Nomos and Narrative in Jewish Law: The Care of the Dying Patient and the Prayer of the Handmaid

Extract

INTRODUCTION

The most frequent and difficult moral quandary faced by medical ethicists is how much effort must be expended to treat a dying patient. This dilemma is a daily occurrence in modern hospitals and causes much anguish to patients and their families. With the advent of new technologies such as mechanical ventilation and dialysis, patients that would have died quickly in the past can now linger for months dependent on these machines for their survival. These developments forced the issue of whether all patients should receive these life extending treatments or be allowed to die without aggressive treatment. The Western liberal answer to this question based on the principles of autonomy and human freedom, has been to let the patient decide how they want to die. The Catholic Church has differentiated between ordinary care which they require and extraordinary care which they leave to the patient’s discretion.¹ Naturally, Jewish decisors where also called upon to address the issue. The primary halachic source for the discussion is the gloss of the Rama in the authoritative Code of Jewish Law:

It is forbidden to cause the dying to die quickly; such as one who is moribund (gosses) for a prolonged time and cannot die, it is forbidden to remove the pillow from under him on the assumption that certain bird feathers prevent his death. So too one may not move him from his place. Similarly, one cannot place the keys of the synagogue beneath his head [because of the belief that their presence may hasten death] or move him that he may die. But if there is something that delays his death such as a nearby woodchopper making noise or there is salt on his tongue, and these prevent his imminent death, one can remove them, for this does not involve any action at all, but rather the removal of the hindrance to death.²