# 安宁疗护与临终关怀的时代意义
# The Contemporary Significance of Palliative Care and End-of-Life Care

*济群导师 2025年7月为生命关怀项目开示*
*A teaching by Master Jiqun for the Life Care Project, July 2025*

- *安宁疗护与临终关怀的时代意义*

- *一、安宁疗护与临终关怀*
  - 1．安宁疗护
  - 2．安宁疗护和临终关怀的不同

- *二、中国古人对死亡的态度*
  - 1．接纳死亡
  - 2．善终为福
  - 3．慎终追远

- *三、现代人为什么要生命关怀*
  - 1．对死亡缺乏认识
  - 2．过分重视身体的治愈

- *四、树立正确的生死观和治疗观*
  - 1．认识生与死的关系
  - 2．建立正确的治疗观

- *五、死亡、投生是怎么回事*
  - 1．四个过程
  - 2．三种力量
  - 3．信、愿、行
  - 4．心的空白处

- *六、临终关怀*

- *七、结说*

- *The Contemporary Significance of Palliative Care and End-of-Life Care*

- *I. Palliative Care and End-of-Life Care*
  - 1. Palliative Care
  - 2. Differences Between Palliative Care and End-of-Life Care

- *II. Traditional Chinese Attitudes Toward Death*
  - 1. Accepting Death
  - 2. A Good Death as a Blessing
  - 3. Careful Funeral Rites and Remembrance of Ancestors

- *III. Why Modern People Need Life Care*
  - 1. Lack of Understanding About Death
  - 2. Overemphasis on Physical Cure

- *IV. Establishing a Correct View of Life, Death, and Treatment*
  - 1. Understanding the Relationship Between Life and Death
  - 2. Establishing a Correct Approach to Treatment

- *V. What Happens at Death and Rebirth*
  - 1. The Four Stages
  - 2. The Three Forces
  - 3. Faith, Vow, and Practice
  - 4. The Open Space of Mind

- *VI. End-of-Life Care*

- *VII. Conclusion*

生命关怀是慈善的重要项目。我们倡导禅意生活，不仅要让生活过得更美好，更有品质和内涵，还要有能力面对衰老、疾病、死亡，这是每个人必须面对的重要课题。
Life care is an important charitable undertaking. We advocate mindful living — not only to make life more beautiful, more meaningful, and richer in quality, but also to cultivate the capacity to face aging, illness, and death. These are essential subjects that everyone must confront.

# 一、安宁疗护与临终关怀
# I. Palliative Care and End-of-Life Care

本次活动主要围绕两个方面，一是安宁疗护，一是临终关怀。后者属于佛教的传统内容，已有不少寺院在做，大家应该不陌生。相比之下，安宁疗护属于新生事物，我们过去的慈善项目有所涉猎，但不深入。
This event focuses on two main areas: palliative care and end-of-life care. The latter belongs to Buddhism's traditional repertoire — many monasteries are already engaged in it, so it should not be unfamiliar. Palliative care, by contrast, is relatively new; our past charitable programs have touched on it but not in depth.

## 1．安宁疗护
## 1. Palliative Care

安宁疗护起源于英国，创始人为西塞莉·桑德斯博士。她曾是一位护士，在照顾癌症患者的过程中发现很多问题，深感传统医疗对末期病人缺乏关怀。基于此，她竭尽所能地为患者减轻痛苦，并在1967年创办了全球第一所安宁疗护医院。
Palliative care originated in Britain. Its founder was Dr. Cicely Saunders. She began as a nurse and, while caring for cancer patients, discovered many problems. She felt deeply that conventional medicine lacked care for those at the end of life. Driven by this insight, she did everything in her power to relieve patients' suffering, and in 1967 she founded the world's first hospice dedicated to palliative care.

近几十年来，随着人口老龄化的加剧，中国癌症患者日益增加。据有关统计，现有癌症存量患者约3000万，而每年因癌症死亡的人数约300万，数量庞大。一旦发现病症，医院和家属往往以治愈为唯一目的。但对某些晚期或无法治愈的病患，医学并不是万能的。一味期待治愈，往往会导致过度医疗。甚至在生命垂危且无治疗价值时，依然拼命抢救，全身插满管子，只为延续几天甚至几小时的存活时间。结果使患者饱受痛苦，在绝望、无助、迷茫中走向死亡。
In recent decades, as the population has aged, the number of cancer patients in China has steadily risen. According to relevant statistics, there are currently about 30 million existing cancer patients, and roughly 3 million people die of cancer each year — an enormous number. Once an illness is detected, hospitals and family members tend to make cure the sole objective. But for certain late-stage or incurable conditions, medicine is not all-powerful. An obsessive pursuit of cure often leads to overtreatment. Even when life hangs by a thread and treatment has ceased to have any value, people still frantically attempt to save the patient — tubes inserted everywhere — just to prolong survival by a few days or even hours. The result is that patients endure terrible suffering, approaching death in despair, helplessness, and confusion.

安宁疗护倡导的，是对病患进行全面关爱，让他们更多尊严、更少痛苦地走完最后一程。这并不是放弃治疗，而是放弃对治愈或延长生命无效的治疗，以缓解身心痛苦、提高生活质量为重点，包括对患者的身体照护、精神抚慰、心灵引导、宗教关怀。如果患者在弥留之际，活着只是增加痛苦，自己并不想接受无谓的抢救时，家人应该接纳并尊重患者本人的决定。
What palliative care advocates is comprehensive care for patients, enabling them to complete the final stretch of life with more dignity and less suffering. This is not giving up on treatment; it is giving up on treatments that are ineffective at curing or prolonging life. The focus shifts to relieving physical and mental pain and improving quality of life. This includes physical care, emotional comfort, spiritual guidance, and religious care. If, at the end of life, merely staying alive only adds suffering, and the patient does not wish to undergo futile emergency interventions, family members should accept and respect the patient's own decision.

疼痛是很多临终者面临的最大困境，由身体、心理、社会关系、精神共同构成，桑德斯博士称之为"整体性疼痛”。其中有疾病造成的身体痛苦，还有因不接纳造成的心理痛苦，因将要失去各种社会关系导致的精神痛苦，以及对未来归宿一无所知的终极痛苦。针对这些问题，安宁疗护要从不同角度，构建全方位的关怀。这就需要多学科、多专业组成的团队，包括医生、护士、心理治疗师、宗教师、志愿者等。
Pain is the greatest difficulty faced by many who are dying. It is constituted by physical, psychological, social, and spiritual dimensions — what Dr. Saunders called "total pain." There is the physical pain caused by disease, the psychological pain of not accepting one's condition, the spiritual pain of facing the loss of all social connections, and the ultimate pain of knowing nothing about one's future destination. To address these issues, palliative care must construct multi-faceted care from different angles. This requires a multidisciplinary, multi-professional team, including physicians, nurses, psychotherapists, chaplains, and volunteers.

