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Zazen is the essence of mind as is...
Harada Roshi

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If before dying we take medicine to reduce pain and unsettledness will there be any negative karma to follow if we are not clear at the moment of departure?

Enlightenment is the clarification of one's existance. Realizing the source of the universe. If it is a matter of information, anyone could understand. But the root of awareness is not reached this way. So the awareness stays confused. Medicine paralyzes the awareness. It is a matter of whether at that moment there is belief in the truth or not.

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