Question: In Singapore, there is the option to opt in the Advanced Medical Directive (AMD). ‘Opting in means to refuse in advance any life-sustaining treatment to be used to prolong your life should you become terminally ill and unconscious, and where death is imminent.’ Should Pure Land practitioners opt in?
Answer: This question has no clear universal answer, with the points in section [2] of https://purelanders.com/2015/12/30/important-guidelines-1-before-dying-pure-land-passport-section-4a to be considered.
‘The key consideration is whether such life-sustaining treatment will help or hamper ability to Niànfó well, such as by causing great pain or discomfort (e.g. from CPR by defibrillators or hand, cardiotonic injections). When uncertain, it is best to swiftly and sincerely pray to Āmítuófó for inspired advice, on what best to do. Those who practise Niànfó well in everyday life are likelier to not have prolonged or painful dying processes, which will instead be swifter and less painful or painless. They are even able to depart before any need for life-sustaining treatment.‘
In summary:
[1] Having reasonable life support that offers more time to Niànfó well can be helpful, while an earlier death that forces unprepared entry into the bardo state can be more dangerous. This is so as the person might quickly follow karmic inclinations then, to be reborn elsewhere. (See [2] below too.)
[2] Having unreasonable life support that causes much pain and discomfort can hamper Niànfó, which can be more dangerous. This is so as strong negative emotions provoked might lead to a negative rebirth. (See [1] above too.)
[3] It is difficult to know in advance what emergency one might have, and thus what kind of life support will be offered then, be it [1] or [2], reasonable or unreasonable. If uncertain on deciding in advance now, on whether to have life support or not later, it is best to follow the advice in bold above, for focusing on preventive measures.
Related Articles:
Should There Be Plugging In To Life Support?
https://purelanders.com/2020/12/09/should-there-be-plugging-in-to-life-support
How Long Should One Be On Life Support (With Ventilator & Tube Feeding)?
https://purelanders.com/2020/11/30/how-long-should-one-be-on-life-support
Should Those ‘Brain Dead’ Be Unplugged?
https://purelanders.com/2018/09/04/should-those-brain-dead-be-unplugged
Section [2]: Considerations On Life Support & AMD
https://tinyurl.com/yc22uxdg
How To Urge Family Of Those On Life Support To Offer Guidance And Support-Chanting?
如何劝运用维持生命治疗者的家属开示助念?
https://purelanders.com/2021/04/20/how-to-urge-family-of-those-on-life-support-to-offer-guidance-and-support-chanting