Does Judaism Believe in the Right to Die?
Traditionalist understandings of Jewish law work to balance preserving life and alleviating suffering.
Fourth, assuming the above three conditions are met, the patient may decline surgery, chemotherapy, and painful invasive treatments but may not decline food, water, or oxygen (which are the normal sustainers of life, the withdrawal of which may be tantamount to murder or suicide). Antibiotics may also fall under the "food" category because they are generally a noninvasive, nonpainful procedure. There is also some question whether tube feeding falls in the category of "food" or in the category of "surgery." Most decisors would place it in the former but emphasize that even if the patient is halakhically obligated to take artificial nutrition, he should not be force-fed or physically-restrained.
In no event may the patient or the physician take any affirmative step that would hasten death. Active euthanasia, regardless of motive, is morally and halakhically equivalent to murder. On the other hand, halakhah would view both the goals and methods of hospice in a very sympathetic light.
Avoiding Living Wills
Judaism thus attempts to strike a balance between the great mitzvah of prolonging life and the recognition that life may become unbearably difficult and painful. The living will, however, which attempts to spell out in advance which treatments should be employed and which should not is too blunt of an instrument to accurately mirror the necessary value judgments. The basis for all of these decisions is the pain and suffering the patient feels at the time of the illness and this can simply not be predicted in advance. Conditions that may seem intolerable to us when we are 35-40 may be quite adequate when we reach 85 and we realize that the alternative would be death.
Keep in mind too that many patients such as those with advanced Alzheimer's or in comas may in fact not be suffering though their existence is undoubtedly a hardship to their families. Moreover, it is almost impossible to spell out all contingencies in advance, making living wills incomplete almost by definition.
Far preferable to the living will is the durable power of attorney (often called a health-care proxy), which simply specifies a person--family member, friend, clergyman-- empowered to make health care decisions on the patient's behalf in the event he or she is incapacitated. The power may in addition specify that all decisions shall be made in accordance with Jewish law and in consultation with a designated clergyman of the patient's choice.
Sample forms--labeled somewhat inaccurately as "Halakhic Living Wills"--have been prepared by Agudath Israel of America, a national organization headquartered in New York. This document insures that decisions will be made consistently with the moral and religious beliefs that the patient holds dear. Obviously, one should discuss these delicate matters ahead of time both with family members and spiritual advisers.
Incapacitation and terminal illness are tragic situations. Let us remember, however, that we come from a tradition that has grappled with these questions and that approaches these issues with sensitivity, compassion, and understanding. Hopefully, none of us will ever be faced with these problems but if we are, let us turn to our tradition for guidance and support.
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