Preparation of Our Advance Care Directives


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Alex Kelly's picture

I posting a comment here because I was intrigued by Tricycle' s advert for this retreat which says:

"In our retreat teaching this week, "Do Not Waste Time," Soto Zen minister Caroline Yongue implores us not to squander the precious opportunity we have been handed to contemplate our own death. By becoming aware of death—and its inevitability—we begin to feel enormous gratitude for the opportunity of life, and are awakened to the joys within it."

While the sentiments may seem at first glance to be worthwhile on reflection it has very little to do with what the real Buddha actually taught about the contemplation and preparation for death. When I say real Buddha I am talking about the Buddha's teachings in the pali Suttas. I realise there are many Buddhist traditions in the world today and that have quite different and divergent teachings. This is all fine as folks are free to follow whatever religious ideas/practices they wish (though not in all societies of course). What is quite damaging I think to Buddhist practices is the modern contention that by contemplating death you can appreciate and enjoy life more. This is spiritual materialism dressed up as pseudo Buddhist philosophy and has no basis in what the Buddha actually taught contemplation of death for. It is simply spiritual consumerism.

The Buddha taught contemplation of death to instil a sense of urgency in the practitioner. This emotion is called samvaga in the pali. Most Buddhists probably know the life-story of Buddha which is pretty much the same across all traditions. Samvega is the emotion the Buddha felt on encountering aging, illness and death. It is a sense of oppressive shock and dismay at life's futility which leaves one feeling chastened. However there is another emotion which the Buddha felt on seeing a recluse, called pasada. This is an encouraging and uplifting sense that there is an escape from the round of birth and death.

The fact is the Buddha gave instructions to both renunciants and laity to contemplate aging, illness, death, loss and kamma on a daily basis. On the one hand it stills both samvega and pasada . Urgency and heedfulness concerning the precarious predicament of life but also confidence that there is way out by cultivating skilful action (kamma) in terms of the Noble Eightfold Path.

So the contemplation of death has absolutely nothing to do with enjoying life in the Buddha's teachings. If that had been the case he would been very unlikely to renounce the worldly life of a prince surrounded by luxury. It would have been a better option to do his utmost to enjoy life whilst bearing in mind that death could come at any time.

Samvega and pasada are very rarely taught in Western Buddhism at all which says a lot about the not so hidden agenda of mainstream Buddhism. The irony is that these are precisely the kind of teachings that are needed in a lot of Western culture and society so that instead of just reinforcing the same old materialistic-consumerism a more wholesome alternative is made available to those who would appreciate it.

maxinelizabeth's picture

Hello caroline, i was sent here by the tricycle facebook pagewith a question i have about fearing death.
You see, it isn't my own death i fear, i really don't care when i die.. Obviously a minimum amount of pain would be preferable but really its not a big fear. I am the mother of a two year old son with a life threatening heart condition. He's had it since 4 mts old. He will probably need a heart transplant. I am beyond terrified of losing him. I don't think i have what it takes to face that fear. Never mind facing the event but facing the fear of the event. Because it feels like if i do that I'm saying "its ok if he dies" and then that's like saying "i don't care if he dies" and neither of these statements are true. The truth is my world would end if anything happened to him and I've been at edge of that precipice and looked over it, when he was first diagnosed and i didn't know if he'd make it. You see from the outside he looks like there is nothing wrong, but there is this ticking time bomb going on inside and I'm filled with anxiety about it. Now mindfulness and meditation have helped me no end but i feel like reconciling this within myself would be a key piece of my development as a human. But i am terrified to think of what that process might involve. I hope I've been clear.

