Jewish Law Responds to American Law 163

and the soul was then given the opportunity to flee the body and find rest.*® Other rabbinic authorities assert that no effort can be withheld from attempting to prolong life. To emphasize the importance of this principle, it is stated that even the sanctity of the Sabbath may be desecrated in order to preserve a life.’ With the exception of the three immoral and heinous infractions of murder, idolatry and sexual offenses, preservation of life takes precedence over all other Jewish principles.’'’ Until very recently the attitude of both orthodox and liberal rabbis was that termi­nation of treatment was not permitted.*'The exigencies of mod­ern life and the pressures created by new medical technologies have caused some modification in the thinking of some rabbis. A reform rabbi asks the fundamental questions when he speculates about those who would choose the hour of their own death. “Increasingly, the time and circumstances of death are no longer entrusted either to chance or to God ; unlike every age before, people are planning, preparing, and controlling the circum­stances of their death.’ Equally, there are those who doubt the certainty of those who would affirm ancient principles without doubt and those who would assert modern standards without hesitancy.“The decision is individual but the context is more than personal. The autonomy[to end ones life] is genuine but it is exercised in terms of realities as real as one’s self.”*'* A creative and authoritative thinker in the orthodox movement, Daniel Sin­clair, principal of Jew ’s College of London, has indicated that halakhah permits patients to predetermine their limitations of medical care when faced with a terminal illness.’* He cites an Israeli case’ where a dying man’s gift was cited in support of a decision to honor the advance directives of a woman not to have her life maintained by artificial means.*'® He noted that’ the court cited the Talmudic dictum?" that‘it is a religious obligation to carry out the instructions of a dying man.””*'*

Is it possible to affirm that there is a clear difference betivn the passive acceptance of death and an act, which hastens deat which can only be morally judged to be assisted suicide. How does one differentiate when a medication, which is intended asa palliative, accelerates the process toward death? A Jewish physi­cian has written:

ease the

death... My pri­f death is not the

Let me acknowledge that I would prescribe morphine to

pain, even though that would probably hasten mary intent is to give comfort... but the agent 0