In many places in the Torah, we find the prohibition of murder. First, in Bereishis 9:6 it says “shofeich dam ha’adam, ba’adam damo yishafeich” — one who spills the blood of another human being, their blood shall be spilled by man. Then in Shemos 20:13 we have the Asered Hadibros — Lo sirtzach — Do not kill. The next perek, in 21:12 it says “Makeh ish vameis mos yumas”. Two verses later it says, “v’chi yazid ish al re’eihu” — if a person acts intentionally against their neighbor even from my altar you shall take them to die. In Vayikra 24:17 it says “v’ish ki yakeh kal nefesh adam mos yumas” — one who kills any person shall be put to death. In Bamidbar 35:30 it says, “kal makeh nefesh lifi eidim yirtzach es harotzeach” — whoever kills any person, the murderer shall be executed through the testimony of witnesses.
Okay, enough with the quoting. To murder somebody? God forbid — nobody would ever do that. No questions asked. No one would take the life of another individual even if he asked you to. The Halacha is that if somebody were to tell you to kill someone hooked up to a respirator or the put a bullet through your brain, I must take the bullet. So what about knowing a person who’s not physically able to enjoy life — is a Jew allowed to close the shutters on that person? Is a Jew permitted to say I’ll look away and say it’s not my business? I’ll keep out of it!
We do not know, cannot know, when a human being is truly incapacitated — when his or her soul has been released. Only when a heart has stopped beating can we be certain that life in its truest sense has ended. And so speeding up death of even a physically or emotionally compromised human being is no less an abortion of meaningful life than gunning down a healthy one.
Dr. Rachamim Melamed-Cohen, is Israel's most famous terminally ill patient. He suffers from ALS, Lou Gehrig's Disease, and is paralyzed from the neck down. Some might think he is waiting to die.
15 years ago, the doctors spelled out for him and his wife Elisheva the entire course of the disease: first his limbs would become paralyzed, to be followed by the muscles of his neck, esophagus, and tongue. "The day will come when a fly will land on your nose and you won't be able to brush it off. You will become dependent on other people for everything." And in the final stage, his lungs would stop working. "You have three to five years to live.”
This was 15 years ago. Three of the doctors who attended on him have since died, but Dr. Cohen, while completely paralyzed, is still going strong. Since the onset of his illness, he has written seven books, the latest by means of a computer that types by his eye movements. He prays 3 times daily and attends Shul every Shabbos. And he goes out regularly, to the theater, to weddings, and to restaurants, although he no longer eats except through a feeding tube to his stomach. As Elisheva explains, "Although he doesn't eat, he sits with us." His company is obviously worth the effort.
"Life today is becoming cheaper and cheaper" he observes. "Among young people it finds expression in drugs, violence and suicide. A healthy 16-year-old girl came to me and said, 'If it's okay to shorten the life of someone because of their suffering — well, I'm also suffering, and I'd rather die than live.'"
There was another ALS sufferer in Israel that decided to end his life. His family agreed, and his request to be disconnected from his respirator was approved by the Israeli medical and legal authorities. When interviewed on Israel television, he described his suffering: "Speech is now difficult for me. I can't walk, I can’t eat, and I can’t move. I've lost interest in life. My condition is irreversible, the pain will only increase, why should I drag it out?" Then, in his last moments, he added, "I hope that I am not making a mistake."
We can’t judge. None of us should ever suffer like that. We can only imagine the depression that such a person is going through.
But Dr. Cohen, who watched the interview from his home, commented, "It's clear to me that this man was ambivalent. On the one hand, he wanted a good place in Heaven; on the other hand, he wasn't sure that he was doing the right thing. I heard in his voice a great deal of hesitation and doubt. In my opinion, societal pressure...drove him to the decision that it would be better to die than live. Had he been taken care of at home, in a warm and supportive atmosphere, it could be that he would have felt differently."
However, Dr. Cohen was not always as resolute as he is today regarding his own case. He relates that a number of years ago, when he was rushed to the hospital after his breathing stopped, he indicated to his loved ones that they should not take extraordinary measures to prolong his life.
"It was my good fortune that I was hooked up anyway. Now, years later, I am happy that they didn't listen to me. I would have missed out on the best, most beautiful years of my life. A person can have a change of heart."
