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Jewish perspectives on living wills and issues regarding nutrition and hydration in the terminally ill patient. My previous article explained why Jewish law condemns the removal of Terry Schiavo's feeding tube. But that does not imply that treatment must always be provided in every case.
The Terry Schiavo case is particularly egregious because the main proponent of removing her feeding tube is her husband, who serves as a very poor surrogate for her. He has far too many conflicts of interest, both monetary a large malpractice settlement and personal he is living with a girlfriend whom he cannot marry as long as Terri Terri schiavo virtue ethics alive to be trusted to protect her best interests.
The question arises, were she to have had a living will clearly spelling out her desires in case of incapacitation, would that change how Jewish law Halacha approaches her case? Additionally, are there any patients for whom provision of nutrition, hydration, and oxygen is not required?
In many states, every patient admitted to a hospital must be offered the option of filling out "advanced directives," commonly know as Terri schiavo virtue ethics living will, indicating their medical wishes in case the patient is not competent to express their desires at a future time.
If the patient has not indicated his wishes in advance, someone else will and that person may not be someone whose choices the patient would accept. A patient may also choose to execute a durable power of attorney, indicating to whom they would like to transfer legal authority to make medical decisions for them in case of incapacitation.
While Judaism may not have encouraged the proliferation of living wills and durable powers of attorney, it has come to terms with them and recognizes the opportunity that these documents offer to have Jewish law applied in end of life situations. The most direct argument for advanced directives is the recognition that if the patient has not indicated his wishes in advance, someone else will and that person may not be someone whose choices the patient would accept.
Both the Agudath Israel and the Rabbinical Council of America have drafted model living wills and powers of attorney that are intended to meet the needs of the Torah-sensitive Jew.
It is important to understand that advanced directives do not intrinsically require lack of treatment in cases of medical emergency. While one may legally choose to refuse life-sustaining treatment in cases of critical illness, one is also free to mandate that "everything" be tried.
The Jewish person contemplating using a power of attorney may name their Rabbi as their legal proxy, ensuring that any issues of Jewish law will be dealt with appropriately.
The crucial issue involved with a living will is whether the Torah grants the Jew the autonomy to refuse treatment. Rabbi Moshe Feinstein, a leading a halachic authority from the previous generation, clearly allows the terminally ill patient in intractable pain to refuse life-prolonging treatment that will neither cure him nor relieve his pain.
Surely, such a patient may refuse resuscitation or intubation if he so chooses.
A non-terminally ill patient may refuse treatment if the proposed therapy is sufficiently dangerous or unproven. Regarding the durable power of attorney, we may gain insight from a different responsum. Rabbi Feinstein states that if a pain-stricken terminally ill patient were to develop a second illness for which there is a cure such as a pneumonia in a terminal cancer patienthe may refuse treatment.
If the patient would prefer to die, it would be "proper not to treat him in any manner that would prolong the dying process," such as treating the second illness. Nevertheless, Rabbi Feinstein writes, this is a decision that the patient must make. He states that if the patient is incompetent, the doctor should consult the family regarding treatment, since they are closest to the patient.
While the family's autonomy is limited by the same factors that limit the patient himself, we see that Judaism does recognize the concept of substituted judgment in such cases. A durable power of attorney is the easiest method for recognizing who should be consulted if the patient is incompetent.
The Torah commandment of "do not stand by idly while your neighbor's blood is being spilled" everyone has a personal obligation to prevent his friend from being harmed would seem to mandate compulsory resuscitation of everyone, since cardiac arrest and apnea certainly represent the ultimate in dangerous situations.
Why then was it not always the custom to attempt CPR on every Jew who died? The reason is because Judaism recognizes the inevitability of death. When someone dies, we are proscribed from desecrating the body, which includes invasion of the corpse. Moreover, the Code of Jewish Law Shulchan Aruch explains that there is a prohibition of touching a moribund patient goses who is estimated to have less than three days to live.
Resuscitation of a goses is not required, and in fact may be prohibited as a forbidden intrusion on the natural dying process. In the right situation, a person may choose not to be resuscitated. Therefore, the underlying assumption in Judaism is that one should NOT resuscitate a gravely ill patient, but only a patient for whom there is a reasonable expectation of reversing the underlying cause of physiologic collapse.
As I mentioned in my previous article, one should not resuscitate a patient whose cessation of life functions is because his or her body could no longer sustain life.As a person of faith who loves the country that he calls home, I want better than what we're getting.
I want the people and leaders here in the United States to deal with real issues. the Terri Schiavo Case Hessel Bouma III In , Terri Schiavo suffered severe brain injury yet lived fifteen years in a vegetative state His scholarly interests are in medical ethics, human biology, and human genetics.
He enjoys reading, a variety of outdoor activities, and photography. He can be contacted at [email protected] Hessel Bouma III. A friend of mine and I had an argument over Terri Schiavo as to whether food and water should be stopped to allow her to die.
I said that to do so would really . Terri Schiavo died 10 years ago today — not long after her feeding tube was removed by order of a Florida judge acting at the request of Schiavo's husband that his wife be allowed to die.
The Case of Terri Schiavo: Ethics at the End of Life. $ Free Shipping for Prime Members. FREE Shipping on orders over $25—or get FREE Two-Day Shipping with Amazon Prime Only 1 left in stock (more on the way). Ships from and sold by iridis-photo-restoration.coms: 3. In most Muslim countries, euthanasia is abhorrent.
But a number of modern Islamic scholars, perceiving the feeding tube as a form of useless treatment, would probably decide Terri Schiavo's case in .