In Instistent Life: Principles for Bioethics in the Jain Tradition, authors Brianne Donaldson and Ana Bajželj provide the first in-depth examination of how Jain religious principles might inform and contribute to ongoing bioethical debates and discussions. As the authors point out in their introduction: “Considering the rich history of Jain encounters with the dilemmas of birth, life, and death, the absence of a book on Jainism in relation to contemporary bioethical issues presents a significant gap in both the fields of bioethics and Jain studies” (1).
In filling this gap, the authors divide the book into two sections. The first, “Foundational Principles,” comprises, essentially, chapters 2 through 4 (the first chapter is introductory). In this section, the authors “explore foundational Jain principles for bioethics based on rigorous analysis of primary sources and available secondary literature” (1). Chapter 2 addresses the distinction in Jainism between life and non-life; the complex workings of karma in determining embodiment; and the taxonomy of possible embodied births within world of perpetual rebirth and re-death. Chapter 3 is a complicated, impressively written piece on its own, focusing on the broad topic of Jain ethics and, more specifically, definitions of right conduct.
Among the chapters in part 1, though, chapter 4, “Jainism’s Evolving View of Medicine,” stands out. Drawing on an extensive array of premodern primary sources, Donaldson and Bajželj provide impressive accounts both of Jain theories as to the cause of disease, both physical and mental, and also of the changing views of Jain mendicants towards caregiving and medicine. While the earliest strata of Śvetāmbara canonical literature largely encourages a mendicant to suffer the pain of illness and rejects the use of medicine as inconsistent with their total abandonment of the body, the authors demonstrate how these views soften in later canonical texts and throughout the medieval period. This leads, Donaldson and Bajželj argue, not only to medical care being condoned and encouraged for mendicants, but also to an eventual duty that mendicants will care for their sick fellows. Donaldson and Bajželj also theorize that this softening occurred because of the evolving character of mendicancy itself: “Taking care of sick mendicants seems to be one aspect of a broader restructuring of the rules of proper conduct…which could be interpreted as reflecting the growth/stabilization of the Jain mendicant community, as well as a concern for its unity” (89). As Donaldson and Bajželj point out, Jain attitudes towards medicine have received little scholarly attention to date, making this chapter’s specific intervention all the more important.
Chapters 5 through 7 make up part 2 of the book, titled “Principles of Application.” The chapters in this section “provide basic overviews of modern bioethical issues and explore Jain principles of application for these dilemmas” (8). These chapters cover topics related to the entire spectrum of human life: nascent life, including abortion, contraception, IVF treatment, cloning, stem cell research, sex selection, and genomic editing; modern medical issues, including surgery, antibiotics, and vaccinations; and bioethical dilemmas surrounding death, including medical definitions of death, organ donation, suicide, euthanasia, physician aid-in-dying, and the voluntary refusal of sustenance. In addressing each topic, Donaldson and Bajželj draw on a wide range of premodern and modern Jain sources, the most thought-provoking of which is the international survey of Jain medical professionals that the authors conducted in 2017. The survey methodology and respondent demographics are introduced in chapter 5, and the results of the survey are interwoven into discussions of each topic. These data reveal the vast diversity of opinions that Jain medical professionals hold with respect to different bioethical issues. The qualitative responses that Donaldson and Bajželj include are oftentimes the most enlightening data, as they demonstrate how Jain individuals draw on diverse resources to conceptualize and speak about their religious beliefs in conversation with their medical training.
The book concludes with a short epilogue, “Multiple Voices and Future Directions in Jain Bioethics.” Here, as the title suggests, Donaldson and Bajželj provide avenues for future research on Jainism and bioethics. These include a more robust examination of how Jain laypeople think about bioethical issues and the possibilities of situating Jain attitudes towards bioethics in conversation with other South Asian religious traditions and sources. In the closing sentences of the work, Donaldson and Bajželj remind the reader of one of the book’s main goals: Insistent Life is not meant to provide a prescriptive account of Jain bioethics; rather, it aims to account for the diversity of Jain thinking about bioethical issues, both historically and in the present day (214).
Insistent Life is an exciting and thought-provoking contribution to the field of Jain studies, particularly because it draws on an impressive array of sources to think about how a minority religious tradition many thousands of years old can (and should) participate in modern, complicated debates about human life. Many of the topics covered in the book are particularly timely at the current moment, given ongoing debates in the United States around issues that intersect with medicine, bioethics, and religious freedom. Furthermore, Donaldson and Bajželj demonstrate how central Jain tenets like ahiṃsā, non-harm, are not as simple and straightforward as they may first appear. In application to modern bioethical issues, these principles become sites of reinterpretation and renegotiation; religious beliefs and commitments, of course, participate in and contribute to larger modes of thinking about the complexities of human life. Specifically, by examining the historical roots and contemporary applications of Jain principles to modern bioethical concerns, Donaldson and Bajželj highlight the “cumulative” nature of Jainism as a diverse religious tradition, in contrast to decades of scholarship that prioritized portraying Jainism as monolithic and anathema to change.
Further, while the present reviewer is admittedly no specialist in the field of bioethics, it is clear that Insistent Life makes important contributions to that discipline as well. Donaldson and Bajželj point out in their introduction that “bioethics as a discipline has been pivotally shaped by enduring philosophical and religious insights that exceed the spheres of science and technology alone” (5). Integrating the rich diversity of Jain religious thought into this discussion should be, I would hope, a welcomed step forward in the field. Furthermore, through their international survey, Donaldson and Bajželj model a method for accessing how religious attitudes influence considerations of contemporary bioethical concerns.
Gregory M. Clines is assistant professor in the Religion Department at Trinity University
Gregory Clines
Date Of Review:
June 30, 2022