Caroline Yongue's picture

Dear Maxinelizabeth, I am sorry to read of the heart condition that threatens your child's life and of the difficulties you are facing with anxiety and fear. Seeking a way to reconcile this is a huge step to freeing yourself of these burdens. Thank you for your willingness to ask. Pema Chodron's book: THE PLACES THAT SCARE YOU could be an important manual for you right now as you seek relief from these mental and emotional states that grip you. As we allow our minds to tighten around fear/anxiety/terror, our external world is projected through that filter. We project a frightening world even if there is nothing in the moment to be frightened of. These mind states can become habitual, keeping us from the present moment. If we train ourselves in and use the Tonglen Practice, we lovingly breathe this fear (or anxiety or terror) into our heart with the in-breath and with the out-breath we send a softening, something that will ease - attempting to do this without judgement. Breathe in fear, breathe out ease, allowing the softening to happen. We may uncover sadness or grief which has a softer, more tender feel than fear. We can then breathe in sadness and grief into our heart space and breathe out ease, further releasing the grip of fear and anxiety. Whenever there is tightness of body, mind or emotion, we can use this technique to soften and bring us back to the present moment. If we become trapped by the non-meritorious habitual pattern, we lose out on the precious pure moment(s) that is free from any worry at all. After you have become comfortable with using Tonglen Practice for yourself, you might use it to ease the discomfort of others. Start with yourself. This won't take away the illness of your child. But, it may allow you to have more pure loving moments with him, free from fear and anxiety. You may learn to make the Tonglen Practice a new meritorious habit. As I do the Tonglen Practice for you, Maxinelizabeth, I breathe in fear and anxiety and send you a softening of ease and tenderness. Many blessings to you and your son. Caroline

Peter L. Albrecht's picture

I'd like to make one suggestion concerning "Five Wishes": have the document reviewed by an attorney practicing in the jurisdiction in which you live. While the instructions state that if you live in one of the specified jurisdictions (40 states plus the District of Columbia), Five Wishes"substantially meets" that jurisdiction's legal requirements, and will be "legal and valid", "substantial" compliance is not "compliance". If there were a dispute among family members - and sadly that is not all that unusual - "substantial" compliance with, for example, such requirements as notarization in a specific form, might not hold up, and the Five Wishes document might be ineffective to prevent, for example, "heroic means" to extend physical existence.
In addition to giving copies of Five Wishes to your health care agent and family members, give a copy to your attorney to keep with your will and other estate planning documents. (I've made an assumption that most people reading this will have a will and an attorney. Every person has an "estate plan" - if it is not spelled out in your will, it's the one prescribed by the statutes of the state you live in.)

Caroline Yongue's picture

Thank you, Peter, for these insights. It is important to review the different state documents to determine which best meets your needs. It is also important to speak with your loved ones, whoever will be carrying out your wishes to let them know how you want to be treated as you are dying and after death. If you speak with them now, you will (may) be able to answer their questions and lessen their fears. It is my experience that if loved ones understand your wishes, they are more likely to carry them out. The majority of people we work with do not have an "estate plan" and have not taken care of advance care directives. Many people cannot afford an attorney to assist in these preparations. At your recommendation, I just searched "North Carolina Estate Planning Laws". Thank you, it spells out the requirements for witnessing or notarizing these documents. To other folks out there who are reading this, at Peter's suggestion, check out the statutes for your state in regards to your "estate plan". Again, Peter, thank you. Caroline

shin's picture

another site that was mentioned I believe.

and a dear friend's site intimately related to this work:

RickHulett's picture

Could you post the web sites that you referenced? I'm getting deaf and it's kind of hard to make out the sites. Probably too much rock and roll. I have on the orders of months left to live and this class looks like exactly what I've been looking for. Is there a schedule for the next sessions yet? I would like to make it for all of them.

Caroline Yongue's picture

Dear Rick, I see that you have received the information on the websites I mentioned. I also wanted to list the books I spoke of:
The Tibetan Book of Living and Dying by Sogyal Rinpoche
Facing Death and Finding Hope by Christine Longaker
Good LIfe, Good Death by Rimpoche Nawang Gehlek
Dying With Confidence by Anyen Rinpoche
Being With Dying by Joan Halifax Roshi
If you have any questions, you may post them here or contact me through The blessings of love and ease I wish for you in these last months of your life. May you recognize and merge with your true nature and rest in emptiness. The merit for all my good acts I do freely offer to you so that you may realize truth. Caroline

RickHulett's picture

I'm sorry, I should have read through to the bottom. I see that you already have. Thanks.

Emma Varvaloucas's picture

Hi Rick,
The retreat runs all month, with new classes being posted on Mondays. So there will be a new session on 11/12, 11/19, and 11/26. Please note that if you are not a sustaining or supporting member you will not be able to watch the upcoming 3 weeks of the retreat. We hope to see you throughout the rest of the month!
Best wishes,
Emma Varvaloucas

shin's picture

Rick, if you scroll down the page you should find the links posted in a response to a similar request by me. shin.

zenja's picture

Thank you.