安宁疗护充分体现了对人的尊重和关爱，自提出以来，很快被联合国推广到全世界。1988年，天津医学院开设了中国第一间安宁病房；2017年，国家卫健委正式发布《安宁疗护实践指南（试行）》，并启动全国试点。如今，安宁疗护服务已覆盖全国185个地区，但相对庞大的人口基数，依然是杯水车薪。面对社会大众的需求，一些慈善组织、民间团体也积极参与其中。在此，深深随喜大家的发心和利他精神。
Palliative care fully embodies respect and care for human beings. Since its inception, it was quickly promoted by the United Nations worldwide. In 1988, Tianjin Medical College established China's first palliative care ward. In 2017, the National Health Commission officially issued the *Palliative Care Practice Guidelines (Trial)* and launched national pilot programs. Today, palliative care services cover 185 regions across China, but given the enormous population base, this is still a drop in the bucket. Faced with the needs of society at large, some charitable organizations and civil groups have also become actively involved. Here, I deeply rejoice in everyone's aspiration and altruistic spirit.

## 2．安宁疗护和临终关怀的不同
## 2. Differences Between Palliative Care and End-of-Life Care

东西方宗教中，都有临终关怀的内容。如基督教的诵读《圣经》与赞美诗，天主教的临终圣事等。佛典也有相关记载，在我的"《四分律删繁补阙行事钞》选读”系列讲座中，就有《瞻病送终篇》，汇集了戒律中关于照护病人和为人送终的各项事宜，具体且详细。可见，这些做法在佛教已有两千多年历史。相对来说，安宁疗护尚属起步阶段。它和临终关怀有相通之处，也有不同侧重。
All major Eastern and Western religions include elements of end-of-life care — for example, the reading of the Bible and hymns in Christianity, and the last sacraments in Catholicism. Buddhist scriptures also contain relevant records. In my lecture series "Selected Readings from the *Dharmaguptaka Vinaya*," there is the *Chapter on Caring for the Sick and Seeing Off the Dying*, which compiles the various matters prescribed in the monastic precepts for nursing the ill and accompanying the deceased — concrete and detailed. Clearly, these practices have a history of over two thousand years in Buddhism. Palliative care, by comparison, is still in its early stages. It shares common ground with end-of-life care, but each has a different emphasis.

从时间跨度来说，临终关怀主要集中在生命即将到达终点的最后时段，而安宁疗护介入更早，可以发生在患病的任何时期。世界卫生组织在1990年重新定义安宁疗护时，强调应"在疾病早期，与其他旨在延长生命的治疗同时应用”。也就是说，安宁疗护可以贯穿患者从得病到死亡的整个过程，延续几个月甚至几年。
In terms of time span, end-of-life care is mainly concentrated in the final period when life is nearing its end, whereas palliative care intervenes earlier and can occur at any stage of illness. When the World Health Organization redefined palliative care in 1990, it emphasized that it should "be applied early in the course of illness, in conjunction with other therapies that are intended to prolong life." In other words, palliative care can run throughout the patient's entire journey from falling ill to dying, lasting months or even years.

从运用手段来说，临终关怀偏向宗教和灵性层面。根据临终者的信仰和意愿，找到相应的宗教师，为其做心理疏解，引导临终者接纳死亡，安然走向未来。而安宁疗护属于全面关怀，除了给病人提供宗教和心理支持，还包括专业的医疗护理，为患者控制症状、舒缓疼痛；帮助患者和家属面对恐惧、焦虑、经济和护理等种种压力。
In terms of methods, end-of-life care leans toward the religious and spiritual dimension. Based on the dying person's faith and wishes, a suitable chaplain is found to provide psychological relief and guide the dying person to accept death and peacefully face the future. Palliative care, on the other hand, is comprehensive care. Beyond offering religious and psychological support, it also includes professional medical nursing — controlling symptoms, alleviating pain — and helping patients and their families confront the many pressures of fear, anxiety, financial burden, and caregiving.

# 二、中国古人对死亡的态度
# II. Traditional Chinese Attitudes Toward Death

安宁疗护的出现，和现代医学有莫大关系。很多新的治疗手段虽能维系生命，但也给患者带来极大痛苦，甚至生不如死。怎样在活着和有质量地活着之间，找到最佳的平衡点？在没有各种延命手段的古代，人的死亡相对自然，他们是怎么看待这个问题的？
The emergence of palliative care is deeply connected to modern medicine. Many new treatments can sustain life but also bring tremendous suffering to patients, to the point where living becomes worse than dying. How do we find the optimal balance between staying alive and living with quality? In ancient times, without all these life-extending measures, death was more natural. How did our ancestors view this question?

## 1．接纳死亡
## 1. Accepting Death

中国传统文化中，将生和死视为生命的自然属性，对死亡会有一份接纳。在我们小时候，人到一定年龄，就要为自己准备一口棺材，称为寿材。泰宁当地的习俗更有意思，每个人出生时，家中就会为其添口棺材，所以泰宁山中有很多没启用的棺材。梅花岛的接待厅，原来存了七八口棺材，木料和做工都很好。岛上现在有间客房叫"无常馆”，就放着一口棺材。入住其中，可与棺材共眠，是别样的人生体验。
In traditional Chinese culture, life and death are seen as natural attributes of existence, and there is a degree of acceptance toward death. When we were children, people of a certain age would prepare a coffin for themselves, called a *shoucai* — longevity wood. The local custom in Taining is even more interesting: when a person is born, the family adds a coffin for them, which is why the mountains around Taining hold many unopened coffins. The reception hall on Plum Blossom Island once stored seven or eight coffins, all of fine wood and craftsmanship. The island now has a guest room called "Impermanence Hall," which contains a coffin. Staying there — sleeping alongside a coffin — is a unique life experience.

中国有句俗话叫"死生有命，富贵在天”，也体现了国人对死亡的认知和心态。虽然佛教并不认同纯粹的宿命论，但在这样的文化熏陶下，人们可以安然接纳死亡，而不是无谓抗拒。这点非常重要，因为抗拒不仅于事无补，还会增加不必要的痛苦。
There is a Chinese saying, "Life and death are decreed by fate; wealth and status depend on Heaven," which also reflects how Chinese people understand and approach death. Although Buddhism does not endorse pure fatalism, under the influence of this culture, people could peacefully accept death rather than resist it futilely. This is very important, because resistance not only fails to help — it adds unnecessary suffering.

## 2．善终为福
## 2. A Good Death as a Blessing

早在三千多年前，中国古人就以五福作为幸福的标配，分别是长寿、富贵、康宁、好德、善终。所谓善终，即无疾而终，安详逝去，为人生画上圆满的句号。相反，"不得好死"则成了最严重的诅咒。
As far back as three thousand years ago, the ancient Chinese regarded the Five Blessings as the standard of a complete happiness: longevity, wealth, health and peace, love of virtue, and a good death. A good death means passing away naturally, without illness — peacefully and serenely — drawing a perfect full stop to one's life. Conversely, "a bad death" became the most severe curse.

