The DSC Triangle Model of Buddhist Palliative Care: Doctrine, Spiritual Pillar, and Community at Wat Kham Pramong

Abstract

This qualitative case study examines Buddhist spiritual care for terminal cancer patients through the case of Wat Kham Pramong in Sakon Nakhon Province, Thailand. It addresses three objectives: to examine how the temple responds to patients’ spiritual needs, to identify the Buddhist teachings and practices relevant to those needs, and to assess the approach’s qualitative impact in terminal care. Drawing on scriptural analysis, narrative review, participant observation, and semi-structured interviews with five care-team informants and five terminal patients, this research article develops the DSC Triangle Model. The model consists of Doctrine, Spiritual Pillar, and Community. Relevant teachings and practices include impermanence (aniccam), suffering (dukkham), non-self (anattā), mindfulness meditation on death (maraṇānussati), Buddho recollection, daily chanting, the herbal medicine and guilt-letter ceremony, and final-day spiritual support. Patient narratives, care-team explanations, and field observations indicate qualitative patterns of movement from fear, resistance, anxiety, unresolved burden, and isolation toward greater acceptance, inner peace, relational connection, and a more meaningful final stage of life. These responses varied according to physical condition, psychological readiness, religious familiarity, family support, and ability to participate. The article contributes a case-derived framework for understanding how Buddhist doctrine, embodied spiritual practice, and community support interact in temple-based palliative care without claiming universal or statistically measurable effects.