Positive values sometimes conflict with each other; this makes for difficult decisions. Nowhere is this more heart-wrenchingly the case than in dealing with issues that often emerge at the end of a person's life.

The process of the dissolution of the bond between body and soul is not always sudden. Just as the soul enters the body in stages (conception, pregnancy, birth, etc.) so, too, it often leaves the body in stages. The person may progressively weaken; faculties such as sight, hearing, cognition or even consciousness may be diminished or depart entirety. But as long as there is any life at all in the body the soul is present within it, even if the body has lost virtually all ability to express the soul.

What is the core, stripped-down-to- its-essence value of a human life? Thus there will be times when we are asked to decide between two compelling truths. On the one hand, our sense of life as being about the experiences we treasure as human beings. On the other hand, a more abstract but very real question: what is the core, stripped-down-to-its-essence value of a human life?

In the first instance, we look at a person, lying immobile in a hospital bed, and ask ourselves: to what purpose are we to prolong his or her life, when s/he can no longer experience all that s/he enjoyed and brought a twinkle to his/her eye? Without joy and pleasure, without the stimulation of the society of family and friends, what value does his/her life have? This question would carry the day if we were indeed simply beings who are composites of our experiences, beings who begin with birth and end with death. However, as we explored in our introduction, there is much more to a human being than that.

We have a body that functions from birth till death and a soul that was there before and continues after. We exist as living
The Torah's absolute standards save us from drawing lines in the sand that may be in the wrong place after all...
beings because G‑d fused the body and soul. We live as long as G‑d keeps those two entities together. The fact that a person is alive means that G‑d desires this presence in our world. If we ask, "to what purpose?" we answer that G‑d's sense of purpose is far deeper than ours, and if we cannot see the crucial value of the unconscious or incognizant person, G‑d can and does. After all, many ancient societies believed the brain had no important function and questioned why it was created.

There are profound dangers in us assigning value to life based on functionality. Shall we then liquidate those with low IQ's or ALS, and so on?

Absolute standards of respect for life as defined by the Torah save us from drawing lines in the sand that may be in the wrong place after all.

On the other hand, the Torah demands that we look at the following considerations, as well:

  • If the individual is suffering pain, this is also spiritually and morally significant, and we have an obligation to alleviate pain even if it contradicts achieving the maximum of life-span for this person. Thus, Torah law sanctions avoiding invasive procedures that do not offer hope of a cure. Torah law also sanctions giving high though not fatal doses of analgesics.

  • Dying is a process of separation of body and soul. Sometimes this divorce is sudden; sometimes it is protracted. We have to be careful not to unduly suspend or interrupt this process. Where lies the "bright line" between hastening death and allowing it carry it course?

All of the aforementioned is why we have an independent source of authority. Halachah is the "way" and "path" of Torah that guides us even in these stormiest of life's waters.

Getting Practical

There are many hard choices to be made as the end of life seems to approach, and often we have the burden of having to choose for our loved ones as they are no longer capable of doing so.

Essentially, the key components of Jewish tradition are:

  1. Our life belongs to G‑d, who entrusted it to us to care for it and preserve it.

  2. Hence euthanasia, and all forms of it, are rejected by Jewish law. Life is G‑d's choice in us. As long as a person breathes and the soul is in the body, life has absolute and irrevocable value.

  3. At the same time, we accept that physical life is finite. Thus we are not obligated to proactively interfere with the process of dying. Medical measures that prolong life but also prolong suffering need not be taken.

  4. Generally speaking, autonomous breathing and heartbeat have to cease before we can harvest the organs of the deceased for transplant. Every life is of equal value—we may not sacrifice one life for the sake of another.

  5. There is a profound difference between intervention and non-intervention. If a particular medical intervention only prolongs dying and suffering there is no obligation to intervene. But if intervention is used to hasten dying—such as removing a respirator or feeding tube—the issues are far more problematic and need expert rabbinic opinion. This is because we may not hasten death at all. Also, intervention to provide nutrition is obligatory, as it is not considered a "medical" intervention.

These are the general guidelines that govern end-of-life issues in Jewish law. The details and applications to specific situations are often complex and difficult, and a competent local rabbinic authority should be consulted.

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