MARK N. STAITMAN
withdrawing of nutrition or hydration from patients in a persistent vegetative state. If such a patient were in need of a respirator, or had been placed on a respirator, traditional Judaism would permit withholding the use of the respirator(and Moshe Tendler has devised a way for withdrawing the use of an already placed respirator). The reason for the difference between the permissibility of withholding artificial means of respiration and artificial means of nutrition and hydration has to do with the theological understanding of breathing as opposed to eating and drinking. Breathing is understood as a basic criterion of life. It is God ’s"breathing the breath of life" into Adam HaRishon which gives life to all humanity. The inability to sustain respiration independently indicates the inability to live. The respirator does not sustain life, but delays death. It has much the same status as the chopping sound which prevents the goses from dying. Removing the sound allows the individual to slip into that peaceful blissful sleep.’
While the natural course of events is that one ceases to breath and thus is dead, this is not the case with nutrition and hydration. The inability to eat or drink is not a criterion for determining death. Depriving one of the artificial induction of nutrition and hydration is understood as taking positive steps to kill an individual, not allowing death to occur.
Finally, specifically addressing the issue of intravenous feedings for terminally ill patients, Rabbi Feinstein says that"for an incurably ill patient who had difficulty breathing, I have already stated that one must give him oxygen to relieve his suffering. It is also clear that such a patient who cannot eat normally must be fed intravenously, since such feeding strengthens the patient somewhat even if the patient does not feel anything,(i.e., is comatose). Food is not at all comparable to medication, since food is a natural substance which all living creatures require to maintain life."®