Two Jewish Views on End of Life Issues

The Conservative movement validates two opinions on ceasing medical treatment for terminally ill patients.

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d. Jewish law includes permission for the patient to refuse any treatment he/she cannot bear, including forms of therapy which, though life-sustaining, the patient judges not to be for his/her benefit.

e. Terminally ill patients may choose hospice or home care.

f. A patient may reject CPR and/or issue a DNR [Do Not Resuscitate] order when these measures are unlikely to restore the patient to meaningfully healthy life.

g. Pain medication may continue even if its probable effect is to hasten the patient's death.

(Teshuvahby Rabbi Elliot Dorff: http://www.rabbinicalassembly.org/teshuvot/docs/19861990/dorff_care.pdf.)

Rabbi Reisner's Position

The critical category for dealing with terminally ill patients is the goses [a halakhic designation for a terminally ill patient expected to die within 72 hours].

a. That which is of the body, of natural function, should be allowed to function. Thus, the withholding or withdrawing of medication, nutrition, or hydration is prohibited, so long as they are believed to be beneficial for the prolongation of life. That which is not of the body, but rather which mechanically reproduces, supersedes or circumvents the body's functions (for example, respirators, mechanical pumps, blood purifiers), may be removed as an impediment to death.

b. Feeding tubes may not be removed from those in persistent vegetative states, as they are not terminally ill.

c. The patient has autonomy to choose between treatment options in a situation where risk and uncertain prognosis exist. If, however, a particular treatment guarantees a cure, it may not be refused. The only choice which is barred is the choice to die.

d. Terminally ill patients may choose hospice or home care.

e. A patient may reject CPR and/or issue a DNR order when these measures are unlikely to restore the patient to meaningfully healthy life.

f. Pain treatment should be pursued, but pain medication must be capped at that point at which its probable effect would be to hasten the patient's death.

(Teshuvah by Rabbi Avram Israel Reisner: http://www.rabbinicalassembly.org/teshuvot/docs/19861990/reisner_care.pdf.)

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