End of Life Issues: A Jewish Perspective
An introduction to Jewish attitudes toward life support, ceasing medical care, living wills, and caring for patients in their final days
Essentially, the way forward in this circumstance, and the associated steps taken (for example, whether to inform the patient of their condition truthfully or whether to leave that to the family to decide), will largely depend on the style of Judaism practiced by the patient. It is important to speak to his or her rabbi about the matter or to seek help from a rabbinical authority.
Situations may arise where a patient no longer has control over the course of his or her own death owing to unconsciousness or disability. The creation of a "living will" is a matter open to much debate among various Jewish groups (for example, does this constitute thoughts about suicide, which is also forbidden under Jewish law?).
However, some Reform groups suggest that a living will relieves medical staff and family of the responsibility of making difficult decisions and allows a patient to die in peace. It may be better to discuss this issue with family members if present, or talk to the patient's rabbi if possible, rather than introduce the subject directly to the patient.
The use of life support is regarded in different ways not only by each of the varied Jewish groups, but also as a reflection of the purpose of its use. For example, the use of life support in the case of temporary coma brought on by head trauma or recovery from major surgery would be seen as a good thing that helps to preserve life, because there will be a point in the future when it can be turned off and--hopefully--the patient will resume breathing and circulation functions for themselves.
The situations where the use of life support causes the most trouble are those where the patient has become reliant on the machinery, such that if the machine were turned off, the patient would probably not begin to breathe unaided. Some authorities subscribe to the idea that prolonging this state of supported life when there is no hope of a cure is not the same as attempting to save a life, and so need not be done. However, it is likely that each case will have to be treated on its own merits according to the beliefs of the patient concerned and the wishes of their family.
Where resuscitation would possibly result in the saving of a life, it is imperative that it is carried out--even if that life were to last only a few minutes before death. If efforts have been made to resuscitate a person but no independent signs of life are seen, it is important to make sure that the moment of death is determined according to halakhah [Jewish law], rather than relying solely on brain death as a determinant.
Before death, a Jewish patient will want to see as many of their family and friends as possible, so expect many visitors and make provision for them. Some of these visitors may be Jewish, some may not.
If possible, try to get a family member to discuss arrangements for visitors with you; for example, try to establish whether the visitors will need to be fed. If so, determine whether the family will make provision for the visitors, or whether they wish to purchase kosher food at the hospital. Don't forget to warn the kitchen manager of the need for additional kosher meals to be provided if necessary.
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