Ancient Answers to Modern Questions: Death, Dying, and Organ Transplants - a Jewish Law Perspective
Werber, Stephen J., Journal of Law and Health
I. INTRODUCTION III. DEFINING DEATH III. ORGAN TRANSPLANTS IV. "CHOOSE LIFE"--MEDICAL DIRECTIVES, EUTHANASIA, SUICIDE
B. The DNR Conundrum
D. Assisted Suicide V. CONCLUSION
Medical advances have made it possible to extend life or defy death as it was known for centuries and have also compelled ethicists and health professionals to rethink our definition of death. Moral issues surrounding application of medical advances upon issues of death and dying have assumed a preeminent position among societal concerns. These moral issues relate to a matrix of other complex issues: the extent to which we should consider the psychological effects of extended long term illness upon the victim and his or her family; defining quality of life and how it bears upon the decision-making process; and placing the financial aspects of the dying process into perspective when we know that a substantial portion of all medical expenditures for a given person are made in that person's final year of life. Although only the most callous would allow financial elements to determine life issues, their ramifications upon the lives of those who survive can be too serious to ignore.(2)
When is it proper to terminate lifesaving efforts? When is it proper for a family member to assist in bringing about an earlier death? Does the answer change if the assistance is provided by a medical professional? Does Jewish Law provide guidance and aid us in drawing lines that are practical while supporting the emotional needs of all concerned? Does Jewish Law permit a modern definition of death (brain death), or must more traditional, ancient definitions apply to foreclose organ transplant procedures which would save or enhance life?(3) Is one view or the other the more moral or correct?
No one can answer these questions for any but himself. No hospital ethics committee can impose its values and norms upon all patients and rest assured that its collective wisdom leads to the right decision. No religion can pretend to provide God's answer or the only resolution.(4) Nevertheless, the wisdom of the sages can provide elements of a value system, logic, and guidance which can ease the anxiety and uncertainty of the decision-making process and remove the edge of guilt which may arise from that process.(5)
Many have dealt with these issues on a personal level. When I was twenty-four the question was put to me: "Should we let her go or should we operate and buy a few days, maybe more?" I had no foundation upon which to base a decision other than my instincts. Despite the passage of over thirty years that decision remains a part of my life. Today, I am aware of sources that would have provided guidance for, and eased the burden of, my decision. These sources are found in the laws of Torah and their interpretations over a period exceeding two thousand years. This article seeks to provide the reader with an introduction to these sources and to suggest some answers found within them.(6) To better appreciate the significance of the laws discussed below a short digression into history and nomenclature may be of assistance.
The Torah is the bedrock source of Jewish Law. It is often referred to as the Five Books of Moses, the Pentateuch, the Tannach, or even the Bible. To Christians it is usually referenced as the Old Testament which includes the books of Genesis, Exodus, Leviticus, Numbers, and Deuteronomy The Torah was developed from approximately the fifth century B.C.E. and became a recognized sacred text circa 400 B.C.E.(7)
The Hebrew word Torah literally means instruction though to some it is considered revelation. The Torah itself is a sacred object. Torah is the original source of how one's life should be led and its laws are directed to this concept. It is erroneous to consider Torah as synonymous with "law" rather than a means of instruction, revelation, and scripture whose commandments will, if followed, provide a complete way of life. …