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In the wake of the globalization of modern Western biomedicine and bioethics, Buddhists felt the need for moral action-guides that provide orientation in ethical dilemmas posed by modern biomedicine. Thus, in the 1980s, Asian Buddhists began to develop distinct Buddhist moral action-guides on issues of selective abortion, stem cell research, genetic enhancement, brain death and organ transplantation from brain-dead donors, and physician-assisted suicide. From the 1990s onward, they were joined by a growing number of Western scholars. Buddhist ethicists emphasize the importance of starting from venture points considerably distinct from Western bioethics: Firstly, they are traditionally less concerned with human dignity and human rights. Instead, with a focus on salvific cultivation, karma, and nonviolence, they predominantly reflect the moral quality of the actor’s intentions, leading to additional suffering in this life or the next. Secondly, bioethics, in harmony with Buddhist ethics in general, is understood as moral cultivation, which puts less emphasis on justification of ethics than on the quality of actual actions. Thirdly, on the one hand Buddhist bioethical reasoning includes aspects such as the harmful “self-centeredness,” while on the other hand it declares compassion to be the core value, including an awareness of the universal interdependence of all forms of sentient existence. In the 1980s, pioneering scholars of Buddhist bioethics Shōyō Taniguchi and Pinit Ratanakul began to outline ethical foundations of Buddhist bioethics. While both suggested that Buddhist ethics are in principle capable of providing orientation in all forms of bioethical dilemmas, their approaches differed considerably, for example regarding the duty of doctors to disclose fatal diagnoses. Dissent on this duty, which is emphasized by Ratanakul but relativized by Taniguchi, reflects not only cultural differences but also the latter’s inclusion of Mahāyāna Buddhist ethics of the bodhisattva’s “skillful means.” Based on a famous Western approach, Ratanakul was the first to outline a system of four principles or duties of Buddhist bioethical reasoning: veracity, noninjury to life (ahiṃsā), justice, and compassion (karuṇā). However, it was a Western scholar, Damien Keown, who in 1995 presented the first book-length treatise to cover almost all major bioethical issues, from embryo research to euthanasia for the terminally ill. Keown argued for a neo-Aristotelian virtue-ethics approach and distilled three basic goods from Buddhist canonical texts. This helped to modernize and transform Buddhist ethics into an operational system of Buddhist bioethics. It is argued that there is an equivalent to human dignity in Buddhism, namely the infinite capacity to participate in goodness, or the potential to reach buddhahood. In this vein, the function of human rights lies in providing a suitable environment for individuals to gradually realize this potentiality. Well into the new millennium, more works on Buddhist ethics appeared in which Western scholars of Buddhism included Tibetan Mahāyāna ethical reasoning (Karma Lekshe Tsomo), reconstrued Buddhist ethics as consequentialism (Charles Goodman), or explored the global variety of Buddhist ethical reasoning (Peter Harvey). Probably the most important contemporary controversy in Buddhist bioethics pertains to the question whether killing out of compassion can in certain circumstances be justified. According to a traditional evaluation of cetanā (intention), it has been argued that the intention to kill cannot coexist with a compassionate intention, whereas others concluded that in regard to both embryonic life and the treatment of terminally ill patients there is room for ethically justifiable options. During the 2010s the global as well as Buddhist discourse on bioethics saw a certain consolidation, but will likely gain momentum again—for example, should genome-edited babies become common practice.

Tibetan medicine, also known as Sowa Rigpa (gso ba rig pa, the art, or knowledge of healing), has had a long and illustrious history, which has been intertwined with Buddhism in various aspects. It has been taught and practiced along with Tibetan Buddhism in areas that encompass the TAR (Tibetan Autonomous Region, since the mid-20th century part of China), areas of mainland China (Sichuan, Gansu, Qinghai, Yunnan), Ladakh, Nepal, Bhutan, Mongolia, and Buryatia (south Siberia, Russia). It is also practiced in India, particularly among the Tibetan exiled community, and in various parts of Europe and the United States.