SUICIDE, ASSISTED SUICIDE, ACTIVE EUTHANASIA

condemned. If we are to view condemned criminals as our neighbors and compassionately provide them with a rapid and non-humiliating death, what, then, is our obligation to innocent life which is suffering terrible pain and a humiliating death?®

INSTITUTIONAL AND SOCIETAL SAFEGUARDS

The model for modern medical care, as it is increasingly practiced and as it ought to exist ideally, is shared decision-making.” Patients have the right, in consultation with competent medical authorities, to determine their own course of treatment. In Judaism great weight is given to the preservation of health and seeking cures for illnesses and preserving life. Medical expertise is highly respect and is to be followed except for good and sufficient reasons.

Suicide represents a special problem because most suicides are depressed.” There are those who argue that there is no such thing as rational suicide. In addition, there is the legitimate concern that if permission is granted to terminally ill patients to commit suicide, others not terminally will be more likely to commit suicide or that people who are old and infirm will feel that they must"do the right thing" and take their own life. My plea with respect to suicide is that we place it in the category of"decriminalization" or, in halakhic terminology, placed into the category lekhathilah- bediavad(an act not valid in the first instance but valid after the fact). Decriminalization rather than legalization® is my preference. There is a difference between"may" and"should". I wish to maintain a negative presumption which must be overridden. We must maintain a strong preference for life over death. On the other hand, this will enable us to be more compassionate in our assessment of those who believe that their impending death should be a mitah yafah which Rashi defines as speedy with a minimum of humiliation. By rethinking our attitude we in fact might find that we are given an opportunity to explore the meaning of life and therefore of death with the terminally ill. If we are serious about self-determination as a characteristic of being b’tzelem elohim, then we must find ways to help make mortal choices in

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