Friday, January 26, 2007

Whose Life Is It?

R. David M. Feldman, Where There's Life, There's Life, pp. 100-104):

Whose life is it? If life is not the questioner’s, is it then for one’s family to determine what to do? No, neither is life the family’s to take, because members of the family are naturally prejudiced, either in favor or against. Either they care too much for the patient and want the doctors to “try everything,” actually to prolong the dying rather than the living, something also to be avoided; or they would hasten death out of genuine, altruistic compassion for the loved one. Conversely, the family could care too little for the patient, consciously or unconsciously, and care too much for ulterior considerations—material, emotional, or otherwise. Prof. Yale Kamisar wrote recently, and counterintuitively, in the Los Angeles Daily [Law] Journal, that “the family should be the last to be asked.” Members of the family may seem to be objective, but how can they really be? He points to the husband tending his cancerous wife who, in desperation, appeals to the doctor to “put her out of her misery.” What he is often really saying, subconsciously, is “It’s time to get on with my own life.” Others would understand his words, “Let’s put her out of her misery,” as meaning possibly, again without conscious awareness, “Let’s put her out of my misery.”

Nor is life the doctor’s to take, from the Jewish and indeed from a cross-cultural standpoint. Click here to read moreThe doctor’s mandate is to heal and relieve, not to kill for whatever reason. Halakhah yields to the physician’s judgment only when he or she offers an opinion that is medical, not personal. It accepts a medical opinion offered about the state of a patient’s health or risks for life or death, but never a personal opinion about whether that life, of diminished quality, is worth saving. In fact, because of the doctor’s mandate to heal, even most advocates of euthanasia have opposed the idea of physician-assisted suicide. This would violate the physician-patient relationship of trust, as well as that mandate to heal. The trust relationship is, in fact, a problem: The New York State Task Force on Law and Life raises the possibility that this trust might lull us into accepting an assisted suicide from someone whose authoritarian or paternalistic view we might accept implicitly.

Similarly, for reasons of preserving the healing function of medicine, the American Medical Association has declined to allow its members to administer lethal injections in criminal execution...

Whose life is it, then? Not the patient’s, not the family’s, not the doctor’s. Life is God’s, or, stated in different terms, life belongs to the principle that the right to life is inalienable, that it is a gift from the Creator, that it would be blasphemous to cast that gift back ungratefully, and that we, being creatures rather than Creator, are not the arbiters of the end of life for ourselves or fellow humans. And we are creatures “in the image of God,” which gives life a sanctity beyond our own estimations thereof, and beyond our right to dispense with...

The idea that “the family is the last to ask” shares a halakhic approach, as can be seen from a different corner of the law. There is a famous story in the Talmud (K’tubot 104a) where the action of the housemaid of R. Judah Ha-Nasi is described. She so sympathized with his suffering at his last illness that she prayed that God would end his life. She did so while his fellow rabbis and pupils prayed for him to live. When his soul left him and he was relieved of further distress, her actions appear to be the subject of praise. The fourteenth-century authority, Rabbenu Nissim (RaN), takes it as such in his Talmudic commentary (to N’darim 40a), and codifies, so to speak, the permission to pray for the death of a person in unmitigated suffering. But a pre-eminent modern authority, R. Eliezer Waldenberg (Tzitz Eliezer, V, addendum ch. 5) allows this to everyone except to close family members, making the obvious assumption of a conflict of interest. Their own relief from burdens associated with the illness would influence their prayers as much as their concern for the patient. Yale Kamisar was unaware that his conclusion is so halakhic; the argument is undeniable.

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