PETER KNOBEL
a considered way. Assisted suicide and voluntary active euthanasia require permission first from the person wishing to die and those who are expected to assist or perform the act. Therefore, they allow and require elaborate procedures to assure the act is consistent with one’s understanding of the sacred quality of their personhood. One of the most difficult aspects of permitting acts of killing is to assure that they are in fact voluntary and in keeping with the total biography of the person. This requires the sustained involvement of a physician, who knows the patient well, consultation with family members and a rabbi, who has had serious conversations with the individual.* The patient’s case needs to be presented to a panel of physicians who must agree on the medical facts involved and, from a Judaic perspective, a Bet Din should also be convened.” These are limitations on the autonomy or self-determination of the patient as there is also an important community interest in preserving life. The issues of informed consent and competence are very important. Advance directives can play a significant role as they are supposed to instruct medical professionals and enable surrogate decisionmaking, and they would also constitute a part of the aggadic record which is essential to the covenantal approach. Such documents, in addition to the legal forms, ought to be like ethical wills which describe the person’s most important values. It is our goal to provide a comprehensive picture based not just on persons as patients or when faced with a terminal illness but when they were best able to express themselves.
My suggestion has a number of common elements with the following procedure which Brock recommends before a patient would be allowed to terminate life or be assisted in the endeavor.
1. The patient should be provided with all relevant information about his or her medical condition, current prognosis, available alternative treatments and the prognosis of each.
2. Procedures should ensure the patients’s request for euthanasia is enduring(a brief waiting period could be
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