60 Mark Washofsky
92. Fora very similar argument see R. Chaim David Halevy,“Nituk choleh she’afsu sikuyav mimekhonat haneshamah,” Techumin 2(1981), 297-305. At p. 304 he describes Isserles ’s example of salt on the tongue as“the perfect analogy”
(hadimayon hashalem) to the case of the artificial respirator. 93. Resp. Igerot Moshe, Choshen Mishpat 2:73. 94. Resp. Igerot Moshe, Choshen Mishpat 2:74.
95. The most powerful formulation of this principle would seem to be that of R. Yaakov Reischer(18" century Germany ), Resp. Shevut Yaakov 1:13: the laws of Shabbat are set aside for the purpose even of extending the life of a goses. For his part, Feinstein declares that“everyone accepts” this rule; Resp. Igerot Moshe, Orach Chayim 3:69.
96. Note that the Isserles passage does not mention pain and suffering as the reason for allowing the removal of impediments to death. Still, one of Isserles ’s sources Sefer Chasidim, ch. 234 does mention pain in relation to the treatment of the goses; see above at note 90. Beit Lechem Yehudah, Yore Deah 339, s.v. mikoach she'omrim, cites the Sefer Chasidim passage and is seemingly the first authority to make the connection between removing impediments and the issue of pain and
suffering
97. The language Feinstein uses in the responsum indicates Tendler ’s concern that the permissive ruling in the earlier teshuvah might be used to justify withholding medical treatment from the insane, from those in a comatose state, and other cases where the patient lacks sufficient quality of life. By restricting the warrant to discontinue treatment to cases involving pain and suffering Feinstein explicitly rejects the inference. At the same time, he does not categorically reject“quality of life” as a relevant consideration. On the subject in general, see Moshe D. Tendler and Fred Rosner ,“Quality and Sanctity of Life in Talmud and Midrash, ” Tradition 28:1(1993), pp. 18-27.
98. W. Gunther Plaut and Mark Washofsky, eds., Teshuvot for the Nineties(New York : CCAR, 1997), pp. 337-361; http://data.ccarnet.org/cgibin/respdisp.pl?file=14&year=5754(accessed September 15, 2010).
99.“This theory” is that of Shiltey Giborim(see at note 80, above)