When a friend is seriously ill
Mahānāma once asked how one lay follower should speak to another who was gravely ill. The answer began not with a teaching on death but with putting the friend at ease — reminding them of their confidence and of the good they had lived by. That order is worth keeping. The suttas also give a reflection to make often — that illness and death will come to me too — as a way of meeting your own fear before you walk in. What the passages do not do is script the visit or override what your friend has asked for. If they do not want to talk about dying, that is theirs to decide. Questions about their illness and treatment are for them and their doctors; you do not need answers to be good company.
What the suttas say
Mendicants, a woman or a man, a layperson or a renunciate should often review these five subjects. What five? ‘I am liable to grow old, I am not exempt from old age.’ A woman or a man, a layperson or a renunciate should often review this. ‘I am liable to get sick, I am not exempt from sickness.’ … ‘I am liable to die, I am not exempt from death.’ … ‘I must be parted and separated from all I hold dear and beloved.’ … ‘I am the owner of my deeds and heir to my deeds. Deeds are my womb, my relative, and my refuge. I shall be the heir of whatever deeds I do, whether good or bad.’ A woman or a man, a layperson or a renunciate should often review this.
The reflection the Buddha asked everyone, monastic or lay, to make often.
Where this stops: Never preached at someone frightened or grieving; owning one's deeds is never a reason to call an illness or a loss someone's kamma.
AN 5.57:1.1–1.9 · Subjects for Regular Reviewing
Pañcimāni, bhikkhave, ṭhānāni abhiṇhaṁ paccavekkhitabbāni itthiyā vā purisena vā gahaṭṭhena vā pabbajitena vā. Katamāni pañca? ‘Jarādhammomhi, jaraṁ anatīto’ti abhiṇhaṁ paccavekkhitabbaṁ itthiyā vā purisena vā gahaṭṭhena vā pabbajitena vā. ‘Byādhidhammomhi, byādhiṁ anatīto’ti abhiṇhaṁ paccavekkhitabbaṁ itthiyā vā purisena vā gahaṭṭhena vā pabbajitena vā. ‘Maraṇadhammomhi, maraṇaṁ anatīto’ti abhiṇhaṁ paccavekkhitabbaṁ itthiyā vā purisena vā gahaṭṭhena vā pabbajitena vā. ‘Sabbehi me piyehi manāpehi nānābhāvo vinābhāvo’ti abhiṇhaṁ paccavekkhitabbaṁ itthiyā vā purisena vā gahaṭṭhena vā pabbajitena vā. ‘Kammassakomhi, kammadāyādo kammayoni kammabandhu kammapaṭisaraṇo. Yaṁ kammaṁ karissāmi—kalyāṇaṁ vā pāpakaṁ vā— tassa dāyādo bhavissāmī’ti abhiṇhaṁ paccavekkhitabbaṁ itthiyā vā purisena vā gahaṭṭhena vā pabbajitena vā.
A carer with five qualities is competent to care for a patient. What five? They’re able to prepare medicine. They know what is suitable and unsuitable, so they remove what is unsuitable and supply what is suitable. They care for the sick out of love, not for the sake of material benefits. They’re not disgusted to remove feces, urine, vomit, or spit. They’re able to educate, encourage, fire up, and inspire the patient with a Dhamma talk from time to time. A carer with these five qualities is competent to care for a patient.
The canon's picture of a good carer — practical, motivated by love rather than gain, not disgusted by the body's needs, and able to encourage.
Where this stops: A description of a monastic carer's competence; it is not medical guidance, and it is not a standard for measuring an exhausted family carer who is doing their best.