如何才是善终？包含身体和心理两个层面。身体上，由自然衰老而终结，就像瓜熟蒂落、叶落归根那样，不是夭折、横死或缠绵病榻，更不是自我了断。心理上，能完成家庭责任，处理好遗产分配、社会关系等问题，避免引起亲属纠纷，死后和列祖列宗埋在一起，就能含笑九泉，死而无憾。标志性的善终场景，就是子孙环绕，交代后事。所以当父母、长辈临命终时，孩子不管多远都要回来见最后一面，否则会让逝者死不瞑目。
What constitutes a good death? It includes both physical and psychological dimensions. Physically, it means ending through natural aging, like a melon ripening and falling from the vine, or a leaf returning to its root — not through premature death, violent death, lingering in a sickbed, and certainly not through taking one's own life. Psychologically, it means having fulfilled one's family responsibilities, properly handled inheritance and social relationships, avoided causing disputes among relatives, and being buried alongside one's ancestors — then one can smile in the netherworld and die without regret. The iconic scene of a good death is being surrounded by children and grandchildren, giving final instructions. That is why, when parents or elders are dying, children will return from however far away to see them one last time — otherwise, the deceased would die with eyes open in grievance.

## 3．慎终追远
## 3. Careful Funeral Rites and Remembrance of Ancestors

《论语》所说的"慎终追远，民德归厚矣”，则体现了儒家对丧祭的重视，以及它所代表的道德教化。慎终，是依礼办理父母、祖辈的丧事，不能草率行事；追远，是定期祭祀，追念祖先，不忘根本。中国文化属于祖先崇拜，很多家族都建有祠堂，供奉着一代代的祖先牌位。人死之后，祠堂就会增加他的位置。所以在传统观念看来，死后就是和父母、爷爷奶奶，乃至祖宗十八代在一起。他们都生活在另一个世界，自己死后，就到那个世界与他们相聚，并不孤单。
The *Analects* says, "Attend carefully to the funeral rites of parents and remember the ancestors; then the people's virtue will return to richness." This reflects the Confucian emphasis on funeral and memorial rites, and the moral cultivation they represent. "Careful funeral rites" means handling the funeral of parents and elders according to propriety, without negligence. "Remembrance of ancestors" means conducting regular memorial ceremonies, recalling the ancestors, and never forgetting one's roots. Chinese culture is an ancestor-worshipping culture. Many families maintain ancestral halls housing the spirit tablets of generations of forebears. After a person dies, their place is added to the hall. So in the traditional view, after death one simply joins one's parents, grandparents — all the way back eighteen generations of ancestors. They all live in another world, and after death, one goes to that world to reunite with them. One is not alone.

中国文化中，人死为鬼。区别在于，无福者会成为孤魂野鬼，无人问津；如果福德深厚，就有人祭拜香火，甚至会成为受人供奉的神。传统习俗中的清明扫墓、七月半祭祖，既代表对祖宗的追思，也是祖先回来看望子孙的日子。所以要在这一天虔诚祭祀，祈愿他们保佑后代。当然从佛教角度来说，亡者早就投生了。"十八年后又是一条好汉"的说法，就受到轮回思想的影响。而儒家没有投生的概念，认为先祖都在另一个世界，并以另一种方式和子孙保持联系。在这样的文化熏陶下，不会觉得死是不可接受的。
In Chinese culture, a person becomes a ghost after death. The difference lies in this: those without merit become lonely, wandering spirits with no one to care for them; those with abundant merit receive offerings of incense, and may even become deities who receive worship. Traditional customs such as tomb-sweeping at Qingming and offering sacrifices to ancestors on the fifteenth day of the seventh lunar month represent both remembrance of the ancestors and a time when the ancestors return to visit their descendants. So on these days, people make sincere offerings, praying for their ancestors' blessings for future generations. From the Buddhist perspective, of course, the deceased have long since been reborn. The saying "in eighteen years I'll be a hero again" is influenced by the idea of rebirth. Confucianism, lacking the concept of rebirth, holds that ancestors all dwell in another realm and maintain a different form of connection with their descendants. Under the influence of this culture, death does not seem unacceptable.

为什么慎终追远，可以让民德归厚？如果有家族观念，一方面会觉得，生活在世间，你不仅仅是自己一个人，还代表亲情和血缘构建的家族系统，牵一发动全身，所以不能德行有亏，更不能为非作歹。否则，既让自己受到指责，也让整个家族蒙羞，这是一份承担不起的责任。
Why can careful funeral rites and remembrance of ancestors make people's virtue return to richness? If one has a strong sense of family, on the one hand one feels that living in this world, you are not merely an isolated individual — you also represent a family system built on kinship and blood ties, where a slight move in one part affects the whole. Therefore, you must not act without virtue, still less commit wrongdoing. Otherwise, you not only bring censure upon yourself but also bring shame upon the entire family — an unbearable responsibility.

除了对祖宗负责，还要为子孙积德。《易经》有句话，叫"积善之家必有余庆，积不善之家必有余殃”。祖宗有德，整个家族就会福泽绵长。从某种意义上说，这也体现业力的相续，和佛教因果观有一定关联。在这样的文化体系中，生命已融入家族系统，是血脉相连的一部分。哪怕我死了，但家族还在，子孙还在，对个体的死亡就不会那么恐惧。
Beyond being accountable to the ancestors, one must also accumulate merit for future generations. The *Book of Changes* says, "A family that accumulates goodness will surely have abundant blessings; a family that accumulates evil will surely have abundant calamities." When the ancestors have virtue, the entire family enjoys lasting good fortune. In a sense, this also reflects the continuity of karma and has some connection to the Buddhist view of cause and effect. Within this cultural system, life is already integrated into the family system, a part of a continuous bloodline. Even if I die, the family remains, the descendants remain — so the individual's death is not so frightening.

同时，中医治疗比较温和，且医生以悬壶济世为使命，不会为利益给人过度治疗。相应的，病患或老人就能在不被过多干预的情况下离去。而在传统的孝道思想中，后辈照护长辈是天经地义的，如果不这么做，将受到社会和良心的双重谴责。所以对患者的生命关怀可以在家族内部解决，不会成为社会问题。
At the same time, traditional Chinese medicine was relatively gentle, and physicians, taking the practice of medicine as a compassionate mission, would not overtreat for profit. Accordingly, patients and the elderly could depart without excessive intervention. And within traditional filial thinking, it was taken as a matter of course that the younger generation would care for their elders; failing to do so would bring double condemnation from society and one's own conscience. Thus, life care for patients could be handled within the family and would not become a social problem.

而对佛教徒来说，修行就是学习如何面对并超越生死。学净土的，可以念佛往生西方；学禅宗的，可以明心见性，了生脱死。所以临终只是一场考试而已，正好看看自己的功夫如何，能不能预知时至，来去自在。
For Buddhist practitioners, spiritual practice is precisely learning how to face and transcend life and death. Pure Land practitioners can recite the Buddha's name and be reborn in the Western Pure Land. Chan practitioners can see their true nature and gain liberation from birth and death. So death is merely an exam — just the right moment to see how one's practice is doing, whether one can know the time of death in advance and depart freely.

