PETER KNOBEL
to die. If the physician attempts actively to hasten the death, that is against the ethics of Jewish law. In the case described, the term used in the question,‘hasten death,’ is perhaps not correct, or at least should be modified. The physician is not really hastening death; he has simply ceased his efforts to delay it." American Reform Responsa, p. 260 Finally in a 1980 responsum Walter Jacob and the CCAR Responsa Committee state,"We would not endorse any positive steps leading toward death. We would recommend pain killing drugs which would ease the remaining days of a patient’s life. We would reject any general endorsement of euthanasia, but where all‘independent life’ has ceased and where the above mentioned criteria of death{sic. brain death} have been met further medical support systems need not be continued."
In a number of cases we may be dealing with a semantic difference between the concept of"doing" and"allowing to happen." A fundamental question remains, if we can relieve suffering for a terminally ill patient who is aware that this will kill him/her and grants permission is this an immoral act? Is there any moral difference between not starting a respirator or removing a respirator? Do we show greater respect for the sanctity of human life in permitting continued suffering or eliminating that suffering at the authorized request of the sufferer?
24. 1 have avoided offering a definition of terminal illness. For my purposes a terminal illness is one which inevitably lead to death and for which medical treatment has been exhausted. Progressive chronic diseases such as Alzheimer’s disease raise important questions. They rob people of their personhood and their ability to function independently. Is dementia pain for the demented or only for those who love that person? I am particularly sensitive to people with AIDS. (See Yoel H. Kahn’s sermon Choosing the Hour of Our Death" CCAR Journal forthcoming). I am opposed to involuntary euthanasia as a violation of the sanctity of human life. A person has a right not to be killed. That right might be waived. I am sympathetic to those, who faced with such a diagnosis, have chosen to end their life. However, the major thrust of this paper concerns those for whom death is certain and pain intractable. Pain management is an art and one at which physicians have become more adept which increasingly relieves the suffering of the dying. I believe the human will to survive and cling to life will limit the number of people who will choose death. However, choosing to die rather than suffer the loss of one’s personhood can be a moral act.
25. As anyone who had studied both recent responsa and medical ethical literature knows the question of what constitutes biological life is much debated. Robert M. Veatch"The Impending Collapse of the Whole-Brain Definition of Death Hasting Center Report 23,#24, 1993, pp. 18-24. Fred Rosner Modern Medicine and Jewish Ethics, New York , 1986, pp. 241-254.
26. Mishneh Torah, Hilkhot Yesodei Ha-Torah 4:8 See Jacob Neusner , The Glory of God is Intelligence, Salt Lake City , 1978 p. 2ff.
27. Irving Greenberg ,"Toward a Covenantal Ethic of Medicine" in Levi Meir, Jewish Values in Bioethics , New York , 1986, pp. 124-29.
Born and A time To Die, p. 128. Kass argues very strenuously here and in his"Is There a Right to Die?" Hasting Center Report, Vol. 23,#1, January-February, 1993, pp. 34-43, against the concept
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