AN 5.124:2.1–2.8 · A Carer (2nd)
Pañcahi, bhikkhave, dhammehi samannāgato gilānupaṭṭhāko alaṁ gilānaṁ upaṭṭhātuṁ. Katamehi pañcahi? Paṭibalo hoti bhesajjaṁ saṁvidhātuṁ; sappāyāsappāyaṁ jānāti, asappāyaṁ apanāmeti, sappāyaṁ upanāmeti; mettacitto gilānaṁ upaṭṭhāti, no āmisantaro; ajegucchī hoti uccāraṁ vā passāvaṁ vā vantaṁ vā kheḷaṁ vā nīharituṁ; paṭibalo hoti gilānaṁ kālena kālaṁ dhammiyā kathāya sandassetuṁ samādapetuṁ samuttejetuṁ sampahaṁsetuṁ. Imehi kho, bhikkhave, pañcahi dhammehi samannāgato gilānupaṭṭhāko alaṁ gilānaṁ upaṭṭhātunti.
They meditate spreading a heart full of equanimity to one direction, and to the second, and to the third, and to the fourth. In the same way above, below, across, everywhere, all around, they spread a heart full of equanimity to the whole world—abundant, expansive, limitless, free of enmity and ill will.
Equanimity as the fourth boundless state, spread with the same abundance as love and compassion rather than held back from them.
Where this stops: Equanimity here is without hostility or ill will, not indifference; it is not a technique for going numb in a caring job, and the formula is generic to the four states.
AN 3.65:42.4 · With the Kālāmas of Kesamutta
upekkhāsahagatena cetasā ekaṁ disaṁ pharitvā viharati, tathā dutiyaṁ, tathā tatiyaṁ, tathā catutthaṁ, iti uddhamadho tiriyaṁ sabbadhi sabbattatāya sabbāvantaṁ lokaṁ upekkhāsahagatena cetasā vipulena mahaggatena appamāṇena averena abyāpajjhena pharitvā viharati.
But some of those liable to death are not frightened and terrified of death. Who are those frightened of death? It’s someone who isn’t free of greed, desire, fondness, thirst, passion, and craving for sensual pleasures.
Four reasons people fear death — craving for pleasures, for the body, having done harm, and doubt — which makes fear legible rather than shameful.
Where this stops: This is an analysis, not a reassurance; the fourth cause (doubt about the teaching) should not be used to pressure belief.
AN 4.184:2.4–3.2 · Fearless
atthi pana, brāhmaṇa, maraṇadhammo samāno na bhāyati, na santāsaṁ āpajjati maraṇassa. Katamo ca, brāhmaṇa, maraṇadhammo samāno bhāyati, santāsaṁ āpajjati maraṇassa? Idha, brāhmaṇa, ekacco kāmesu avītarāgo hoti avigatacchando avigatapemo avigatapipāso avigatapariḷāho avigatataṇho.
“Sir, I haven’t heard and learned it in the presence of the Buddha how a wise lay follower should advise another wise lay follower who is sick, suffering, gravely ill.” Mahānāma, a wise lay follower should put at ease another wise lay follower who is sick, suffering, gravely ill with four consolations. ‘Be at ease, sir. You have experiential confidence in the Buddha … the teaching … the Saṅgha … And you have the ethical conduct loved by the noble ones … leading to immersion.’
Mahānāma asks how one lay follower should speak to another who is gravely ill; the first thing is to put them at ease by reminding them of their confidence and their good conduct.
Where this stops: Written for a friend who shares the practice. What follows in the sutta leads the sick person to let go of concern for parents, partner, and children; that is for them to take up, never for a visitor to press.
SN 55.54:1.11–2.7 · Sick
Na kho netaṁ, bhante, bhagavato sammukhā sutaṁ sammukhā paṭiggahitaṁ sappaññena upāsakena sappañño upāsako ābādhiko dukkhito bāḷhagilāno ovaditabboti. Sappaññena, mahānāma, upāsakena sappañño upāsako ābādhiko dukkhito bāḷhagilāno catūhi assāsanīyehi dhammehi assāsetabbo: ‘assāsatāyasmā— atthāyasmato buddhe aveccappasādo itipi so bhagavā …pe… satthā devamanussānaṁ buddho bhagavāti. Assāsatāyasmā— atthāyasmato dhamme …pe… saṅghe …pe… ariyakantāni sīlāni akhaṇḍāni …pe… samādhisaṁvattanikānī’ti.