总之，不管儒家思想还是佛教信仰，都在不同程度上包含了生命关怀，让人为死亡早做准备。
In summary, whether Confucian thought or Buddhist faith, both contain, to varying degrees, elements of life care that help people prepare for death in advance.

# 三、现代人为什么要生命关怀
# III. Why Modern People Need Life Care

虽然我们生活在儒释道文化体系中，但这种思想并没有得到很好的传承传播，所以多数人不能像古人那样坦然接纳死亡。生活中可以看到，重疾患者往往是在迷茫、恐惧、绝望中挣扎，身心煎熬，有如炼狱。我曾在一个开示中说到，人越有钱，可能死得越痛苦。因为不甘心，就会拼命治疗、抢救。对患者来说，其实是折磨到最后一刻，连自然死亡的权利都没有。如果在确认治疗无效的情况下，能够顺其自然，反而会走得自在些。
Although we live within the cultural system of Confucianism, Buddhism, and Daoism, these ideas have not been well inherited or transmitted. As a result, most people today cannot accept death as calmly as the ancients did. In everyday life, we can see that those with severe illness often struggle in confusion, fear, and despair — body and mind tormented as if in a living hell. I once said in a teaching that the richer people are, the more agonizing their death may be. Because they cannot let go, they will fight to the end with treatments and emergency interventions. For the patient, this is actually being tortured until the very last moment, denied even the right to a natural death. If, once it is confirmed that treatment is ineffective, one can let things take their natural course, one may actually depart with greater ease.

一位从事安宁疗护的教授在论文中引用我的这段话，并用数据作了证明。有份死亡质量调查报告显示，他们对全世界80个国家做了调查，发现中国人的死亡质量排在第71位。从古人的观念看，很多人都说不上好死，而是在饱受煎熬的过程中离去。为什么存在这种现象？我觉得有以下几方面原因。
A professor working in palliative care cited this passage of mine in a paper and supported it with data. A report on the quality of death surveyed 80 countries worldwide and found that the quality of death for Chinese people ranked 71st. From the perspective of ancient ideals, many people today cannot be said to have had a good death; instead, they depart in the midst of prolonged torment. Why does this phenomenon exist? I think the following factors are at work.

## 1．对死亡缺乏认识
## 1. Lack of Understanding About Death

我们现有的教育偏向知识、技能，主要解决生存层面的问题，缺乏人生价值、心灵归属、如何面对死亡等生命层面的教育。日常生活中，大家也往往回避死亡，不愿面对，甚至说到"死”都觉得晦气。这就使得现代人不了解，也不接纳死亡。
Our current education emphasizes knowledge and skills, mainly addressing survival-level needs, but lacks education on the level of life itself — life's meaning, where the heart finds its true home, and how to face death. In daily life, people tend to avoid the topic of death and are unwilling to face it; even mentioning the word "death" is considered unlucky. This leaves modern people neither understanding nor accepting death.

但不了解、不接纳，不等于可以躲开。事实上，死亡是每个人的必然结局，是人生不可或缺的重要课题。只有了解它，才能清醒、笃定地走向终点；只有接纳它，才能在这一天到来前做好准备，而不是惊慌失措，不知如何应对。
But not understanding and not accepting does not mean one can avoid it. In fact, death is the inevitable conclusion for every person — an indispensable and essential subject in life. Only by understanding it can one walk toward the end with clarity and composure. Only by accepting it can one prepare before the day arrives, rather than panicking, not knowing how to respond.

通过学习佛法，我们会知道，死亡只是一期生命的句号，并不是彻底结束，生命还会生生不息地延续。而怎么死，才是下一世投生哪里的关键所在。这就需要通过闻思和修行，了解投生原理，看清生死真相，获得超越生死的能力。只有这样，才能生固欣然，死亦无憾。因为生和死都是生命流转的过程，过好当下每一天，才能让生命生生增上。这就从被动等死，转为主动把握命运，超越生死。
Through studying the Buddhadharma, we come to know that death is merely the period at the end of one phase of life; it is not a complete end. Life continues on and on, unceasing. And *how* we die is the critical factor that determines where we will be reborn in the next life. This requires, through study and practice, understanding the principles of rebirth, seeing clearly the truth of life and death, and gaining the ability to transcend them. Only then can we be at ease in life and without regret in death. For both life and death are processes in the flow of existence. By living each present day well, we can continuously elevate our life, life after life. This shifts us from passively awaiting death to actively taking hold of our destiny and transcending birth and death.

## 2．过分重视身体的治愈
## 2. Overemphasis on Physical Cure

据相关调查，很多疾病的治疗费用，有三分之一发生在生命最后一个月。因为此时的病人和家属往往充满恐惧，哪怕有一线生机，也会对医生言听计从，孤注一掷。如果医院特别看重经济利益，就可能过度治疗，以此牟利。甚至明知没希望了，还在拼命抢救。对患者来说，只是徒增身心痛苦；对家属来说，则会增加巨大的经济负担，使得不少家庭因病返贫。
According to relevant surveys, one-third of the medical costs for many illnesses occur in the final month of life. At this point, the patient and the family are often filled with fear. Even if there is only a glimmer of hope, they will follow whatever the doctor says, staking everything on one throw. If the hospital places particular value on financial profit, it may overtreat for gain — even continuing aggressive interventions when it is already clear there is no hope. For the patient, this only adds physical and mental suffering; for the family, it imposes a crushing financial burden, driving many families into poverty because of illness.

到底应该治疗到什么程度？作为病人和家属来说，一方面要了解疾病本身、医疗条件、治疗效果和治愈概率；一方面要认识到，有生必然有死。只有坦然面对，才能客观评估，为自己作出合理的决定，既不轻言放弃，也不一厢情愿。
To what extent should treatment go? As patients and family members, on the one hand, we must understand the illness itself, the medical resources available, the treatment's effectiveness, and the probability of cure. On the other hand, we must recognize that with birth, death is inevitable. Only by facing this squarely can we make an objective assessment and a reasonable decision for ourselves — neither giving up lightly nor indulging in wishful thinking.

一个人临终时，不仅要经历身体、心理的痛苦，还有社会关系和灵性层面的问题。我们活了几十年，在社会上经营了几十年，有各种人际关系、爱恨情仇，现在即将离开，如果放不下，也是死不好的。此外，很多人之所以怕死，是出于对未知的恐惧，不知道死了去哪里，又会发生什么。可以说，对这方面没有丝毫了解，也没做好任何准备。从这个角度，安宁疗护和临终关怀都离不开宗教。因为这是终极问题，不是现实层面或已有经验可以触及的。
As a person approaches death, they experience not only physical and psychological suffering, but also problems on the social and spiritual levels. We have lived several decades and built social connections over decades — all kinds of relationships, loves, and resentments. If, at the moment of departure, we cannot let go, we will also die badly. Moreover, many people's fear of death stems from fear of the unknown — not knowing where they go after death and what will happen. It can be said that people have not the slightest understanding of this and have made no preparation whatsoever. From this perspective, both palliative care and end-of-life care cannot be separated from religion, because these are ultimate questions that cannot be reached through the mundane level or through existing experience.

