Rabbi Tanchum Burton

EUTHANASIA

Portions of a four-hour videotaped examination of Terri by [Dr.] Hammesfahr were shown to the court during the evidentiary hearing. In the video, Terri appears to interact with her mother with a reaction of happiness, follow commands to open and shut her eyes and lift limbs, and tracks a Mickey Mouse balloon across the room with her eyes.


Terri responds to her mother.

Anderson later described her behavior in a statement to an appellate court.

"Terri smiles appropriately, she laughs appropriately, she tracks a balloon with her eyes, she tracks a set of flashing lights with her eyes, she opens her eyes wide on command, she squeezes her eyes shut on command, she turns her head and looks in the direction of the speaker, she follows Dr. Hammesfahr's movements around the room with her eyes, and, perhaps most poignantly, Terri tries as hard as she can to do that which is asked of her," Anderson said.

Schiavo's experts chalked Terri's responses to commands up to "involuntary reflexes." Cranford called the videotape a "cheap trick."

In his closing statements, Felos urged Greer to review the full four hours of tape.

"We see Terri moan, we see Terri make facial gestures. Yes, some of her gestures and moans are involuntary response to the environment. Some are random," he said. "I'm sorry to disillusion anyone. But it's unfortunate that Terri doesn't have the cognition or the ability to recognize and make that expression."

Asked to describe his reaction to the video, Michael Schiavo told WND: "I see a shell of somebody I used to know. Somebody I loved and adored very much. And now she's a shell. ... She's existing. That's not life." [1]

"The overwhelming majority of people would agree that there are fates worse than death," Felos summed up in his closing arguments at the evidentiary hearing. "Can you imagine the agony and torture ... if Terri Schiavo had cognition of her condition? Thank God she doesn't," he said.

Terri's sister, Suzanne Vitadamo, offered a contrasting interpretation of the taped medical examination.

"I see a horrific scene of somebody that's been neglected. She hasn't been ... given rehabilitation in over 10 years, but I still see my sister. She's in there. She is severely brain damaged. But she shows us all the time that she's in there just by her reactions," she told WND.

From: Diana Lynne The whole Terri Schiavo story. WorldNetDaily: March 24th, 2005.

Points to Ponder:

o  Do people have the right to end their own lives?

o  Do their reasons make a difference?

o  What if a person is severely depressed, terminally ill, or vegetative?

o  Can others help them commit suicide?

o  What about doctors?

o  What about ‘passive euthanasia’ – i.e. cutting off a feeding tube?

o  What does Judaism have to say about it?

NOTE: Nothing in the study session should be taken as either authoritative Jewish law or even practical advice. This booklet is meant simply to raise questions and help the process of discussion and discovery. Any practical questions should be directed to a competent Torah authority.

OUTLINE:

JUDAISM AND PERSONAL AUTONOMY

MURDER AND SUICIDE

THE SANCTITY OF LIFE AND A DOCTOR’S OBLIGATION

The Sanctity of Life

The Role of Doctors

INDIRECT KILLING

SUICIDE BECAUSE OF PAIN

QUALITY OF LIFE

VALUES vs. LIFE

GIVING ADVICE

JUDAISM AND PERSONAL AUTONOMY

How much authority do we have over our own bodies?

Is one allowed to do anything one wishes to one’s own body?

Get a tattoo?

Injure oneself?

Commit suicide?

Submit to be killed by someone else?

Donate one’s body to science?

Consider these texts:

Leviticus 19:28
And you shall not make any cuttings in your flesh for the dead, nor imprint any marks upon you: I am G d.[2] / ויקרא פרק יט
(כח) וְשֶׂרֶט לָנֶפֶשׁ לֹא תִתְּנוּ בִּבְשַׂרְכֶם וּכְתֹבֶת קַעֲקַע לֹא תִתְּנוּ בָּכֶם אֲנִי יְקֹוָק:

Talmud, Bava Kama 91a

One is not allowed to injure oneself[3] / תלמוד בבלי מסכת בבא קמא דף צא עמוד ב
אין אדם רשאי לחבל בעצמו

What about donating one’s body to science?

