Thursday, October 28, 2010

Is There a "Right to Die" In Judaism?

Euthanasia has always been one of those tricky situations in biomedical ethics. The Religious Right purports that permitting euthanasia would cause a slippery slope from voluntary euthanasia to involuntary euthanasia that would erode the intrinsic value of life. Whether it is rationing health care to the elderly or worries of kin using it as a means to acquire an inheritance, the Religious Right does have some valid worries. On the other hand, what do you do when someone is in such excruciating pain and nothing can be done? What do you do when someone is so debilitated that they will never recover from what they have and can never function without the usage of machinery and feeding tubes?

This question becomes all the more important for me when questioning the notion of being “created in G-d’s image.” If being “created in His image” denotes potential to be actualized, whether that would be in terms of intellectual cultivation or doing good deeds, and you are bedridden with something such as persistent vegetative state (PVS), does that mean you no longer are “created in His image?” The question of whether a human being can be [or become] nothing more than an animal in a human body can be applied to other issues of life, including abortion and the death penalty. Although going into further detail on this would be beyond the scope of ascertaining whether euthanasia is permissible in Judaism, I still think it holds bearing on how we define the meaning of life and whether life is intrinsically valuable or not.

In Judaism, there are some traditional values that would make euthanasia prohibited. That would first be pikuach nefesh, the preservation of life. With few exceptions, saving another life surpasses all other mitzvot.  As the Mishnah teaches, "Whoever saves a single life, it is as if he has saved an entire world (Sanhedrin 4:5)." The second is that many in Jewish thought view life with infinite, as opposed to relative value. The third is that we are not in control of our bodies; G-d is (Ezekiel 18:4). This would negate unlimited personal autonomy. This notion keeps in mind that ethics is not about what one can do, but rather what one should do. The fourth value is that Judaism recognizes that technology and scientific advancement are gifts of divine revelation, thus rejecting the notion that “we are not supposed to play G-d.”

This would come off as an open-and-shut case, except like most things in life, it’s not. We forget the “other side’s” concern of unimaginable pain, which would bring in the mitzvah of alleviating pain and suffering. Now would be a good time to distinguish between active and passive euthanasia.

Active euthanasia is the accelerated causation of death, which usually entails the use of lethal substances or forces to kill. In many cases, this is done by a physician. Active euthanasia is the most controversial, and thus the most heavily debated form. Passive euthanasia, on the other hand, is the withholding of common treatments to prolong one’s life. Examples of passive euthanasia would be refusal of chemotherapy or not carrying out a life-extending operation.

Although other ethicists might debate the merits of the “mercy” involved behind active euthanasia, Judaism is unequivocally against it. Judaism’s stance against active euthanasia is rooted in the belief that the body is G-d’s possession because He created and thus owns everything in the universe. There are so many laws on the books that teach us the importance of preserving health and life. Short of the three exceptions of martyrdom, those being murder, idolatry, or sexual immorality, one should prolong one’s life as possible.  In short, active euthanasia would be either considered suicide [if performed by the patient] or murder [if performed by the doctor].  The Talmud (Shabbat 151b) states that it is forbidden to close the eyes of a dying person.  It is akin to "touching the dying flame of a candle, and thereby extinguishing it," and "one who does so is regarded as a 'shedder of blood.'"

For further description on the matter, please consult R. Elliot Dorff’s teshuva on the topic of assisted suicide in the form of active euthanasia. Not only does he adequately explain the mainstream Jewish stance, but he also discusses the importance of developing community and the mitzvah of bikkur cholim, visiting the sick.

As for passive euthanasia, we’ll have to save that for another time…………

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