Venerable Khamkhian, one of the most respected Buddhist monks in Thailand, passed away peacefully at his temple last August due to Oesophageal cancer. Ekkapop Sittiwantana of the Buddhika Foundation and Tharin PHenwan, MD, reflect on what we can learn from the way he handled his death.
In most circumstances, famous monks in Thailand are given the most aggressive treatment that their local hospital could offer, usually against their own will. This is because, as venerated members of Thai society, they mostly have privileged access to advanced care at the hospitals, and their disciples also want them to ‘live’ as long as possible.
However, Ven. Khamkhian had successfully overcome this fate and could pass away as he had wished, peacefully and consciously, at his temple.
This led to other questions, such as: “How could he achieve a peaceful death?” and “What can we learn from it?”
Following his death, more than 200 people joined in a forum held by Thai Palliative Care Society (THAPS) and Buddhika Foundation. The main objective of this meeting was to announce his passing and discuss what we have learnt from it. Buddhist monks and doctors who took care of him also partook as well.
From the discussion, key contributions which lead to Ven. Khamkhian’s peaceful passing are:
Good attitude towards death
Ven. Khamkhian himself regularly practiced mindfulness, making him fully aware the very nature of life. One of his teachings was to be “free from self and attachment”. It teaches us about how all things in nature change over time. This means that all things and phenomenon in nature – living and non-living – are all ephemeral and will eventually succumb to nothingness at the end. Hence; there is no him, me, pain, cancer, etc. Therefore there is no need to feel attached to those things because they will eventually become nothing.
From this mentality, he could cope with his cancer and upcoming end very well. He also lived up to his teaching by refusing any unnecessary advance treatment that would prove futile and decided to stay at his temple among his disciples where he felt belonged.
Written, clear Advance Directive
Ven. Khamkhian had completed his advance directive a long time before his passing. He clearly stated in his living will that he:
- Would not want unnecessary treatment that would only prolong his life; and
- Wished to stay and pass away at his temple.
He also instructed his followers as to how to prepare his body, as well as specifying the requisite tools for the ceremony after he had gone. The healthcare team and his disciples who also acted as his carers were all fully aware of his wishes and humbly accepted these.
Large multidisciplinary team with good communication skills
His followers, Buddhist monks and laymen, volunteers and health care team, had pledged themselves to take care of their master during his time of need. Apart from taking care of the basic needs and medical care, they also screened other faithful pilgrims that hailed from various places just to see Ven. Khamkhian one last time. They also gave a clear explanation regarding his condition to the non-stop arrival of the faithful ones and had to take turns in a small team to prevent burnout from taking its toll.
Access to palliative care in the community
Ven. Khamkhian’s temple in Chaiyapum district has a good access to a hospital which provides palliative care services. The team at the hospital also has good palliative care knowledge and does community visits. These factors enabled Ven. Khamkhian to stay at his temple while receiving adequate care all the time.
Even though Ven. Khamkhian has already left his mortal shell, he has imparted the very mortal lessons to us all: how we live is how we die; how being mindful and accepting is a factor in reaching a ‘good death’; how palliative care – a growing and much needed trend in Thailand – respects people’s lives and answers their wishes.