Responsa, Igros Moshe YD 3:140

As to the question posed from the Office of the President in Washington[4] regarding the use of the organs of a corpse for medical purposes, as commanded in that person’s will: I respond concisely according to Torah law which the Sages received one from another back to Moses our teacher, peace be upon him, which he in turn received at Mount Sinai.
No one has ownership over his body to the extent that he can command that others use his body—or even one small limb—for any purpose, not even for medical research.
How much more is this true of his children and relatives; they certainly have no ownership of his body[5]. / שו"ת אגרות משה חלק יו"ד ג סימן קמ
בדבר שנשאל מוואשינגטאן מלשכת הנשיא (אפיס של הפרעזידענט) בדבר שמוש באברים של המת על פי צואתו לצורך רפואה, הנני משיב בקצרה כי על פי דין התורה שקבלו חז"ל איש מפי איש עד משה רבינו ע"ה שקבלנו מסיני
אין שום אדם בעלים על גופו לצוות שיעשו בגופו ואפילו רק באבר אחד מאבריו שום דבר אף לא לצורכי השגת ידיעה לעניני רפואה,
וכל שכן שבניו וקרוביו אינם בעלים על זה

How would you summarize these ideas?

According to Jewish sources, do individuals ‘own’ their own bodies?

MURDER AND SUICIDE

The following is perhaps one of the most famous commandments in the entire Torah:

Exodus 20:12

You shall not murder / שמות פרק כ
(יב) לֹא תִּרְצָח

What is so wrong about murder?

What is so special about the human being?

Genesis 9:6

One who spills the blood of man, through man his blood shall be spilled[6], for in the image of G d did He make man[7]. / בראשית פרק ט
(ו) שֹׁפֵךְ דַּם הָאָדָם בָּאָדָם דָּמוֹ יִשָּׁפֵךְ כִּי בְּצֶלֶם אֱלֹהִים עָשָׂה אֶת הָאָדָם:

What is defined as murder?

Maimonides[8], Laws of Murderers and Guarding One’s Life 2:2
But one who hires a murderer to murder one’s friend, or sends his servant to do so, or binds up his fellow and leaves him in front of a lion or the like, and the animal kills him; even one who kills himself—each one of these is considered a murderer, guilty of murder, and liable to death at the hands of Heaven[9] / רמב"ם הלכות רוצח ושמירת הנפש פרק ב הלכה ב
אבל השוכר הורג להרוג את חבירו, או ששלח עבדיו והרגוהו, או שכפת חבירו והניחו לפני הארי וכיוצא בו והרגתו החיה, וכן ההורג את עצמו, כל אחד מאלו שופך דמים הוא ועון הריגה בידו וחייב מיתה לשמים

THE SANCTITY OF LIFE AND A DOCTOR’S OBLIGATION

The Sanctity of Life

Compare the following verses dealing with the creation of birds, animals and man.

What unique feature do you notice about the creation of man?

בראשית פרק א

(כא) ויברא אלהים את התנינם הגדלים ואת כל נפש החיה הרמשת אשר שרצו המים למינהם ואת כל עוף כנף למינהו / Genesis 1:21
And G-d created the giant creatures and all of the living beings that creep, swarming in the waters according to their kind, and all types of winged birds according to their kind.

בראשית פרק א

(כה) ויעש אלהים את חית הארץ למינה ואת הבהמה למינה ואת כל רמש האדמה למינהו /

Genesis 1:25

And G-d made the animals of the earth according to their kind, and the cattle according to its kind, and all creeping things according to their kind

בראשית פרק א

(כז) ויברא אלהים את האדם בצלמו / Genesis 1:27
And G-d created the man in His image

Did you notice anything particular about how Man was created?[10]

Jerusalem Talmud, Sanhedrin 4:22:1
Thus man was created singular, to teach that one who destroys a single life is regarded as one who has destroyed an entire world, where as one who saves a single life is regarded as having saved an entire world / תלמוד ירושלמי מסכת סנהדרין פרק ד דף כב טור א /מ"ט
לפיכך נברא אדם יחידי בעולם ללמד שכל המאבד נפש אחת מעלין עליו כאילו איבד עולם מלא וכל המקיים נפש אחת כאילו קיים עולם מלא

The Role of Doctors

What role do doctors play in preserving life?

