Right to die as well as pos­si­ble

The Jewish Chronicle - - COMMENT - Jonathan Ro­main

IF SOME­ONE you love is at the end of life, dy­ing in great pain, wishes not to con­tinue and in­stead wants take med­i­ca­tion that will al­low them to gen­tly slip away, should that op­tion be avail­able? At present, this is il­le­gal in Bri­tain – those who do so fall foul of the Sui­cide Act and any­one who as­sists them can be li­able to prose­cu­tion. How­ever, leg­is­la­tion to in­tro­duce as­sisted dy­ing will be de­bated to­day (Fri­day, July 18) in the House of Lords.

How should Jews re­act? Sui­cide has al­ways been re­garded as wrong, but as­sisted dy­ing is a dif­fer­ent sit­u­a­tion. It does not ap­ply to people who, for in­stance, if they over­came their de­pres­sion, could live hap­pily for many years to come, but to people who are ter­mi­nally ill. Their only choice is how and when they die.

Un­til now, Jewish med­i­cal ethics has recog­nised that there are in­stances where one can stop some­one from be­ing kept alive ar­ti­fi­cially, such as through a life sup­port ma­chine, but has op­posed al­low­ing pa­tients to take life-end­ing med­i­ca­tion.

Rab­bis tend to re­fer to “the sanc­tity of life” . Sanc­tity of life means valu­ing each in­di­vid­ual life, but does it in­clude in­sist­ing some­one lives on, against their will, in pain?

Some see value in suf­fer­ing, and it is cer­tainly true that it can al­ter one’s per­spec­tive, but what use is that in one’s fi­nal days, es­pe­cially if the per­son is semi­con­scious with mor­phine, while it is a cruel God who uses hu­man agony as a divine black­board.

Oth­ers ar­gue that “God gives and God takes” and we can­not usurp that pre­rog­a­tive. Yet we are con­stantly de­fy­ing God’s hand­i­work at both ends: help­ing women other­wise un­able to con­ceive, or giv­ing heart trans­plants to those who need them.

There are many who re­gard a painful death as a re­gret­table part of the nat­u­ral cy­cle of life, to be mit­i­gated through med­i­cal care if pos­si­ble and to be en­dured if not. That is en­tirely their view and must be re­spected.

But should those who wish to avoid that pain and in­dig­nity have the right to do so? And do other people have the right to pre­vent them mak­ing that choice?

Ec­cle­si­astes says: “There is a time to be born and a time to die”. It is no­tice­able that it does not say who chooses that time. Maybe it can be our de­ci­sion.

Of course, there are prac­ti­cal con­cerns that as­sisted dy­ing may ren­der some people vul­ner­a­ble to pres­sure from un­scrupu­lous rel­a­tives, but the Bill has nu­mer­ous safe­guards.

The process can only be ini­ti­ated by the pa­tient; it must be con­firmed by two in­de­pen­dent doc­tors that they are ter­mi­nally ill and of sound mind; they must be coun­selled by a pal­lia­tive care ex­pert to en­sure they have con­sid­ered other op­tions; there has to be a 14-day wait­ing pe­riod for re­flec­tion; and they can change their mind at any time. The same process was le­galised in Ore­gon in 1997. Sev­eral thou­sand dy­ing pa­tients per year en­quired about the pos­si­bil­ity, but only around 0.2 per cent (in 2012 this meant 75 people) ac­tu­ally chose it.

It in­di­cates that many people wish to have the emo­tional safety net of know­ing they can re­sort to an as­sisted death if their sit­u­a­tion makes life in­tol­er­a­ble, but the vast ma­jor­ity find they never reach that stage.

This is dif­fi­cult ter­ri­tory, but it is re­li­giously ap­pro­pri­ate to try to nav­i­gate it. If there is a right to die well — or at least to die as well as pos­si­ble — it means hav­ing the op­tion of as­sisted dy­ing, whether or not it is taken up.

We defy God’s work in med­i­cal treat­ments

Jonathan Ro­main is rabbi of Maiden­head Syn­a­gogue and edi­tor of As­sisted Dy­ing – Rab­binic Re­sponses (Move­ment for Re­form Ju­daism)

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