SURGERY AT NINETY-SIX Walter Jacob

QUESTION: A ninety-six-year-old woman who lives in a nursing home has recently been informed that severe hardening of the arteries necessitates the amputation of her foot. As a result of the shock of hearing this news, she has become severely disoriented. Her family was subsequently advised of her situation and several alternatives were presented. She may submit to amputation with a chance that her condition will be permanently corrected. However, there is no assurance that she may not die during surgery or soon thereafter. Furthermore, her other foot may be similarly affected, or her rehabilitation may not be successful. The alternative is a slow and painful death which can be partially relieved by sedation. The family wants the mother to make the decision. She refuses to sign the release for surgery. But as her lucid moments are brief, it is not clear whether that is what she actually wishes. Should there be surgery or should matters simply be allowed to take their course?(Rabbi , Illinois )*

ANSWER: We shall look at both the traditional and modern components of this question. Rabbinic tradition from Talmudic times onward has encouraged the utilization of all possible medical procedures for life threatening situations. Sanhedrin(23a) advocates this direction on the basis of"you shall not stand idly by the blood of your fellow"(Lev. 19.16). Baba Kama(85a) bases itself on"he shall cause him to be thoroughly healed"(Ex. 21.20). There are other parallel passages In which the citations are a little less clear. Nahmanides ,(13th century) in his commentary on Leviticus 25.36("and your brother shall live with you"), followed this path, earlier proposed by Hai Gaon (10th century). Yehuda Lev Zirelson(20th century) applied this line of reasoning to less dangerous, non-life threatening situations(Teshuvat Atzei Levanon#61). The general principle that medical intervention is to be widely used has thus been established.