我曾在新西兰开讲"《心经》的生死观”，谈到佛教对死亡的态度和做法，并与一位当地从事安宁疗护的专家进行对话。他们对这些内容很感兴趣。怎么面对死亡？各种宗教有不同的处理方式。应该说，佛教对生死的认识最为透彻，因为佛陀出家修行的初衷，就是为了解决生死问题。所以佛教的很多教义和法门，都是围绕生死展开。遗憾的是，很多人并不了解这些思想，甚至因误解而排斥这一智慧文化。
I once gave a lecture in New Zealand titled "The *Heart Sutra*'s View of Life and Death," where I discussed the Buddhist attitude toward and approach to death, and held a dialogue with a local expert working in palliative care. They were very interested in this content. How should we face death? Different religions handle it in different ways. It must be said that Buddhism's understanding of life and death is the most thorough, because the Buddha's original purpose in leaving home to practice was precisely to resolve the problem of life and death. Consequently, many of Buddhism's teachings and methods revolve around this question. It is regrettable that many people do not understand these ideas and even reject this wisdom culture out of misunderstanding.

通过生命关怀，可以为大家宣导佛教的生死观，让人在身体无法治愈时，看到新的希望。因为心才是生命的主宰，当心能够自主、自在，就不会被身苦束缚，从而直面生死、超越生死。
Through life care, we can share the Buddhist view of life and death, helping people see new hope when the body can no longer be cured. For the mind is the true master of life. When the mind can be autonomous and free, it will not be bound by physical suffering, enabling us to face life and death directly and transcend them.

# 四、树立正确的生死观和治疗观
# IV. Establishing a Correct View of Life, Death, and Treatment

## 1．认识生与死的关系
## 1. Understanding the Relationship Between Life and Death

作为生命关怀，我们首先要树立正确的生死观。佛教的三法印，是"诸行无常，诸法无我，涅槃寂静”，告诉我们，世间一切都在变化中，月圆月缺，四季更替，从未停止。生命也是同样，从出生开始，无论存活多久，每一刻都在走向死亡。
In providing life care, we must first establish a correct view of life and death. The Three Dharma Seals in Buddhism — "all conditioned phenomena are impermanent, all phenomena are without self, nirvana is peace" — tell us that everything in the world is in constant change. The moon waxes and wanes, the four seasons cycle, never stopping. Life is the same: from the moment of birth, no matter how long one lives, every moment is moving toward death.

死是必然的，也是无常的，不知何时就会到来，关键在于怎么死。这就需要构建良性的生命积累。就像我们要活得好，得有相应的因缘因果。希望身体健康，就要学习养生之道，动静结合；希望心理健康，就要摆脱负面情绪，建立良性品质；希望人际和谐，就要理解、接纳、善待他人；希望福报广大，就要多行善事，慈悲众生。
Death is inevitable and also uncertain — we never know when it will arrive. The key lies in *how* we die. This requires building positive life accumulations. Just as living well requires the right causes and conditions, if we want physical health, we must learn the way of nurturing life, balancing movement and stillness. If we want mental health, we must let go of negative emotions and cultivate positive qualities. If we want harmonious relationships, we must understand, accept, and treat others well. If we want abundant good fortune, we must do more good deeds and extend compassion to all beings.

生命是无尽的累积，就像河流，从无穷的过去延续到无限的未来。死亡只是其中的过渡，并不是彻底消失。如果当下是良性的积累，就能让生命在延续过程中不断增上，拥有美好未来。就像换到更好的地方去生活，何必不舍，何必畏惧？
Life is an endless accumulation, like a river flowing from the infinite past into the boundless future. Death is merely a transition within this flow, not an absolute disappearance. If our present moment is a positive accumulation, then life can continuously elevate as it continues, moving toward a beautiful future — like moving to a better place to live. Why cling? Why fear?

其次，还要认识死亡对生命的意义。苏格拉底说：哲学就是练习死亡。他自己正是这一理念的践行者，当他被判有罪时，不仅拒绝逃亡，还从容饮下毒酒。因为他对生死看得很透彻，心性修养也达到一定高度，有能力直面死亡。西方人本主义思想认为，人是宇宙的精华，万物的灵长。我们得到生命，是极其可贵的机会。怎么才能用好它？存在主义哲学家海德格尔提出了"向死而生”。认识到人终将死亡，就会知道生命的有限性，不能麻木且混混沌沌地度过此生。
Next, we must also recognize death's significance for life. Socrates said that philosophy is the practice of death. He himself was a living embodiment of this idea: when sentenced to death, he not only refused to escape but calmly drank the hemlock, because he had seen through life and death thoroughly, and his inner cultivation had reached a level where he could face death directly. Western humanist thought holds that human beings are the essence of the universe and the spirit of all things. The life we have received is an extraordinarily precious opportunity. How can we make the best use of it? The existentialist philosopher Heidegger proposed "being-toward-death." Recognizing that we will eventually die, we come to know the finitude of life — we cannot pass through this life in numbness and confusion.

从佛法的角度，是让我们看到人身的暇满、义大、难得。得到人身，尤其是有能力、有时间修学佛法的人身，千载难逢，意义重大。在六道中，人道是一个中转站。因为人有理性，可以决定自己的身口意三业。善用理性，就能追求真理，完善道德，造福社会，乃至成佛作祖，所以诸佛世尊皆出人间。但不善用理性，不仅给自己制造无量烦恼，使生命走向堕落，还会对他人、世界造成极大破坏。
From the perspective of the Buddhadharma, we are guided to see the leisure, opportunity, great meaning, and rarity of human life. To obtain a human body — especially one with the capacity and time to study and practice the Dharma — is an opportunity that comes once in a thousand ages, of immense significance. In the six realms, the human realm is a transfer station, because humans possess reason and can determine their own actions of body, speech, and mind. When we use reason well, we can seek truth, perfect our moral character, benefit society, and even attain Buddhahood. That is why all Buddhas and World-Honored Ones appear in the human realm. But if we misuse reason, we not only create measureless afflictions for ourselves, sending our lives into decline, but also cause tremendous harm to others and to the world.

总之，死亡让我们看到今生的短暂，从而珍惜这一难得易失的机会，实现人生的最大价值。
In short, death makes us see the brevity of this life, and thus cherish this rare and easily lost opportunity to realize the maximum value of human existence.

