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The Right to Live

The Right to Live

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It's been five days since the feeding tube was removed from Terri Schiavo. By the time this article is posted, it will either have been reinstated, or she may already be dead.

As an American citizen, I am shocked that a woman--conscious, albeit in a severely brain-damaged state--could be starved to death. As a human being, I am horrified.

I've seen the pictures of her smiling as her mother hugs her, huge eyes open wide as she surveys her surroundings. She supposedly has the responses of a 6-11 month old baby. My daughter is seven months old. She laughs, she cries. She knows joy, fear, pain, and hunger. She is far from unaware. Perhaps Terri is not even this responsive, although she is conscious and can swallow and breathe on her own. But her abilities would depend on who you ask: her husband, a man who already has two children with another woman; or her parents and siblings, who have stood by her side since that fateful day when Terri collapsed from a vitamin deficiency fifteen years ago.

Since that day there has been no improvement -- at least none that can be seen or detected. Does that mean that her condition can't change? According to certain doctors that answer is "no, it can't"; others believe that with the correct therapy, the answer could be "yes." However, if she is starved to death this week, we will never know.

In Judaism there is a law against taking one's own life. Even if the sword is against one's throat, we are taught that we are not allowed to despair. Why? The answer is that if we believe there is a G‑d in this world, then we must believe that we can be saved, even at the last minute--even at the last second.

Throughout our history, Jews who could have avoided painful, torturous deaths at the hands of their enemies if they had taken their own lives suffered these fates because they believed that their desperate situation could change. Many were right and lived to tell the stories of a miraculous escape, a gun that jammed, a bullet that missed its mark.

However, Halachah (Torah law) is not cruel. It is not senseless. It is compassionate and understanding and recognizes that there are certain people who are suffering an incredible amount of pain.

A patient on his deathbed, for whom no cure is deemed possible and death is an inevitable, immediate reality, must be allowed to die (Shulchan Aruch, Yoreh Deah, 339:1). In a case such as this, one is not required to continue treatment, unless the treatment will help ease the pain of the patient. A person in such a state is called a goses.

But Terri Schiavo is not a goses. She wasn't dying when the feeding tube was removed. She's dying now only because she's cruelly being denied food and water. She's being starved to death simply because her husband believes that hers is a life not "worth" living.

Terri went from a young, vivacious woman, to her current vegetative state, in about five minutes. If five minutes could change her life in this direction, how can we not believe that in five minutes it could be turned the other way? How can we decide for her that she would no longer want to live?

And yet, a current CNN poll indicates that 56% of those who responded agree that the tube should be removed. The majority of American citizens and the courts seem to agree that there is no reason to have hope and no reason to have faith. They believe that since nothing has changed until now, nothing will.

This is a terrifying reality for each and every one of us.

Terri is only one example, but the ramifications of this situation are enormous. What the courts are telling us is that someone can decide for you, on your behalf, if your life is worth living. And even if you never clearly stated such a desire, and certainly didn't put it in writing, your legal guardian's word will be trusted.

Jewish law requires witnesses. Two people can love each other. They can choose to marry. They can have a ceremony and write a contract. But their marriage will only be accepted under Jewish law if there are two witnesses, and witnesses, by definition, cannot be relatives. The assumption is that anyone with a connection or bond as strong as family cannot be trusted to be a reliable witness. If a witness has something to gain from the outcome, that person cannot be counted.

But in Jewish law, the question goes even further than simply whether or not Terri's husband and appointed legal guardian has the right to determine for her, or state on her behalf, if she would want to "live this way." According to Halachah, the question exists as to whether even Terri herself could make such a decision. Could Terri decide to take her own life, to stop her own treatment? Do we possess the ability, or the authority, to decide that our life is not worth living?

If G‑d didn't want us to be alive, we wouldn't be. We don't create life, and we certainly don't have the authority to end it. We didn't choose to be here, and we cannot choose to leave here. Furthermore, the assumption is that a healthy person shouldn't want to take his or her life. We even consider someone who is suicidal to be mentally ill. If a person wants to die, clearly there is something wrong which must be treated. We often claim that someone who threatens suicide doesn't really want to die but rather is screaming out for help. And the Torah teaches that we have an inner will and desire to live, even if we do not think that we do.

If Terri Schiavo dies, or rather, if she is deliberately and inhumanely murdered, a piece of each and every one of us will die with her. It is time we take a good look at ourselves and the world we live in. We need to wonder why the majority of Americans support this course of action while only a handful protest.

