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
The following article, written for hospital or hospice workers, is primarily geared to educate them about end-of-life issues for Jewish patients. As such, it also provides an introductory overview of Jewish attitudes toward ceasing medical care for terminally ill patients, living wills, and other issues of Jewish medical ethics. Reprinted with permission from Ethnicity Online, a website with resources about medical care of people of different religious and ethnic groups.
Dealing with death is always a traumatic time for patients and their family. Medical advances made within the past 50 years or so have created situations that were never thought of at the time the Torah became the basis of Jewish law, and so there are some situations associated with the processes of death and dying that may not have clear resolutions. It is strongly suggested that when dealing with terminal illness, life support, organ donation, and the potential for resuscitation that the advice of a rabbi skilled in Jewish medical ethics is sought and that matters are then discussed with the patient and family as early as possible. However, it is also necessary to show great sensitivity at this time and respect the wishes of patient and family, whatever they might be.
Jews have a responsibility to accept medical treatment when there is a possibility of treatment saving their life. However, opinion becomes divided about whether treatment artificially prolonging life falls under this therapeutic category and therefore whether a patient has an obligation to accept such treatment.
Before death, a patient may fall into the category of being a goses. During this state, no action can be taken that will either hasten or delay death, and so, medically speaking, no treatment may be started to delay death and no treatment may be stopped if it would hasten death. Exactly how this translates into medical care may need to be discussed with the family and a rabbi; dealing with the death of a Jewish patient can be a complex affair.
The diagnosis of a terminal illness brings with it some complications in terms of medical treatment. If a treatment holds out hope of a recovery, or an extended period of life (that is, life that would not be possible if treatment was not given), then most authorities agree that a Jewish patient has a duty to accept the treatment. However, if the illness has advanced to the state where no cure is possible, then opinion becomes divided about whether the acceptance of pain relief, life support, nasogastric feeding and other treatments is obligatory. The issue of "quality of life" is not as important as the requirement to preserve life for as long as is possible without heroic efforts.
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