Exodus 21:19
… he shall cause him to be thoroughly healed. / שמות פרק כא
(יט) … וְרַפֹּא יְרַפֵּא
Talmud, Berachos 60a
From here we learn that the Torah has given doctors license to heal. / תלמוד בבלי מסכת ברכות דף ס עמוד א
מכאן שניתנה רשות לרופא לרפאות

Leviticus 19:16

You shall not stand idly by your fellow’s blood[11]. / ויקרא פרק יט
(טז) לֹא תַעֲמֹד עַל דַּם רֵעֶךָ אֲנִי יְקֹוָק:
Talmud, Sanhedrin 73a
From where do we know that if one’s fellow is “losing” his physical well being that one is obligated to help him? The Torah states, “and you shall return it to him”. / תלמוד בבלי מסכת סנהדרין דף עג עמוד א
אבדת גופו מניין - תלמוד לומר והשבתו לו!

Can a doctor refuse to help someone?

Shulchan Aruch Yoreh Deah 336:1

The Torah has given license to the doctor to heal; it is a mitzvah [to do so], and within the boundaries of rescue. If [a doctor] withholds himself [from treating a patient], it is considered as if he is shedding blood[12]. / שולחן ערוך יורה דעה סימן שלו סעיף א
נתנה התורה רשות לרופא לרפאות. ומצוה היא. ובכלל פיקוח נפש הוא. ואם מונע עצמו, הרי זה שופך דמים

INDIRECT KILLING

What if a doctor ends a patient’s life indirectly, rather than directly?

Is this a way to ‘get around’ the prohibition mentioned above?

For example:

A proposed method of “mercy killing” is to inject a patient with lethal drugs; this would be considered a direct method.

However, if a doctor took a patient off of life support, it is not this act that actually kills the patient, but the inadequacy of the patient’s body to survive by itself. This can be referred to as the indirect method.

From a Jewish point of view, are these indirect forms of euthanasia acceptable?

Consider the following text:

Talmud, Tractate Kesubos 104a

The day that Rebbe[13] died, the rabbis decreed a fast and prayed for Divine compassion. They said: anyone who says, ‘let Rebbe’s soul rest’ should be thrust through with the sword. Rebbe’s handmaid went up to the roof and said: the world above wants Rebbe, and the world below wants Rebbe. Let it be Your Will that the world below triumphs over the world above. When she saw that he repeatedly traveled to the lavatory, etc., and was suffering, she said, “may it be Your Will that the world above triumphs over the world below.” Now the rabbis had not ceased praying for Rebbe’s recovery. The handmaid took an earthenware vessel and threw it down from the roof. For a moment, the rabbis fell silent, and then Rebbe died. / תלמוד בבלי מסכת כתובות דף קד עמוד א
ההוא יומא דנח נפשיה דרבי, גזרו רבנן תעניתא ובעו רחמי, ואמרי: כל מאן דאמר נח נפשיה דר', ידקר בחרב. סליקא אמתיה דרבי לאיגרא, אמרה: עליוני' מבקשין את רבי והתחתוני' מבקשין את רבי, יהי רצון שיכופו תחתונים את העליונים. כיון דחזאי כמה זימני דעייל לבית הכסא, וחלץ תפילין ומנח להו וקמצטער, אמרה: יהי רצון שיכופו עליונים את התחתונים. ולא הוו שתקי רבנן מלמיבעי רחמי, שקלה כוזא שדייא מאיגרא [לארעא], אישתיקו מרחמי ונח נפשיה דרבי.

What is the lesson of this text?