KellentS38's picture

Yes, wonderful and timely information for me, too. Thank you so very much, Caroline. I have started to prepare but have a serious question (for me) without an answer so far. My husband had donated his body to our local medical center and when he died, cared for by Hospice and me at home, his body was taken away a few hours after his last breath. When I consider my directives to my children, I am torn between giving my body for medical research/training and to a good cause (also for ease of the survivors who do not have to deal with funeral homes and all sorts of arrangements and costs) and my knowledge that the body should preferably not be disturbed for three days. Are the two ways mutually exclusive? I would so appreciate if you could throw a little light on this dilemma. With a bow, Sigrid

Caroline Yongue's picture

Dear Sigrid, I am sorry that your husband is no longer with you. This is a question(s) that does require a bit of thought and planning on your part. I commend you for thinking about this now, while you are able. Regarding disturbance to the body before the three days has ended: check with the institution where you wish to donate your body and see how quickly they must receive it after the last breath and how soon embalming must take place. Ask if they can refrigerate the body and delay embalming for three days. Some institutions will pay for transportation, cremation and death certificate. Some won't. There are at times age and health restrictions. This varies from institution to institution. In Tennessee, the Genesis Medical Education and Research Insititute, does not require embalming - they will freeze the body to be used for orthopedic teaching. They pay for transportation, death certificates, cremation and the cost of returning the cremains. Body Farms are an option where, I believe, embalming is not required. All of this said and perhaps too much information, if your body is to leave the home before the three day period and be disturbed by embalming, ask a member of your family or a dharma friend to remind you of your desire to donate your body and to stay present to the sound of their voice, guiding you back to your spiritual practice. Next week I will speak more on this when I talk about Organ Donation. As for the topic of Autopsy that I mentioned this week, the same would be true for organ, tissue, or whole body donation: write out a script, provide music, readings, chants, etc. that your loved ones can offer to you during this three day period to support your spiritual transition. There is great merit in offering your body to benefit another sentient being. There is also great merit in allowing your loved ones the opportunity to be with your body for this three day period. They will see the transient, impermanent nature of the body. They will see that "Sigrid" is no longer in the body left behind. If you are concerned about your loved ones having to plan and pay for the disposition of your body, you can plan all of that now and leave them instructions about how to carry out your wishes. In the upcoming classes, I will also be speaking about shopping around when making funeral arrangements.

KellentS38's picture

Thank you with all my heart for your caring, detailed, and so helpful answer (also in your second talk), Caroline. I am so sorry to be so late responding, but this was my first chance to be back online and catch up on talks 2 and 3 and the comments/replies. Very appreciatively, Sigrid

PS: Just ordered Nancy Spence's adaptation for reading to the dead. Just what I had always wished would exist and had not yet found. Will you do another retreat with her as you did earlier this year?

Caroline Yongue's picture

Segrid, Nancy and I just offered "How A Buddhist Prepares for Death" retreat in California. At present, we do not have another retreat with this topic scheduled. If you would send me an email at and let me know that you are interested in a this retreat, I will add your name to our mailing list and let you know when one is scheduled. Caroline

shin's picture

could you provide the link to the site mentioned in the video. I would like to link through the Canadian Death Midwifery site.

with metta & gratitude


Caroline Yongue's picture

Shin, To get to our website: Here you can download the pdf: Declaration Regarding Disposition of Physical Body, After Death. The site U.S. Funeral Consumer Rights by State is: But, that won't help you in Canada. I hope this answers your question. I will be checking out the Canadian Site. Blessings to you in your work. Caroline

shin's picture

posted the link on a deathmidwifery facebook site and other members then shared another inspiring link above of your tedx talk. blessings

cachidlaw's picture

Perfect. Thank you! You have captured my wishes and my thoughts so clearly and succinctly, and given me a blueprint to help me prepare the truly ridiculous amount of paperwork required just to be able to die in this culture! I have had many discussions with my husband regarding my wishes, as we live in the Deep South where elaborate funerals, immediate embalming, viewing of the body by all, are a way of life. But now I feel more equipped to request that my needs/desires be carried out despite their unpopularity in this particular culture. This is IMPORTANT information, timely presented, kindly and compassionately discussed.

patkerr's picture

Thank you for this. Just what is needed right now.