If the courts determine that a person can choose when he or she no longer wants to continue with his life, then where do we draw the line? If someone verbally states, or even declares in writing, that he or she no longer wants to live under certain circumstances, how can we ever know that this person still feels this way? For a healthy, able-bodied person, the prospect of living with a severe handicap is too awful to contemplate. Who hasn't said at some point that "I'd rather be dead" if he or she couldn't walk, talk, see, or hear? But when, G‑d forbid, one suddenly can't, as is the case for many after an accident or illness, opinions change. Suddenly life become much more valuable and not as easily disposable.

Death is not a decision that can be changed after the fact. What kind of power are we giving our government, our guardians and even ourselves?

I guess we must all hope and pray that we are never in such a situation. For perhaps if we were the one lying on the bed, we would have a very different view of the world around us.

Sara Esther Crispe, a writer, inspirational speaker and mother of four, is the co-director of Interinclusion, a nonprofit multi-layered educational initiative celebrating the convergence between contemporary arts and sciences and timeless Jewish wisdom. Prior to that she was the editor of TheJewishWoman.org, and wrote the popular weekly blog Musing for Meaning. To book Sara Esther for a speaking engagement, please click here.
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elie August 2, 2015

health care proxy Great Article. Thanks for the info. Does anyone know where I can find a blank health care proxy form to fill out? Reply

Laura Hall Syracuse, NY October 19, 2010

RE: Extraordinary measures It is, perhaps , comforting to tell ourselves that we "did the right thing" when we have given ourselves permission to be released from the burden of caring for and watching a suffering loved one. I consider these decisions to be primarily selfish, even though they are described using the language of reason. The fact remains that NO ONE has the right to decide it is time for someone to die. If no extraordinary means are required to sustain life; if only food and water are needed ( as with an infant) and we choose to starve and dehydrate a human being, we are then guilty of murder. It is that simple, and all the rationalizing in the world will never change it. Reply

Anonymous August 15, 2008

Extraordinary measures Ms. Schiavo has been gone for some time now and the unseemly hoopla has died down. Autopsy showed that her brain had turned to mush. Once that happens, nothing can change it. I had to make the decision for my mother 5 years ago, and for my best friend two and half months ago. My mother did appear to respond to certain stimuli, even though her brain was crushed and turning to mush. It really bothered me, but I did what I knew to be right. I do not regret it. Those "reactions" come from the brain stem, not the brain. It's like the chicken running around after its head is cut off.

Some posters say that the nation has come to a sad pass because Mr. Schiavo allowed her to die. I think we've come to a sad pass because we have the attitude that if we can do it, we should. I wanted my mother and best friend to stay here, but acting on that wish would have meant I was thinking of myself, not of them. Reply

sandy February 10, 2008

Interesting perspectives, for sure! I work in a subacute and long term care facility. There are many, many patients on feeding tubes. To those who are so shrill about it being "artificial", I guess they prefer our country save lots of healthcare dollars by refusing feeding tubes to these patients. After all, it's "artificial".

I think of my patients, especially the ones with Alzheimer's who for various reasons are no longer able to swallow, and I say, wow...

America has never been taken so low before. Excruciatingly sad. The most progressive society has now regressed more than words can depict. Reply

Anonymous Australia April 1, 2007

Well a post that is 2 years too late but still all the more relevant. Just so the lot of you people should know, the video footage of Terri supposedly "responding" to her parents kisses amounts to 6 minutes of footage edited from 6 HOURS of total video recorded. The rest of the footage her parents did not select for showing to the press clearly shows her as an unresponsive vegetable that she was. Don't second guess the experts with years of study and experience in this field. They say she was finished and I fully agree 100 percent with them. Reply

Binah Bindell Brooklyn, New York via jerusalemchabad.com May 3, 2005

Terri Shiavo I was horrified that people could be so cruel as to starve terri. I applaud you for your well written article. Your words expressed my thoughts and feelings in this unbelievable and sad story.

PS.. I just read your response to anonymous... well said (your response) Reply

Joyce Lewisville, TX April 5, 2005

Do No Harm This first guiding rule of medicine is do no harm. I have worked with childern in worse shape than Terri. I have been fortunate enough to bear personal witness to great love and devotion between parents and handicap children. I ask you this: If Terri's family was willing to devote themselves to her physical and financial care...where's the harm? On the other hand, great harm was the outcome....to more than just Terri.
Reply

Alexander Flyax New Orleans, LA April 4, 2005

About Terri's state Dear Ms. Crispe:

As an American citizen you should be shocked at the level of ignorance in this country. Jewish religion is unique in its emphasis on intelligent decisions, and philosophy of Chabad (on whose website your article is printed) is founded on rational and logical approach and prevalence of intellectual faculties over emotional ones. You, however, state that "a woman--conscious, albeit in a severely brain-damaged state--could be starved to death. I've seen the pictures of her smiling as her mother hugs her, huge eyes open wide as she surveys her surroundings. She supposedly has the responses of a 6-11 month old baby." You stated all of this about a person, whose cerebral cortex had been destroyed, 80% of whose middle brain had been destroyed, who had no EEG activity, and was doomed to death one way or another. She was not conscious and felt nothing, since the part of the brain that is responsible for consciousness or feeling did not exist in her body anymore. Reply