## 2．建立正确的治疗观
## 2. Establishing a Correct Approach to Treatment

除了生死观，我们还要本着对患者的理解、尊重、关爱，帮助他们建立正确的治疗观。很多人对患者的关爱，主要是基于身体层面。其实一个人面对疾病、死亡时，不仅身体需要关爱，心灵也需要关爱，包括对情绪的疏解，及灵性层面的引导。所以安宁疗护团队要由多专业的人员组成。
Beyond the view of life and death, we must also, on the basis of understanding, respect, and care for patients, help them establish a correct approach to treatment. Many people's care for patients is mainly on the physical level. But in reality, when a person faces illness and death, not only the body needs care — the mind also needs care, including the soothing of emotions and guidance on the spiritual level. That is why palliative care teams must be composed of professionals from multiple disciplines.

在西方国家，从事安宁疗护需要通过一定训练，具备相应资质。未来，我们同样要有一批人去接受专业学习，在此基础上，增加佛法内涵，配合正念修行，就能做出具有东方智慧高度的生命关怀，为安宁疗护提供新的视角和探索。
In Western countries, working in palliative care requires specific training and qualifications. In the future, we must likewise have a cohort of people who receive professional training. On that foundation, by infusing the content of the Buddhadharma and integrating mindfulness practice, we can create a life care that reaches the heights of Eastern wisdom, offering a new perspective and a new exploration for palliative care.

# 五、死亡、投生是怎么回事
# V. What Happens at Death and Rebirth

不论做安宁疗护还是临终关怀，了解死亡和投生非常重要。怎么才能安详离去，投生善道？这是有技术含量的。
Whether engaged in palliative care or end-of-life care, understanding death and rebirth is essential. How can a person depart peacefully and be reborn in a good realm? This is a matter that carries real technical depth.

## 1．四个过程
## 1. The Four Stages

佛法告诉我们，生命延续包含生有、本有、死有、中有四个过程。生有，即出生之时；本有，即今生的存续；死有，即死亡的刹那；中有，即死后到投生前的中阴状态。就像你大学毕业，或从单位辞职，尚未找到工作的空窗期。
The Buddhadharma tells us that the continuity of life consists of four stages: birth existence, life existence, death existence, and intermediate existence. Birth existence is the moment of birth. Life existence is one's present lifespan. Death existence is the instant of dying. Intermediate existence — the bardo state — is the period after death and before taking rebirth, like the interval after graduating from university or resigning from a job, when you have not yet found new work.

从生到死，只是一期生命的开始和结束。在生命长河中，这样的生命一期接着一期，相续不绝。佛教认为，中阴身通常会在七天内投胎。如果没有投胎成功，就会继续下一个七天，一般不超过七七四十九天。所以，中国人以为祖宗会在祠堂等着，其实他可能早就成了你的子孙后代。因为很多时候，祖宗可能执著这个家庭，就会不断来此投胎。这是佛教和中国文化对生死的不同认识。
From birth to death is simply the beginning and end of one phase of life. In the long river of existence, one such phase follows another in unbroken continuity. Buddhism holds that a being in the intermediate state will usually take rebirth within seven days. If rebirth does not succeed, it continues for another seven-day period, generally not exceeding seven cycles of seven — forty-nine days. So, while Chinese people imagine ancestors waiting in the ancestral hall, the reality is that the ancestor may long since have become one of their own descendants, because ancestors often remain attached to the family and will repeatedly take rebirth within it. This is a key difference between Buddhist and traditional Chinese understandings of life and death.

在中国传统文化中，人死就变成鬼，并且一直在鬼道。但佛教认为，生命在六道轮转不休，包括天、人、阿修罗、畜生、饿鬼、地狱。通过修行，就能转凡成圣，成为圣贤，包括声闻、缘觉、菩萨、佛四种。由六凡四圣，组成十法界。因此，人死为鬼只有十分之一的可能。
In traditional Chinese culture, a person becomes a ghost after death and remains in the ghost realm. But Buddhism holds that life revolves unceasingly through the six realms — heavens, humans, asuras, animals, hungry ghosts, and hell beings. Through practice, one can transform from an ordinary being into a noble one — becoming a sage — including the four kinds: hearers, solitary realizers, bodhisattvas, and Buddhas. These six ordinary and four noble destinies together form the ten dharma realms. Thus, becoming a ghost after death is only a one-in-ten probability.

## 2．三种力量
## 2. The Three Forces

死后会进入六道的哪一道，是由三种力量决定的。
Which of the six realms one enters after death is determined by three forces.

第一是随业，即随着业力。但人的业力很多，包括重业和轻业、定业和不定业等。其中，最重的业会快速成熟，所谓"如人造罪，强者先牵”。就像欠了钱要卖房还债，你欠哪家的债最多，就得先还哪一家。
The first is going with karma — following one's karmic force. But a person accumulates much karma: heavy and light, fixed and unfixed, and so on. Among these, the heaviest karma ripens the fastest. As the saying goes, "When a person creates offenses, the strongest pulls them first." It is like being in debt and having to sell your house to repay — whoever you owe the most to gets paid first.

第二是随习，即随着串习。习惯的力量很大，我们做什么或不做什么，喜欢或不喜欢什么，看起来是自己决定的，其实往往是在不知不觉中被习惯左右，身不由己。所以，我们想知道未来生命会怎样，看看现在就知道了。你每天在想什么，做什么，由此积累的力量，就会推动你往哪里投生。我们之所以要禅修，就是帮助自己开启觉知，摆脱串习，不被惯性左右。否则，生命就会耽于无明，日复一日，年复一年。一转眼，十年过去；一转眼，二十年过去，都不清楚自己做了些什么。
The second is going with habit — following one's habitual tendencies. The power of habit is immense. What we do or don't do, what we like or dislike — it seems we decide for ourselves, but in fact we are often unconsciously carried along by habit, helpless to resist. So if we want to know what our future life will be like, we can know by looking at the present. What you think about and do every day — the force accumulated thereby — will propel you toward a corresponding rebirth. The reason we practice meditation is precisely to help us awaken awareness, to break free from habitual tendencies, and not be driven by inertia. Otherwise, life sinks into ignorance — day after day, year after year. In the blink of an eye, ten years have passed; in another blink, twenty — and we are not even clear on what we have been doing.

第三是随念，即随着起心动念。我们通常以为，自己是生活在现实中，其实，很多时候是生活在自己的心念中。念头决定你怎么看世界，也决定了你做什么不做什么。我们每天会见到各种人，面对各种事，这些人和事会对你产生什么影响，让你是喜是忧，是爱是恨，都和你的认知有关，和你的念头有关。
The third is going with thought — following the thoughts that arise at the end of life. We usually think we are living in reality, but in truth, much of the time we are living in our own thoughts. Thoughts determine how you see the world and what you do or don't do. Every day we meet various people and face various situations. Whether these people and events make you happy or sad, fill you with love or hatred — all of this is bound up with your perceptions and your thoughts.

