The voluntary assisted dying debate is not so easy
Voluntary assisted dying is not a new issue created by advances in medical technology.
Rabbi Raymond Apple
As far back as the time of the Bible, some believed it was a mercy to put a suffering person out of his agony: II Samuel, chapter 1, records that King Saul, mortally wounded, asked an Amalekite to slay him in order to hasten his death.
In most circumstances, death is the great enemy, to be opposed with heart, soul and might. Life is the great friend, to be loved, cherished and hung on to. Life is the great blessing, the great privilege, the great opportunity. Every ounce of life is precious and must be guarded and preserved at whatever cost.
But there are times when this kind of poetry becomes a mockery when death becomes the great friend and life ceases to be such a blessing. It is then that the plea is heard, “Let me die in dignity”, implying, “I can no longer live in such agony”.
The problem is that any deliberate induction of death sends shudders through most people. It certainly raises moral issues of massive dimensions. They hinge on the question, “What are we talking about – shortening life, or shortening dying?”
If it is shortening life that is the issue, the principle surely has to be that life, every life, has inherent value and sanctity, and even the best-intentioned induction of death is a violation of the right to stay alive, however limited the quality or duration of a given life might seem to be. Assisted dying is too easy an option.
What right do I have to dispose of or write off my own or another person’s body? The question of who owns my body is complicated in law, but in religious morality, the body is unequivocally the property of God, given to me as a trust, not a possession. To think I have the right to decide about the fate of my body is to trespass upon God’s prerogatives.
Who am I (doctor, minister, counsellor, relative) to judge that a life is now no life? (“Who made you a prince and a judge over us? Thinkest thou to kill me?” asks Exodus 2:14). Do I have my own agenda or vested interests?
Whose life is it that is in the balance? Does it make a difference that the patient may be old, poor, lonely, black, or homosexual, or belong to some other category that the Nazis used to call “useless eaters”?
What does the phrase “quality of life” mean? Is it limited to active participation in social interaction? Does quality of life not fluctuate? And whose quality of life am I concerned with – the patient’s, or my own? (My own quality of life may diminish if I have responsibility for a gravely ill patient.)
Where will it all lead? If I start diminishing human lives will a banality of euthanasia set in so that I find I no longer exert myself too greatly to preserve life?
Will there come a time when I do not wait for the consent of the patient or relatives, and perform involuntary assisted dying because I deem it to be in the patient’s (or society’s) best interest, or because I have run out of patience?
Yet if the issue is not the shortening of living but the shortening of dying, the situation may change. A person has a right to live; they also, when the time comes, have a right to die. If the natural life forces are clearly ebbing, why should they be artificially held back by machinery or medical instrumentation?
Interestingly, rabbinic tradition asserts that as there is a time to pray that a person may live, so too there is a time to pray that they may die. A Jewish legend finds God imploring His creatures, “Do not try to take away the sword of the angel of death; My world needs death!”
But the circumstances in which it is legitimate to withdraw artificial impediments to dying have to be properly addressed.
Rav Moshe Feinstein holds that when a patient is gripped by unbearable pain and suffering, nature should be allowed to take its course. Thus when a patient is on a respirator and the machine is temporarily removed for servicing, if the patient shows no signs of life the machine need not be restored.
The distinction between shortening life and shortening death is helpful, but there is a grey area between the two. Making day to day decisions in that area is not likely to be carried out frivolously, but guidelines and safeguards need to be worked out by the medical profession in consultation with the ethicists.
But even that is not the only question that has complicated our agendas. Sonya Rudikoff, in an article in Commentary as long ago as February 1974, makes the important observation that medical treatment is so complex today that almost any death is in some way an act of euthanasia.
“Recent developments,” she writes, “are troubling, and they provide ample warrant for wondering whether anyone can die his own death anymore.” Indeed, the possibility of euthanasia in an extended sense is there from the moment I first visit my doctor and repose my trust in him or her to make the right decisions about my treatment and ultimately my life.
The Talmud says, “A person who revises his studies a hundred times is not as good. as one who revises them a hundred and one times”.
We suggest a similar approach to the proponents of voluntary assisted dying. Think about it over and over again, and never be too sure you are making the right decision.
An excellent article, thanks!