Intro to talk on Buddhist Perspectives on Social Justice at event hosted by Interfaith Dialogue Institute (IDI)/Faith Communities in Action Against Poverty (ISARC)/Church of the Holy Trinity

Sean Hillman MA, BA
Doctoral student, South Asian Religions/Bioethics
Department for the Study of Religion
Joint Centre for Bioethics
University of Toronto   

Full talk can be seen here:
Buddhist Perspectives on Social Justice, Sean Hillman (IDI/ISARC interfaith dinner) 

For the sake of brevity, rather than a broad spectrum talk about the various social injustices perpetrated internally within the Buddhist traditions themselves, those social injustices that have Buddhists as their target, and the many ways in which these problems have and have not been addressed by Buddhists and those concerned with their well-being, I will instead briefly zero in on a particular case of a Buddhist death in a Toronto Catholic hospital to highlight some key issues with end-of-life care delivery to diverse patient populations. My ongoing research project has as its object of focus Buddhists, Hindus and Jains of South Asian descent, and as its main concern the unique, religiously-based conceptions of these groups that affect their end-of-life decision-making. Although my upcoming ethnographic fieldwork will be investigating how religious ideas affect end-of-life decision-making of adherents within India, some of the questions that I have asked in my earlier work concern South Asians in diaspora:

• Can South Asians have their religious needs met in end-of-life care settings in diaspora? 
• Can healthcare providers with a different worldview than their patients successfully meet their patients’ religious needs?

I have some current and emerging questions yet to be answered and hopefully something we can discuss during our gathering today:

• Is the term ‘diversity’ a useful one? Here in Toronto we pride ourselves with our incomparable diversity, but does the defining of a patient group as ‘diverse’ actually distance healthcare providers from the ‘other’ that we are caring for? Is such terminology actually an ‘othering’ technique?
• Is it possible for cultural-sensitivity training and diversity education in healthcare to be an overdetermination of the unique needs of certain patient populations?
• Is there a point at which accommodations for unique religious healthcare needs actually begin to impinge on other patients by taking away from their due share of resource entitlements? 

These questions are not comfortable ones, which is that they challenge my own ideas as an academic, as a caregiver and as a Buddhist. Growing up in quite a sheltered Jewish environment, and subsequently being exposed to an almost unlimited number of people of various backgrounds both in hospital and in my travels, I came to cherish diversity. With newly opened eyes, I then also came to directly experience the mistreatment of some patients from diverse backgrounds. Such obvious and undeniable ethical breaches strongly influenced me in the personal, religious and academic spheres of my life to tackle the problems in healthcare delivery to diverse patient populations: not just to point at the difficulties but to attempt to discover and offer solutions as well. I aspire to compile a South Asian Religious Health Ethics Guide to assist those of South Asian descent and those caring for them, and it may well end up being gray literature addended to my dissertation or a separate project. My very recent discomfort with how we address diversity in healthcare, however, has arisen from problematizing my own work. With the distance of time and analysis I could see in retrospect that my deep concern with meeting the religious needs of my patients was at times not totally helpful but was, in fact, troublesome for my co-workers, my patients and their families, and myself as well. I will come back to this point in the narrative of the case study.

    Before I touch on the case study, I wish to say that I firmly position equity in healthcare delivery to diverse patient populations as a matter of justice. From a Rawlsian standpoint, utilising his second principle of justice, we can argue that the requirement of the difference principle to arrange social and economic inequalities to be of the greatest benefit to the least-advantaged members of society can and should include the ill and the dying without a breach in logic. I would even be so bold as to say that the conditions of the fair equality of opportunity principle need not merely refer to access to offices and positions in society, but also to healthcare.

[case study can be found in "A Bioethical Analysis of a Buddhist Death in a Catholic Hospital"]