Treatment Decisions Near the End of Life
TREATMENT DECISIONS NEAR THE END OF LIFE ARE AMONG the most common—and most wrenching—issues in bioethics. In countries such as the United States, most deaths are accompanied by decisions about whether to forgo life-sustaining treatment. These situations include dramatic decisions to terminally wean a patient from a respirator, controversial decisions to forgo artificial nutrition and hydration, and simple and sometimes implicit decisions not to try yet another round of chemotherapy. Choices about forgoing treatment can be informed by values and precedents of traditional discourse. They have generated extensive discussion in Jewish and Catholic bioethics.
Discerning treatment decisions near the end of life involves central values of each tradition in powerful but often ambiguous ways. Respect for divine sovereignty and the responsibilities of stewardship could support continuing life-sustaining treatment, avoiding what might be regarded as a decision against life; yet at some point respect for divine sovereignty may require letting go and accepting the inevitable end of mortal life. Values such as love of neighbor and human dignity could support either continuing treatment or allowing a patient to die.
Judaism and Roman Catholicism share a commitment to the value of life and the responsibility to provide healing to persons in need. Life is understood to be a gift entrusted to human persons by a loving and beneficent Creator, the author and sustainer of life. Accordingly, people are responsible to preserve life and health and to pursue effective and beneficial medical treatment. Both traditions have long opposed active euthanasia, assisted suicide, and suicide, and most authorities today continue this opposition. The two traditions agree that patients