Essential to Dr. Cohen's determination to carry on is his Yiddishkeit. "I feel at times that God has allowed me to live in order to show the world that even in such a condition one can continue to be creative and contribute to society... The message of Judaism is that one must struggle until the last breath of life. Until the last moment, one has to live and rejoice and give thanks to the Creator."
He has gained a certain prominence in the Israeli media for his outspoken opposition to the euthanasia movement. "What is mercy-killing?" he asks. "For whom is the mercy? Is it for the person with an illness? Or is it for the family, so that they should not have to suffer? For the medical establishment, to reduce expenditures? For the insurance companies? Mercy means helping others to live, and with dignity. Helping people to cut their lives short cannot be called mercy."
And indeed, removing life-sustaining measures, "pulling the plug," is forbidden by Jewish law.
Oregon permits doctors to help patients end their lives. We live in a world where youngsters regularly murder for a car, a pair of shoes, or even just for fun. Women routinely decide to stop an unborn child’s life to accommodate their personal or professional goals. Bottom line: in our society, an elderly or infirm persons life just doesn’t command the consequence in once did.
This is nebach — the perspective of the secular world around us. Rabbi J. David Bleich writes ("The Quinlan Case: A Jewish Perspective," Jewish Life, Winter 1976) of visiting an elderly relative in critical condition and in a coma on the eve of Shabbos. He examined the patient's medical chart and saw that his relative was not being treated aggressively. The attending physician informed him that this was because the doctors were unanimous in their opinion that the patient's condition was terminal, and they saw no point in trying to prolong her life. Rabbi Bleich insisted as a matter of Halacha that she be administered the appropriate medication. When he returned on Shabbos afternoon to the hospital, he was told that the patient remained totally unresponsive. He nonetheless went to her hospital bed and greeted her with a loud "Gut Shabbos." Her eyebrows flickered, and she quietly responded "Gut Shabbos." Rabbi Bleich recounts that at that moment there flashed in his mind the comment of Rabbi Akiva Eiger (Orach Chayim 271:1) that even the simple, standard Shabbos greeting expressed by one Jew to another constitutes a fulfillment of the mitzvah (religious duty) of Zachor es Yom HaShabbos le'kadsho (Remember the Shabbos day and keep it holy).
Or take the story of a doctor in Mayanei Hayesuah Hospital in Bnei Brak. This is an elderly doctor that made aliyah from the United States. He was a totally secular Jew and a prominent physician that had many religious Jews as patients. He is currently religious due to the following story:
He says that approximately 20 years ago he had a terminally ill patient, who after consulting with many top specialists in the field, it seems they were all in agreement that this fellow had a maximum of six months to live. And this was if, and only if, he would be willing to undergo a very painful procedure in three weeks. The doctor sits down with the patient and his family and started going through all the options. Nobody wanted to make the decision. Finally, the patient, who was a student of the great Rabbi Moshe Feinstein, tells the doctor he is going to go speak to the Torah leader of American Jewry. This doctor had never seen an Orthodox rabbi and he asks if he can come along.
They go together to see Rabbi Moshe Feinstein, they come into the room and for the first time in his life he sees a Gadol B’Torah. He explained the situation to Reb Moshe, and he asked many questions without leaving any stone unturned. And Reb Moshe started crying — for 20 full minutes. This doctor couldn’t believe it! This giant in Torah, who would speak to tens if not hundreds of people a day about all of their difficulties, should have been crusty and hardened by all of it. This is the only way doctors are able to handle all of the delicate and difficult situations they are in. And this elderly Rabbi is sobbing!
In the end, Reb Moshe tells them he needs a day to think it through before issuing a ruling. The next day they came back together. Reb Moshe greeted them both warmly, and he said to his student with confidence “go through with the procedure. We will all Daven for you and you will live a long life”.
This doctor cannot contain himself when he heard these words. Why should this fellow have to go through all the pain? Why should this fellow be forced to live without any quality-of-life?
As if reading his mind, Reb Moshe says to him “you should know, that over the next six months this fellow is going to be able to answer Amen to many blessings. Each Amen that a person orders creates a Malach that is a meilitz yosher — an advocate- which comes before the heavenly court and say look at the person who created me! In the merit of my being created they deserve to live a long life”.
This doctor said, “after seeing how much love Reb Moshe has for every single person and after it was explained to me the power and beauty of every single Amen that can be uttered, and realized what I’m missing in life”.
This patient lived for many more years. You should know, the word Amen and the word Malach have the same numerical value — 91.
We are just scratching the surface of this very real issue.