佛教的因果故事中，记载了很多相关案例。比如有人在床下埋了几块金砖，走时没来得及和儿女交代，后来就变成一条狗，每天围着那地方不走；有个奶奶很爱她的孙子，走了之后万般牵挂，结果投胎回来，成了孙子的媳妇；还有人死时生起强大的嗔心，结果变成一条毒蛇。这些都是念头导致的。
The Buddhist stories of cause and effect record many relevant cases. For instance, someone buried several gold bars under the bed and passed away without telling his children; he later turned into a dog that circled that spot every day without leaving. There was a grandmother who loved her grandson dearly; after she passed, she was so attached that she took rebirth and became his grandson's wife. Someone else generated intense anger at the moment of death and turned into a venomous snake. All of these outcomes were brought about by thoughts.

包括六道轮回，也不仅是生命形态，还代表着心理状态。换句话说，不同心理会展现相应的生命形态。一个人从观念形成行为，再由行为的重复形成习惯，由习惯的积累形成性格，再由性格的固化形成人格。可以说，人格就是某些心理被不断强化，呈现出的特定形态。
Furthermore, the six realms of cyclic existence are not only forms of life but also represent psychological states. In other words, different mind states manifest as corresponding life forms. A person moves from views to behavior, from repeated behavior to habit, from accumulated habit to character, and from the solidification of character to personality. One could say that personality is simply the specific shape taken by certain mental states that have been repeatedly reinforced.

从这个角度看，人道也有六道之分。如果充满愚痴，就等同动物的表现；如果充满贪婪、匮乏，就显现饿鬼的特点；如果充满嗔恨、对立，就属于阿修罗的生命；如果充满慈悲、智慧，就在向佛菩萨不断靠拢。这也就是佛法所说的"心种种故，色种种”。各种各样的心，会呈现各种各样的生命形态。
From this perspective, even within the human realm there are the six realms. If one is full of ignorance, one manifests behavior comparable to animals. If one is full of greed and a sense of lack, one displays the characteristics of hungry ghosts. If one is full of anger and antagonism, one belongs to the life of an asura. If one is full of compassion and wisdom, one draws ever closer to the Buddhas and bodhisattvas. This is what the Dharma calls "mind being various, forms being various." The variety of minds manifests the variety of life forms.

尤其在临命终时，出现什么样的心念，就会唤起什么样的业力。了解到决定投生的力量，我们就知道如何选择了。如果想投生善处，就要修习善业，具足善行和善念，临命终时，这些善业、善行、善念将引领你投生善道。反之，如果总是造作恶业、恶行，心存恶念，大限到来，就会随着这些恶业、恶行、恶念堕落恶道。
Especially at the time of death, whatever kind of thought arises will call forth the corresponding kind of karma. Understanding the forces that determine rebirth, we then know how to choose. If we wish to be reborn in a good destination, we must cultivate good karma, be endowed with good conduct and good thoughts. At the end of life, these good karma, good conduct, and good thoughts will guide us to a good rebirth. Conversely, if we habitually create bad karma, bad conduct, and harbor unwholesome thoughts, when the great limit arrives, we will follow this bad karma, bad conduct, and unwholesome thoughts and fall into the lower realms.

## 3．信、愿、行
## 3. Faith, Vow, and Practice

能够影响业力的，还有愿力。可以说，这是一种特定的念力。多数人因为看不清生命真相，只能随业流转。但我们通过学佛，知道生命是可以自主选择的。一方面要从现在开始止恶修善，集资净障；一方面要发起大愿，让生命拥有新的方向。
What can also affect karma is the power of vow. One could say this is a specific form of the power of thought. Most people, unable to see the truth of life clearly, can only drift along with karma. But through studying the Dharma, we know that life can be chosen with autonomy. On the one hand, we must begin from this moment to stop evil and cultivate good, accumulating merit and purifying obstacles. On the other hand, we must generate great vows, giving our life a new direction.

净土法门提倡信、愿、行，以此作为往生最重要的三种资粮。首先要对西方极乐世界和净土法门生起信心，相信这是生命最好的归宿。有了信心，才会进一步引发愿力。然后，这份愿力就会推动你努力践行，对往生西方极乐世界的条件，逐一落实。就像知道移民的要求后，会根据相关内容做好准备。
The Pure Land path advocates faith, vow, and practice as the three most important provisions for rebirth. First, we must generate faith in the Western Land of Ultimate Bliss and the Pure Land Dharma path, believing this to be the best destination for life. Only with faith will vow further arise. Then, this power of vow will propel us to practice diligently, fulfilling every condition for rebirth in the Western Land of Ultimate Bliss one by one — just as, upon learning the requirements for immigration, we make preparations according to the relevant criteria.

事实上，修习任何法门，乃至生活中要做好一件事，同样要有信愿行。比如解脱，只有对解脱生起信心，才会发愿解脱，进而落实于修行。
In fact, practicing any Dharma path — and even doing anything well in life — equally requires faith, vow, and practice. Take liberation, for example: only when we have faith in liberation will we vow to achieve it, and then put that vow into practice through cultivation.

## 4．心的空白处
## 4. The Open Space of Mind

除了业力、串习、念力，还有一种更高级的力量，就在心的空白处。
Beyond karma, habitual tendencies, and the power of thought, there is a still more advanced force — right in the open space of mind.

前面讲到，中阴是生命转换间隙时的形态。对心念来说，在前念已过后念未生之间，也有这样的间隙，那就是本心。我们平常都是活在念头中，就像被云彩笼罩着，遮蔽着。但在重重云彩的背后，还有无云晴空，代表内心觉醒的力量，自我解脱的能力。
Earlier, we discussed that the intermediate state is the form taken during the gap between life phases. For thoughts, too, there is such a gap — in the interval after the previous thought has passed and before the next thought has arisen. That is the true mind. In ordinary life, we live entirely within our thoughts, as though shrouded and obscured by clouds. But behind the layers of cloud, there is the cloudless clear sky — representing the power of inner awakening, the capacity of self-liberation.

禅宗典籍中，记载了很多禅师无疾坐化的实例。如志端禅师生前就预告归期，但没有任何病相，并如常指导弟子。到了这天，禅师在饭后上堂辞众，问大家：世尊什么时候灭度的？大家说：二月十五日子时。禅师说：我今天子时前走。然后泊然坐化。神赞禅师临终前剃发沐浴，召集弟子，问：你们识得无声三昧吗？弟子说：不识。禅师道：你们现在好好听着。当弟子们侧耳静听之际，禅师就怡然坐化了。此外，还有华亭水化，石霜坐化，圆照卧化，隐峰倒化，都是生死无碍、来去自在的显现。
The Chan records contain many accounts of Chan masters passing away in seated meditation without any illness. For example, Master Zhiduan foretold the date of his passing while showing no sign of illness, guiding his disciples as usual. On that day, after the meal, he ascended the teaching seat and bid farewell to the assembly. He asked, "On what day did the World-Honored One enter cessation?" Everyone replied, "At the hour of zi on the fifteenth day of the second month." The master said, "I shall go before the hour of zi today." Then he quietly passed away in seated meditation. Master Shenzan, facing the end of his life, shaved his head, bathed, gathered his disciples, and asked, "Do you recognize the samadhi of soundlessness?" The disciples said they did not. The master said, "Now listen carefully." As the disciples inclined their ears to listen intently, the master serenely passed away in seated meditation. There were also those who passed away in water at Huating, in seated meditation at Shishuang, lying down at Yuanzhao, and hanging upside-down at Yinfeng — all demonstrations of unimpeded mastery over life and death, coming and going in complete freedom.