Anonymous Buffalo, New York April 3, 2005

Terri I don't think anyone will ever truly know what Terri Schiavo would have wanted. Unfortunately, she never filled out a living will or, more importantly, appointed a health care proxy to make decisions for her. The health care proxy would have discussed all of the moral, ethical, and religous implications of deciding to discontinue life support or life sustaining treatment. The proxy would have to have the courage to sign the DNR/DNI papers and, in the case of Terri, approve of the discontinuation of the feeding tube.

I don't mean to cause further anguish to Terri's husband, however, I think he could have been more reasonable and sensitive with her family. They are devout Catholics and yet he initially denied Terri the right to recieve the the eucharist and wine on the holiest day for Christians--Easter Sunday. And now, he is having her remains cremated instead of allowing her to be buried.

Why all the cruelty? He could have provided some solace. Reply

Anonymous stamford, ct March 31, 2005

It is the afternoon of March 31, and Terri Schiavo has just died.

I feel ashamed and terrified to have been forced-witnessed a living being die of dehydration. If we found a wounded bird on the ground, breast pumping in its terrified inability to fly to safety, we would wrap it in a towel and bring it to a vet.

I feel as though I watched a murder and was unable to prevent it. It is amazing to me that here in America we could have same "enlightened" doctors and scholars as pre-war Germany. Anyone who thinks this is too broad a comparison should read Robert J. Lifton's "The Nazi Doctors." This Harvard psychologist studied the rise of ideologies which would allow the best-educated members of a society, those sworn to never harm if they cannot help, to believe in the "progressive" mission of genocide. Reply

confused palm springs, ca March 29, 2005

re: terri For some reason i find this whole situation overwhelming. the fact remains that marraige is a sacred 'oneness' with G-d and each other. it is not for us or even her parents to be involved in this decision, and it is shameful that her parents did not respect her covenant with G-d and her husband. he is not killing her... the heart attack has deteriorated her body to the point that she cannot sustain her own life without intervention. i, personally, would be horrified in her situation, i would want to be allowed to rest in peace when my body could no longer sustain itself (meaning that i could not swallow and ingest food on my own). we all do not have enough information on terri, we have not lived with her, seen her progress or deterioration over the last fifteen years, known her wishes, nor struggled with her during her illness (bulemia) that brought on the vitamin deficiency that caused her heart attack, therefore we should not be involved in this decision at all... live life carefully Reply

Helen F. Stanbro Los ALamos, NM March 28, 2005

a similar case Apropos of Terri Schiavo, this abstract about a somewhat similar case with a better-than-anticipated outcome may be of interest:
Brain Inj. 2004 Sep;18(9):935-40.
Further recovery in a potential treatment withdrawal case 10 years after brain injury.
McMillan TM, Herbert CM.
Psychological Medicine, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK. t.m.mcmillan@clinmed.gla.ac.uk

A young woman was rendered tetraplegic and anarthric as a result of a traumatic brain injury in 1993. Two years later, she was considered to be in a minimally conscious state and became the subject of legal debate in the UK with regard to withdrawal of artificial feeding and hydration. Before injury, she made a verbal advanced directive that she would not wish to continue living if ever becoming severely disabled. Neuropsychological assessment found statistically significant evidence for sentience and expression of a Further meaningful recovery occurred between 7-10 years after injury. She now lives in the community with 24 hour care. She speaks, initiates conversation and actions, expresses clear and consistent preferences and has a spontaneous sense of humour. She uses an electric wheelchair, eats solid food and drinks through a straw. Her mood is variable and sometimes low. This case demonstrates the need for careful consideration of advanced directives and for specialist neuropsychological assessment in people with severe cognitive and communication difficulties. It supports the view that routine assessment and follow-up of people thought to be in minimally conscious states is important. In addition, it shows that recovery with reduction in disability and significant implications for quality of life can continue for at least 10 years after extremely severe traumatic brain injury.
Copyright 2004 Taylor and Francis Ltd
Reply

Mark Rumbak Tampa, Florida March 27, 2005

Terri Schiavo I am a critical care physician who lives in Tampa and has watched the Terri Schiavo case for many years now. The facts are as follows:

Terri sustained a cardiac arrest and landed up in a persistent vegetative state. Her husband tried for 2 years using conventional medical tratment to help his wife. He further tried for 3 years using unconventional means to rehabilitate Terri. This cannot be done. He then tried to carryout her wishes that she does not want to live in this state. Under the law in Florida, he has the right to withhold life sustaining means.

