The following article explores from an Orthodox perspective issues relating to living wills and the right to die. The author describes the need to balance between two Jewish priorities: preserving life and alleviating suffering. The author ultimately opposes as too broad the idea of a living will, as the term is usually used: a document instructing doctors in advance on whether to proceed with treatment in certain situations. Instead, he advocates “health care proxies” that would designate someone else to make decisions in accordance with Jewish law on behalf of the patient. Reprinted with permission from JLaw.com.
American society has increasingly come to recognize what is known as the “right-to-die”. In the famous Cruzan case, the Supreme Court of the United States in a 5-4 decision ruled that a patient who has clearly communicated his or her wishes regarding the use of life support machinery or the provision of hydration and nutrition has a constitutional right to have those wishes respected even if the patient is not suffering from a terminal condition….
Under a recently-enacted federal law, persons entering hospitals or nursing homes must be informed of their rights to execute living wills or other advance directives spelling out ahead of time that certain medical interventions should not be employed. What does the Jewish tradition say about these matters? Does halakhah [Jewish law] take positions on advance directives? Does Judaism recognize a right to die?
Briefly stated, the Jewish tradition rests on a number of assumptions:
1. The preservation of life [pikuah nefesh] is considered to be of paramount importance, surpassing virtually all of the other commandments of the Torah. One may and must violate Yom Kippur or the Sabbath, eat non-kosher food, etc. if there is the slightest chance that human life may be preserved or prolonged.
2. The quality and/or duration of the life being saved is irrelevant. Life is of infinite, not relative, value and mathematically, any fraction of infinity must also be infinite. Once life is assigned a relative value–once we start making judgments as to which lives are worth living and which are not, once we assign value to people because of what they can do instead of what they are we have demeaned the intrinsic sanctity of existence for all human beings and have embarked on a dangerous exercise of line drawing. What about the elderly, what about the severely retarded, what about the handicapped: Are they any less human because their productivity is impaired?