SELECTED REFORM RESPONSA
We should make a distinction between the frail elderly and a goses(a dying individual). Nothing needs to be done for someone who is clearly and obviously dying and whose death is close. At that stage, we may not remove life support systems, but we also need not institute any procedures. There is a long tradition for allowing individuals not only a return to health but also a peaceful death.
Already in Talmudic times, the pupil of Rabbi Judah Hanasi stopped his colleagues’ prayers so he could die more comfortably (Ket. 104a) and one may pray for death(Nisim Gerondi to Ned. 40a). In another instance, a servant stopped the chopping of wood as the rhythmic beat of the axe disturbed the passage of the individual from this world(Seder Hassidim#723).
The chief problem with a goses lies in the final stages when family, medical personnel, and hospitals may not know how to proceed and may fear legal or other consequences. This situation may be helped through some form of a“Living Will ” which would describe the condition under which no further direct medical assistance should be provided. There are problems with the“Liv ing Will, ” too. They have been described and discussed in another responsum in this volume. This is probably the best vehicle we now possess to deal with these issues.
The frail elderly should understand that they may amend or totally reject this document at any time. That is particularly important for individuals in a nursing home who may not have relatives nearby. In this way they will feel in control of their future rather than having the nursing home staff control their lives.
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