Compare the following sources:

Maimonides, Laws of Murderers and Guarding One’s Life 3:10
But one who ties up his fellow and leaves him to starve to death, or in a place where the cold or heat will kill him, or if one ties a barrel onto him, loosens ceiling plaster to fall on him, causes a snake to bite him, and of course if one entices a dog or snake to attack him—in all these cases even though a human court does not put him to death, he is considered a murderer and the One who demands an account of blood will seek his blood[14]. / רמב"ם הלכות רוצח ושמירת הנפש פרק ג:י
אבל הכופת את חבירו והניחו ברעב עד שמת, או שכפתו והניחו במקום שסוף הצנה או החמה לבוא לשם ובאה והמיתתו, או שכפה עליו גיגית, או שפרע עליו את המעזיבה, או שהשיך בו את הנחש, ואין צריך לומר אם שסה בו כלב או נחש, בכל אלו אין בית דין ממיתין אותו, והרי הוא רוצח ודורש דמים דורש ממנו דם.
רמ"א יורה דעה סימן שלט סעיף א
וכן אסור לגרום למת שימות מהרה, כגון מי שהוא גוסס זמן ארוך ולא יוכל להפרד, ז אסור להשמט הכר והכסת מתחתיו, מכח שאומרין שיש נוצות מקצת עופות שגורמים זה וכן לא יזיזנו ממקומו. וכן אסור לשום מפתחות ב"ה תחת ראשו, כדי שיפרד.
אבל אם יש שם דבר שגורם עכוב יציאת הנפש, כגון שיש סמוך לאותו בית קול דופק כגון חוטב עצים או שיש מלח על לשונו ואלו מעכבים יציאת הנפש, מותר להסירו משם, דאין בזה מעשה כלל, אלא שמסיר המונע /

Rema, Yoreh Deah 339:1

It is forbidden to cause a quick death, as in the case of someone who has been a goses[15] for an extended period of time, and whose soul seemingly cannot depart. It is forbidden to remove the pillow of sheet from under him, etc. or to move him from his place. Similarly it is forbidden to place the synagogue keys under his head in order to cause his soul to depart[16].
However, if there is anything preventing the soul’s departure, such as a knocking sound (like that of a woodchopper), or a grain of salt on his tongue, it is permitted to halt or remove these things, for such does not constitute an affirmative act at all, but rather is a removal of obstacles.

How do you understand these sources?

What differences do you notice?

SUICIDE BECAUSE OF PAIN

Can one choose to end one’s own life because of pain?

NOTE: Nothing in the study session should be taken as either authoritative Jewish law or even practical advice. This booklet is meant simply to raise questions and help the process of discussion and discovery. Any practical questions should be directed to a competent Torah authority.

Talmud, Avodah Zarah 18a

[The Romans] found Rabbi Chanina ben Teradyon sitting and learning Torah, gathering the community, and carrying a Torah scroll on his chest. They seized him, wrapped him in a Torah scroll, surrounded him with bundles of grapevines, and lit him on fire. They also soaked sponges of wool and placed them near his heart, so that he would not die quickly.
His daughter said to him: father, how can I bear to see you this way? He said to her: if they burned me alone, this would be difficult for me; now that I am being burned with a Torah scroll, I know that He Who demands an account of the desecration of a Torah scroll will demand an account of my desecration.
His students said to him: master, what do you see. He said to them: the scroll is burning and the letters are flying away.
[They said]: open your mouth, so that the flames will enter it! He said to them: it is better that He Who gave me my soul should take it, than for me to injure myself. / תלמוד בבלי מסכת עבודה זרה דף יח עמוד א
מצאוהו לרבי חנינא בן תרדיון שהיה יושב ועוסק בתורה ומקהיל קהלות ברבים וס"ת מונח לו בחיקו. הביאוהו וכרכוהו בס"ת, והקיפוהו בחבילי זמורות והציתו בהן את האור, והביאו ספוגין של צמר ושראום במים והניחום על לבו, כדי שלא תצא נשמתו מהרה.
אמרה לו בתו: אבא, אראך בכך? אמר לה: אילמלי אני נשרפתי לבדי היה הדבר קשה לי, עכשיו שאני נשרף וס"ת עמי, מי שמבקש עלבונה של ס"ת הוא יבקש עלבוני.
אמרו לו תלמידיו: רבי, מה אתה רואה? אמר להן: גליון נשרפין ואותיות פורחות. אף אתה פתח פיך ותכנס [בך] האש! אמר להן: מוטב שיטלנה מי שנתנה ואל יחבל הוא בעצמו.

How flexible is Jewish law in terms of responding to a person’s pain?