PETER KNOBEL
35. I wish to emphasis that the use of word"killing" is deliberate. We must always be aware of the moral seriousness of a decision to terminate human life. While Jewish law and many ethicists make a moral distinction between killing and allowing to die, I am convinced that first of all, in many cases, the distinction is not really clear, for example, the notion of double effect where one gives pain medication in sufficient doses to relieve pain but at the same time one actually hastens death. Since the intent was the relief of pain, not Killing the patient, it is morally permissible, but giving a deliberately lethal dose of the pain-killer is ethically wrong. The concept of shev v’al 1a’aseh(sit and do nothing) requires re-examination.
36. Abortion raises a number of the same issues. While the status of the fetus is not that of a nefesh "juridical person," it is clear that its status as a potential life is not morally trivial. Most authorities limit permissible abortion to cases where there are direct or indirect threats to the mother’s life or health. Where authorities permit the abortion of a severely handicapped fetus, it is done for maternal reasons. It is the mother’s quality of life which is at stake. Some liberal authorities have argued that a severely impaired fetus has a right not to be born. The danger of the slippery slope exists in these cases as well where perfection is seen as the ideal. How much handicap is sufficient to waive the fetus’ right to be born? I always think about a wonderful young man in my congregation with Downs Syndrome who is one of the sweetest people I know and a young boy who is profoundly deaf. In spite of some limitations they bring great joy and beauty to the world.
37. Capital punishment is a case in point. It is clear that both the Torah and later rabbinic literature permit capital punishment. The judicial restrictions against enforcement, which develop mostly after Jewish courts no longer have the authority to impose capital punishment, make it clear that even killing a guilty person is not done without some moral reservations.
40. Avram Reisner in his response to Elliot Dorff in describing natural death, indicates how far, in many cases today, we are from such a concept, and, therefore, places certain mechanical devices such as heart-lung machines, respirators, dialysis machines and some transfusions in the category of "impediments to dying". He, like most Jewish authorities, wants to maintain the ethical distinction between removing impediments to dying and killing. There is a danger here that such a way of thinking will in fact dilute the moral seriousness of these issues.
What constitutes natural death? The cessation of the integrated biological functioning of an organism due to natural causes. Perhaps surprisingly, all deaths have one proximate cause- the deprivation of oxygen to the cells. The mechanisms that lead to a shortage of oxygen and the death of a cell may differ considerably, but whether the heart ceases to circulate the blood due to mechanical failure or whether the lungs cease to maintain the oxygen levels in the blood or whether either of these follow upon a breakdown of instructions from the brain stem(brain death as it must be defined by the
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