Woodchopper Revisited 33

even in his suffering, if there is a chance that another, more knowledgeable physician can in the meantime be consulted about the case. Second, he emphasizes that his permit applies only to situations where the patient is experiencing yisurin, physical suffering.

It is obvious(pashut) that R. Moshe Isserles would agree. Although in Yoreh Deah 339 he permits the removal of a factor that impedes the departure of the soul, it is obvious (pashut) that he does so solely because of the yisurin that the goses experiences. In the absence of pain, there is no reason to permit even the removal of a factor that impedes the departure of the soul. On the contrary, we would be obligated to introduce such a factor into the situation.... Why would we endeavor to remove impediments to death if the patient were not in pain? Rather, it is certain(vadai) that the permit to remove impediments is because the goses suffers pain when his death is an extended process. It is certain(vadai) that R. Moshe Isserles and those who preceded him possessed an authoritative tradition on this point.

Here Feinstein states the interpretive assumption that governs his use of the analogy. Despite the technological gap that separates the target case(the contemporary question of withholding medical treatment from the terminally ill) and the basepoint cases(B. Ketubot 104a and, to a lesser extent, Isserles in Yoreh Deah 339), the two are significantly similar in their concern that we not prolong the suffering of a dying person when there is no medical remedy for him. Yet even as he draws the analogy, Feinstein sharply restricts its scope. The warrant to discontinue or withhold treatment exists only in cases where two factors are present: the patient has no hope for recovery and is suffering great pain. This would exclude the comatose patient and the one lying in a persistent vegetative state, let alone the person who is terminally ill but not yet experiencing yisurin. Feinstein supports this limitation not by citing texts but by claiming that the limitation is