EcoSangha Perspectives: The Medical Model of Buddhism

Buddhism is based on a medical model. This is clearly seen in the Buddha’s first sermon (sutra), “Turning of the Wheel of the Dharma,” where he presents the Four Noble Truths.  

In medical terms, they are: 1) symptom; 2) diagnosis; 3) prognosis; and 4) cure. I have heard it conjectured that these truths may have derived from Indian Ayurvedic medicine and been transmitted to ancient Greece by Buddhist monks, where they formed the basis of Western medical technique. Speculation on origins aside, the Buddha is often referred to as “The Great Physician” whose mission is essentially to identify the cause of pain and suffering (dukkha, Skt.) and bring about a cure.

By comparison, Jesus is also called “The Great Physician,” but only Buddhism is based on a medical model. The Judeo-Christian tradition is based on a legal model: The Covenant (contract law), The Ten Commandments, judgment, reward-and-punishment, are all legal terms.  

Particularly, fundamentalists, who are extremely influential in American politics at present, believe God has a divine plan that is working itself out in history and will be resolved on Judgment Day. Such a belief avoids human responsibility for the environmental crisis since, ultimately, “It’s in God’s hands.” 

The medical model of Buddhism, by contrast, is a path of personal responsibility. There is no God who will intervene to save us from our destructive actions. As Buddhists, we begin our quest for liberation with the experience of “dukkha,” a Sanskrit word usually, and inadequately, translated as “suffering.”  

While suffering is one type of dukkha, the term has a vastly broader meaning, including pain, dissonance, disharmony, etc. Dukkha is related to the English word “disease,” which relates well to our medical model and the often-heard statement, “Mother Earth is sick.”

Mother Earth is not just mildly sick, but is in distress, adding a great sense of urgency to the First Noble Truth of symptom. The cause of the crisis, the diagnosis, is generally obvious to anyone paying attention to environmental science and is extensively written about and broadcast in documentaries and the news. The major source of disagreement I’ve seen regarding the cause of the crisis is the role of overpopulation, a topic I intend to write about in a future article.

The Third Noble Truth, prognosis, directs us to the issue of sustainability, meaning the adoption of a lifestyle where all beings live in harmony with the resources of the Earth.  

The “Earth Charter,” adopted in The Hague on June 29, 2000, states, “As never before in history, common destiny beckons us to seek a new beginning …. Let ours be a time remembered for the awakening of a new reverence for life, the firm resolve to achieve sustainability, the quickening of the struggle for justice and peace, and the joyful celebration of life.” (Pope Francis’ “Praise Be to You” pages 139-140).   

The issue of sustainability was adopted in recent years by the United Nations and constitutes the basis of its Sustainable Development Goals, which are a collection of 17 interconnected global goals designed to achieve a more sustainable future for all by 2030.

As for the prognosis for Mother Earth, I believe we must think a cure is still possible. Otherwise, there is no point in going on to the Fourth Noble Truth — the cure. Normally, the Fourth Noble Truth is presented as the Eightfold Path. I agree with many scholars who believe the Eightfold Path was added to the Four Noble Truths at a later date. Being practice-oriented, the Eightfold Path is not emphasized in our Jodo Shinshu tradition.

However, all Buddhist schools, Jodo Shinshu included, adhere to the basic medical model.  

If we examine the Fourth Noble Truth, cure, from a Shin perspective, it takes us back to the BCA EcoSangha Resolution adopted in 2015:  “BE IT RESOLVED that each BCA temple be encouraged to adopt policies that promote an awareness of the profound implications of our behavior on future generations and to promote ecologically friendly behavior in the spirit of ‘mottainai.’”  

This is why I have been writing so much about the meaning of mottainai — in order to get a visceral sense of what it means, for with the spirit of mottainai we get a healthy dose of environmental medicine: humility, reverence, harmony, self-restraint, sustainability, etc. We can’t do everything. We can’t even do much, but we can do our part. Remember, the cure is contagious.