怎么做到这一点？首先要通过禅修开启觉知清明的心，和念头保持距离，不再陷入念头，被念头带走。经由不断训练，就能看到一切的一切，从起心动念到言行举止，从生老病死到山河大地，都是心灵天空的影像，如梦幻泡影。
How is this accomplished? First, through meditation practice, we must open a mind that is awake and clear, maintaining distance from our thoughts, no longer falling into them or being carried away by them. Through continuous training, we come to see that everything — from arising thoughts to speech and action, from birth, aging, illness, and death to mountains, rivers, and the great earth — is but an image in the sky of the mind, like a dream, an illusion, a bubble, a shadow.

佛陀发现了念头背后的本心，告诉我们：每个人都有自我疗愈、自我解脱的能力。只要找到这个心，我们就能在念头中自主，在生死中自在，就有能力选择生命的去向。这种力量非常重要。藏传佛教讲中阴救度，其实中阴救度不只是在临命终时，每时每刻，每个当下，只要不陷入念头，我们就能体会心的空白处，体会觉知、解脱的力量。
The Buddha discovered the true mind behind our thoughts and told us that every person possesses the capacity for self-healing and self-liberation. As long as we find this mind, we can be autonomous amid thoughts and at ease amid life and death; we gain the power to choose the direction of our life. This power is profoundly important. Tibetan Buddhism speaks of bardo deliverance. But in truth, bardo deliverance is not only at the time of death — every moment, every instant of the present, as long as we do not fall into thought, we can experience the open space of mind, the power of awareness and liberation.

所以，不是到了死时才考虑解脱。在每个当下开启内在觉知，熟悉清明的心，我们就能在当下解脱。临命终时，才可能生死自在，坐脱立亡。如果等到死之将至再来修，往往就来不及了。如果你的恶业、串习太重，也没福报感召别人为你引导、助念，就只能随业流转。
Therefore, do not wait until death arrives to consider liberation. By opening inner awareness in each present moment and becoming familiar with the clear mind, we can be liberated right in the present. Then, at the end of life, we may be at ease in life and death, passing away in seated meditation or standing. If we wait until death is imminent to start practicing, it is often too late. If our negative karma and habitual tendencies are too heavy, we may not have the good fortune to invoke others to guide us and chant supportively — we can only drift with karma.

真正的修行要在平时训练。修习正念就是帮助我们开启觉知，认识本心，在内心空白处，体会清清楚楚、了了明知的力量。这种力量不仅能解决现实烦恼，也能为生命找到尽未来际的永恒福祉。因为你已开启生命的无尽宝藏，可以生死自在、自利利他。这是佛法给我们提供的，最究竟的生命关怀。
True practice must be trained in ordinary times. Mindfulness practice is precisely what helps us open awareness, recognize our true mind, and, in the inner open space, experience the power that is luminously clear, distinctly knowing. This power not only resolves present afflictions but can also find for life an eternal well-being that extends into the endless future, because you have already opened the inexhaustible treasure of life itself. You can be at ease in life and death, benefiting both yourself and others. This is the ultimate life care that the Buddhadharma offers us.

# 六、临终关怀
# VI. End-of-Life Care

了解死亡、投生是怎么回事，就要基于这个前提来做临终关怀。
Having understood what death and rebirth involve, we must base our end-of-life care on this understanding.

首先是营造良好氛围。就像静茶七式前要布置场地，临终关怀更是如此。有一个庄严、清净、如法的氛围，既可以让参与者收摄心念，还能让亲属知道，眼前最重要的是做什么，对临终者最有利益的是什么，而不是大声哭泣，甚至为分财产吵架，结果引发临终者的贪嗔之心，障碍其顺利离去。更重要的是，良好氛围可以让临终者减少对死亡的恐惧，安住当下，保持正念。
First, create a good atmosphere. Just as we arrange the space before the Seven Steps of Mindful Tea, end-of-life care requires this even more. A dignified, pure, and proper atmosphere allows participants to gather their minds, and also makes clear to the family what matters most at this moment and what is most beneficial to the dying person — rather than wailing loudly or even arguing over inheritance, which would stir up the dying person's greed and anger, obstructing their peaceful departure. More importantly, a good atmosphere can reduce the dying person's fear of death, enabling them to rest in the present and maintain mindfulness.

如果临终者还有事放不下，我们要为他做一些心理疏解，引导他放下万缘，不再纠结。如果临终者自身的修行没把握，我们就要通过助念等方式，帮助临终者提起正念。若是临终者信仰净土法门，希望往生西方，就为他念阿弥陀佛，以佛号令其安住；若是临终者对三皈依更熟悉，就为他念诵三皈依，帮助他把心安住于对三宝的信心。更究竟的，是开启内在觉知，体会心的清明，这是最好的自救之道。如果临终者有其他宗教信仰，我们也要表示尊重，为他做好相关事宜。
If there are still things the dying person cannot let go of, we should offer psychological relief, guiding them to release all attachments and entanglements. If the dying person's own practice is not yet stable, we should, through supportive chanting and other means, help them bring forth right mindfulness. If the dying person has faith in the Pure Land path and wishes to be reborn in the West, we recite Amitabha Buddha's name so they may rest in the Buddha's name. If the dying person is more familiar with the Three Refuges, we chant the Three Refuges, helping them rest the mind in faith toward the Three Jewels. The ultimate approach is to open inner awareness and experience the clarity of mind — this is the best path of self-liberation. If the dying person has other religious faith, we should show respect and help make arrangements accordingly.

# 七、结说
# VII. Conclusion

生命关怀包括安宁疗护和临终关怀，是一项重要课题。一方面，每个人都有生老病死，了解这些原理，自己就能正确面对。另一方面，身边很多人会有这个需要。尤其在国际弘法中，海外华人身处异域文化，在患病和临终的特殊时刻，更需要这方面的关怀。希望大家做好项目建设，构建六步成长，未来能出一批达人、主讲、讲师，去各地传帮带，服务大众。
Life care, encompassing both palliative care and end-of-life care, is an important endeavor. On the one hand, everyone experiences birth, aging, illness, and death. Understanding these principles enables us to face them correctly ourselves. On the other hand, many people around us will have this need. Especially in international Dharma propagation, where overseas Chinese find themselves in a foreign culture, the need for this kind of care is all the greater in times of illness and at the end of life. I hope everyone will carry forward the project well and establish the six-step growth path. In the future, may we produce cohorts of practitioners, presenters, and teachers who go everywhere to share, guide, and serve the community.
