A diverse group of rabbis and religious leaders speak about end-of-life issues and how they integrate Jewish tradition into their own teaching and care for others. Created by the Center for Pastoral Education at JTS as part of What Matters: Caring Conversations About End of Life, a joint project of JTS’s Center for Pastoral Education, JCC Manhattan and The New Jewish Home, with generous funding from Plaza Jewish Community Chapel.
Artificial Nutrition and Hydration
- A central question to ask ourselves: Are we keeping the person alive, or letting the person die?
- Artificial nutrition is not eating, it is artificial, therefore it may be removed to allow for natural death.
- Removal of nutrition or medicine is controversial in Jewish medical ethics.
- A rabbi can help by listening and understanding the values of the congregant: tradition has a vote, but not a veto.
- Tradition does not require us to prolong a life of suffering; allowing a natural death is permitted.
- Life is of infinite value, It is also a divine gift, and therefore not entirely our own.
- We may not hasten death, but we may allow the natural process of dying to take place.
- When quality of life is diminished, there is flexibility in Jewish law to withhold or withdraw life prolonging measures.
- Question: Are we feeding or medicating? If we are medicating, then we may withdraw nutrition to allow death. If we are feeding, we may not.
- This remains controversial in Conservative interpretation of Jewish law. Conservative Jews may select which of these two options they agree with when planning.
- Judaism celebrates this-worldly life.
- There is a time to live, but there is a time to die as well: We may not hasten death, but we may remove impediments to allow for the natural process of dying.
- What constitutes an impediment is controversial.
- A spiritual guide can be helpful by listening and understanding the values of the potential patient: tradition should guide us in this endeavor.
- The Jewish tradition distinguishes between preserving life and preventing death.
- If it can be established that a person cannot ever recover to a point at which they will be able to live meaningfully without life support, then we may remove it.
- Brain death remains controversial in Jewish tradition.
- Even though saving a life is among the highest Jewish values, medical interventions are not always considered “saving a life.”
- Medical technology makes it hard for us to see when a person has reached their “time to die.”
- Jewish tradition is opposed to interventions that only delay death and prolong suffering.
- Cases have to be individually determined: what is an irreversible state, in this case? What are the family dynamics, in this case?
- Jewish Law does not allow us to “pull the plug” on mechanical life support.
- Reduction or withdrawal of nutrition is allowed.
Do Not Resuscitate (DNR)
- Choosing life means choosing a vital, full life. However, the Jewish tradition distinguishes between preserving life and merely preventing death.
- Our answer to whether or not to have extraordinary measures will (and should) change with time and circumstances.
- When a person is a goses (destined to die), extending their life may possibly be a violation of the Divine will.
- Choosing not to extend life in the face of suffering may allow for death with dignity.
- If a person cannot live with dignity, perhaps they are not living, anyway.
- Jewish tradition would prefer that we live fully, and that’s what living by the commandments means.
- If there are external impediments to death, they may be removed.
- Resuscitation can be an external impediment to death.
- Reform Judaism allows individuals to decide for themselves.
- It is important to have a health care proxy, preferably someone who loves and cares about you!
- Death is not necessarily an emergency. Death is a natural life-stage.
- If we treat it that way, we may be comfortable, surrounded by those we care about, and who care about us, as we die. Death can be the smooth transition that tradition speaks of.
- Dying in this way is part of living to the fullest.
- Jewish tradition wants us to choose life. Yet there comes a time to end treatment, if life is at its end.
- Jewish tradition endorses hospice and palliative care. Hospice and palliative care considers healing of the soul. It is not giving up.
- Palliative care is a choice to make the person’s life as comfortable and significant as possible at the end.