For the second time in less than four years, a debate is taking place in our nation over the issue of physician-assisted suicide. It is a debate that has serious moral as well as public policy implications. It is also, disturbingly, a debate that most of the Jewish community seems to be ignoring.
The “pop” image of physician-assisted suicide is that of Jack Kevorkian administering a lethal injection to an ailing individual on 60 Minutes. The image offered by advocates of its legalization is certainly more sympathetic; it imagines a terminally ill person suffering horrible pain due to the inadequacy of legal, pain relief medications and that allowing someone to “die with dignity” is the truest act of love in such circumstances. Unfortunately, this sympathetic image is as detached from reality and the kind of society we should champion as is the first.
Moreover, in any of these circumstances, Jewish tradition has clearly enunciated the infinite value of life and its prohibition for this active form of euthanasia.
As recently as October 17th, the Portland Oregonian newspaper featured a detailed account of one person’s assisted suicide odyssey from the only state where this practice has been legalized. The account highlighted the real world dangers inherent in the legalization of this practice, especially as relates to those least capable of protecting themselves from harm. 85 year old Kate Cheney, suffering from inoperable cancer, petitioned to be assisted in committing suicide. As a result of her illness, she suffered bouts of dementia and was, therefore, referred by her doctor to a psychiatrist for evaluation as required by Oregon’s “Death With Dignity” law. The psychiatrist found Ms. Cheney to be suffering from short-term memory loss and, more worrisome, wrote that the Cheney’s daughter was the proponent of the suicide much more than the Kate herself. Ms. Cheney was thus refused assistance in killing herself.
But the story does not end there. Cheney’s daughter took her suffering mother to a second doctor who referred her to a psychologist, who determined that the mother was competent to kill herself with assistance. The final decision on the matter fell to the “ethicist administrator” for Kate Cheney’s HMO; he approved the lethal prescription, she took it, and died.
Reflecting upon this report, the Oregonian editorialized that “tales of some Oregon assisted suicides betray more troubling issues than anything assisted suicide foes could call up.” The editorial recognized that the law’s safeguards contain huge loopholes that could never be closed and underscored the substantial financial interest health insurance companies have in terminal patients committing suicide rather than insisting upon receiving costly palliative care. The editorial concluded realizing that passage of the pending federal legislation would rescue the state from these moral crises.
We well know that Jewish tradition holds the preservation of human life as one of its supreme moral values. It takes precedence over virtually all other moral values to the degree that only the violation of three cardinal sins (idolatry, adultery and murder) in limited circumstances can claim precedence over the imperative to preserve life. Nevertheless, Judaism — acutely linked to the reality of the human condition – realizes there are circumstances in which a person might long for death. The Talmud reports of Rabbi Judah the Prince suffering great pain from an illness and his righteous maidservant praying for his death as an end to his suffering. At least one commentator cites this passage as an approbation of praying for the merciful death for one suffering in pain from illness.
Even with this appreciation of our human reality, Jewish Law does not reduce the mandate that we preserve life, even under the most challenging conditions. While rabbinic authorities, ancient and modern, debate whether under limited circumstances medical treatments may be withheld from a suffering person (thus, no longer delaying an inevitable death), it is abundantly clear that one may not proactively hasten death. At the same time, Jewish Law would endorse the aggressive palliation of pain to a degree not currently practiced in the medical profession. Rabbinic authorities place such treatment under the rubric of loving one’s neighbor as one’s self (Leviticus 19:18) and condone even the use of narcotics to ameliorate a person’s pain.
In 1997, the U.S. Supreme Court was asked to invalidate state laws in New York and Washington that criminalized physician-assisted suicide and recognize a constitutionally protected right to obtain such assistance. The Orthodox Union, along with many other concerned constituencies, argued before the high court that the Constitution clearly did not speak to this issue, let alone resolve it in favor of a right to die. The court prudently ruled as such and recognized that this policy debate should be resolved in a legislative body, not a court.
America’s national legislature has now acted upon the court’s holding. [Two weeks ago,] the House of Representatives took up this critical issue and voted 271 to 156 in favor of the Pain Relief Promotion Act of 1999. This measure does two important things thoroughly consistent with the Jewish values outlined above. First, it promotes the aggressive treatment of pain by offering doctors a “safe harbor” for prescribing controlled substances to reduce pain, even if the use of these otherwise illegal drugs results – unintentionally – in the patient’s death. Second, the bill largely overrules an Oregon law legalizing physician-assisted suicide in that state. The legislation now awaits action in the U.S. Senate where its chief proponents are Don Nickles (R-OK) and Joe Lieberman (D-CT).
The bill has been endorsed by many groups including the American Medical Association, National Conference of Catholic Bishops as well as former Surgeon General C. Everett Koop. To date, the Orthodox Union has served as the sole Jewish voice in this coalition; a puzzling fact considering the clear moral and societal import of this issue as well as the clear message of the Jewish tradition on it as well. We hope the broader Jewish community will join with us in an effort to promote the fundamental value of the sanctity of human life we have long professed.
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