What would you do if the same had happened and she was on mechanical ventilation? Would you withdraw it if your loved one had no hope of meaningful life? Would you elect not to place the patient on life sustaing means in similar circumstances?

The patient is not your lovely daughter who is full of the joys of life but someone who is a shell. These patients can track and grin, can withdraw to pain but cannot do more. Reply

Bob March 26, 2005

How far will it go? When we decide that a human life is no longer worthwhile, and kill that person, as is being done to Terry, where will it end? When someone decides again that Jewish lives has no value and so it is OK to take it?

The Holocaust happened because of decisions like these: that we feel we have the right to say whose life is worthy of continuation, and whose is not. Reply

Anonymous CT March 26, 2005

Halakhah (=Jewish law) is very clear that one can not deny food and water from someone just because s/he is in a vegitative state with major brain damage. (Note: unlike secular American ethics, Halakhah distinguishes between brain stem dead, terminally ill, and vegitiative state with major brain damage.) Be that as it may, Halakhah is for Jews. Therefore, whereas it would be against Halakhah for a Jew to deny food and water to another Jew who is in a vegitative state with major brain damage, according to Judaism does the same ethic apply to non-Jews? The answer to this question would determine how we as Jews should respond to the Terri situation. In any case, it is still a sad situation and may HaShem grant healing to everyone who is involved. Reply

KL duPre' Poulsbo, WA March 26, 2005

Terri Sciavo Thank you for your article Mrs. Crispe. I agree with you completely. Daniel, from Munich, Germany, also makes a compelling comment about Dr. Mengele, which is, I think, not overstated.
Readers, don't miss Yanki Tauber's article, "The Value of a Life", also on this site. For me, the moral, ethical and religious bottom line on this subject. Reply

Eileen Coral Springs, FL via coralspringschabad.org March 26, 2005

Parents v/s Spouse & inhumanity Who chooses? The Law of the United States says that a spouse who is in all terms a Unity. This is the person who must make the call when to remove there spouse off life support. This is a law WE passed. I do agree that as we marry we are one, a union, a unity bound together until DEATH DO WE PART. If someone has to make a decision I am un-able to make, G-d willing they shall let it be the person whom I have chosen to be one (1) with. Let NO other man or women decide this. If you are forced with a decision that you cannot leave up to the ALMIGHTY, yet you cannot make it, who can, if someone has to? .. Why are we choosing her parents...?

I agree it is inhumane what they are doing, completely. We have medicines and advanced technology, yet they choose to let a women die, by starving her? They do not even do this to criminals! It is called IN HUMAIN~ what happened to meds? A painless way to go. Why are we resulting to starving this women...? Reply

Anonymous March 24, 2005

I agree with you 100%. It's truely terrifying what our world has come to. It's scary when people have the nerve/arrogance to believe that they can make a call on who lives and who dies. Only The Almighty can do that. This woman has the right to live just as much as the next person. There are people who love her and are willing to take care of her no matter what. Let them! She can breath on her own, her heart beats on its own. Her husband has obviously moved on, so why not divorce her? This scnenario paints a dark picture of where the morals of this world is going. Reply

Lee R Tracy los angeles, ca March 24, 2005

What makes this case special... ... is NOT the ethical facts. Hundreds of other people in similar situations have had their feeding tubes removed with no fuss and no pious commentaries from us. Where was our outrage then? We didn't care about these people because they were not on our TVs. And why not? Because the families agreed on the outcome. If we really think that all life is equal, feeding tube or no, we should FORBID anyone from having any life support removed, ever. And don't tell me that a feeding tube is not artificial life support. It absolutely is an artificial device. And from tubes to ventilators to whatever modern science dreams up in the future, this "ethical" choice to keep people alive at all costs is at its core a fundamental repudiation of "bitachon." When we make an idol of life and decide that the worst thing that can happen to a person is to die, we turn our backs on the reality of life in a most unethical way. Reply

Daniel Munich, Germany March 24, 2005

Life is nothing to play with,

Untill we find anyone who can judge spiritually and medically with absolute certainity, it is in no way right to starve another human being to death.
I am bored and annoyed by the argument of a non working neocortex, etc. Who of the ones who use this argument knows exactly about the neocortex, it`s interactions with other parts of the brain, the settelment of the soul in the body, etc ...
And at all, if the heart is working and the breathing, how can we declare someone as dead. The logic behind this is the kind of logic, that Dr. Mengele had .. because in his eyes he also only observed scientifically bodily reactions of human bodies so to say experimented to death.
If our society allows crueltiy to be happen, we show, that we feel ok with crueltiy and than we are ready to experience crueltiy. Sodom felt also o.k. with it.... Reply