Hastening Death vs. Letting Death Come
When it's acceptable to use a "living will" to end treatment of terminally ill patients
The following is a responsum (rabbinic ruling on Jewish law)of the Reform movement's rabbinical body, the Central Conference of American Rabbis. It differentiates between situations when ceasing treatment is considered euthanasia or assisted suicide--and therefore unacceptable--and those times when a patient is considered already dead and life support may be removed. The piece also deals with the special case of a person in a "persistent vegetative state"--in a coma-like situation without brain death--where a living will is particularly helpful to guide treatment decisions. Reprinted from the Central Conference of American Rabbis.
QUESTION: What is the Jewish attitude toward a "living will"?
ANSWER: The "living will" provides a legal method for terminating life support systems in the case of individuals who are dying because of serious illness or accident. The pain of family members or friends in comas over long periods of time and in a "persistent vegetative state" while attached to life preserving machinery has led to the consideration of such documents. At that juncture often no one will agree on what should be done. In some occasions the courts have intervened; in others eventually a family member or physician intervenes, but at the risk of subsequent legal action.
Those who wish to spare their family from this agonizing decision may decide on a "living will," a form frequently used with a proxy designation statement reads as follows:
Living Will Declaration
To My Family, Physician and Medical Facility I,_______________, being of sound mind, voluntarily make known my desire that my dying shall not be artificially prolonged under the following circumstances:
If I should have an injury, disease or illness regarded by my physician as incurable and terminal, and if my physician determines that the application of life-sustaining procedures would serve only to prolong artificially the dying process, I direct that such procedures be withheld or withdrawn and that I be permitted to die. I want treatment limited to those measures that will provide me with maximum comfort and freedom from pain. Should I become unable to participate in decisions with respect to my medical treatment, it is my intention that these directions be honored by my family and physicians(s) as a final expression of my legal right to refuse medical treatment, and I accept the consequences of this refusal.
Designation Clause (optional*)
Should I become comatose, incompetent or otherwise mentally or physically incapable of communication, I authorize ___________________, presently residing at ________________________ to make treatment decisions on my behalf in accordance with my Living Will Declaration and my understanding of Judaism. I have discussed my wishes concerning terminal care with this person, and I trust his/her judgment on my behalf.