechanisms are in place to guarantee that these decisions are truly those of the individuals and families involved, and that the medical facilities involved have the requisite skills and facilities to properly carry out the wishes of those of the individuals and families. Legal structures must also be in place to insure that these mechanisms are, in fact, in place.
         Nevertheless, with regard to those individuals whose personal worldview does not recognize the concept of brain death, that worldview must be faithfully and unfailingly honored. As is clear from the report of the Special Commission on Brain Death, opinions are divided regarding whether or not brain death constitutes biological death. As noted above, laws relating to brain death must be enacted, but such laws must include provisions to protect the rights of those who do not recognize brain death as constituting the death of the individual.
         A legal standard that allows for both points of view—that brain death does constitute biological death and that brain death does not constitute biological death—is a standard that honors the importance of the individual’s personal worldview. At first glance it may seem the height of irresponsibility to set a standard that makes no definitive judgment one way or the other. However, the matter is one that defies clear-cut criteria. From the point of view of those who see the recognition of brain death as opening the way to expressing respect for human dignity, failure to recognize this form of death can result in wasting the precious opportunity that a person’s death provides. From the point of view of those who see rejection of the concept of brain death as rooted in true compassion for their fellow humans, acceptance of this concept suggests the malicious influence of mechanistic Western values. Can questions of human life and death ever be settled in a simple, black-or-white manner? And would settling such questions in this manner be the Way of the Buddha?
         Each person lives and dies in the context of his or her own thoughts. If in that world there is a place where each person’s thoughts of can be accepted and the voices of those who are suffering can be heard, that place is surely the realm of the Buddha. If there is a standpoint in which people can develop through those very thoughts and sufferings, that standpoint is surely Buddhism. If there is a person who can experience the opening of a transcendent and inclusive world though the recognition of those very thoughts and sufferings, that person is surely a monk. Only when this place, this standpoint, and this person exist can one’s world be fully realized. To approve of one position as correct and simultaneously approve of the opposite position as correct may seem a do-nothing way to respond to a situation, but realizing the standpoint from which one can see both positions as equally correct is actually the most difficult of all things. To do so is the vocation of the monk.
         A monk is both an individual and a member of society. Monks also are creations of their own thoughts, and monks also as members of society must make decisions of right versus wrong. From that point of view it is possible to decide that the concept of brain death is right, or that it is wrong. One must keep in mind, however, that one’s position, be it for or against, expresses only one aspect of the overall situation, and that only when one realizes that where there is white there is black and where there is “pro” there is “con” is the Buddha Way complete. When this is forgotten the monk becomes an agitator and Buddhism no more than an ideology. In this sense, too, the issues of brain death and organ transplant test the essence of the monk.