懺悔法門在末期病人靈性照顧的應用
釋慧岳1 釋宗惇 釋德嘉 陳慶餘
台大醫院家庭醫學部緩和醫療病房、1羅東博愛醫院安寧共同照護
佛教認為「罪業」存在會造成影響心性光明的理事二障，所以必須發露出來，承認自己的不是，乃至獲得被寛恕的機會，恢復平安。在傳統的佛教中，懺悔法門有兩種層次，一為事懺；一為理懺。前者指在固定儀軌中，天天誦或禮拜與懺悔罪業相關的經典(如：八十八懺悔文、慈悲三昧水懺、大悲懺、金剛懺、藥師懺等等)，時時懺除自己所做種種的不善業；後者在外在事件之上深入的探討，發現罪業產生的原因在於貪、瞋、痴，而其根源則在於「我執」的存在，進一步在個人相應法門的修行上，從誦經拜佛啓發智慧的實修中，印證五蘊的「苦」、「空」、「無常」、乃至「無我」而究竟得解脫。
臨床佛教宗教師在安寧緩和醫療照顧中，發現部份末期病人所呈現生死困頓的靈性課題如不捨、心願未了以及死亡恐懼等，而從生命回顧中，得知病人對人生經驗中違反倫理道德的事件深受良心自責而不安，如此不僅加重身心症狀，甚至在臨終階段的譫妄中頻頻出現影像，影響生活品質與善終。總之懺悔是除障、歸零的法門，皈依之前要先懺悔，懺悔可以打開清淨境界，有其臨床適應症和療效。本文以個案報告方式，探討懺悔法門於末期病人的臨床應用。
Application of Repentance in Spiritual Care of Terminal Cancer Patients
Hwei-Yue Shi1, Tsung-Tueng Shi, Der-Chia Shi, and Ching-Yu Chen
Department of Family Medicine, National Taiwan University Hospital , Taipei , Taiwan
1Lo-Tung Pohai Hospital, Hospice Palliative Share Care Team, Yilan , Taiwan
Introduction
Buddhism believes that the existence of offenses affects the brightness of one’s mind. Through repentance, one discloses one’s offenses; those who confess and are forgiven will regain peace of mind. Traditionally there are two levels of repentance in Chinese Buddhism: repentance of specifics and repentance of principles. The former(1) is practiced by chanting or bowing to repentance scriptures such as the Eighty-eight Buddhas Repentance(2), Compassion Samadhi Water Repentance(3), Great Compassion Repentance(4), Vajra Repentance(5), Medicine Master Repentance(6), etc. One repents all the bad deeds one did in the past. The latter is practiced by investigating deeply into the external matters, one finds that the causes of offenses are greed, hatred and delusion and that the root of the problem is self-attachment. Through reciting sutras and bowing to Buddhas, one attains wisdom and realizes that the nature of the five skandas is suffering, empty, impermanent and of no self. One ultimately attains liberation.
In the hospice palliative care, it is well known that many terminal patients experience spiritual distresses, such as unable to renounce, wishes unfulfilled, fear of death, etc.(7) During life review process(8) we also found that past immoral deeds or deeds against the Eight Right Paths caused a patient’s conscience to reprimand himself/herself. As a result, the patient was deeply disturbed and experienced the above-mentioned spiritual distresses. These sufferings not only worsen the symptoms in the patient’s body and mind, but also result in seeing related images in his/her terminal illusory state and affect the qualities of his/her life and death.
To sum up, repentance is a Buddhist way to eradicate obstacles and restore peacefulness. Before one takes refuges, one repents first. Repentance may result in a state of purity and have therapeutic effects in certain clinical situations. This paper reports some case studies on the application of repentance in hospice palliative care of terminal cancer patients.
(本文發表於100年5月25-27日由政治大學宗教研究所等五單位主辦的「宗教經驗與臨床療癒：人文、科學的百年相遇與對話」國際研討會)
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