COMMENTARY: Suddenly, the hospital room is a moral arena

c. 1996 Religion News Service (Rabbi Rudin is the national interreligious affairs director of the American Jewish Committee.) (RNS)-Two recent federal court decisions on physician-assisted suicide have raised profound questions for America’s religious communities, issues that many clergy are ill-prepared to face. In March, a Washington state law banning medical suicides was struck down; in […]

c. 1996 Religion News Service

(Rabbi Rudin is the national interreligious affairs director of the American Jewish Committee.)

(RNS)-Two recent federal court decisions on physician-assisted suicide have raised profound questions for America’s religious communities, issues that many clergy are ill-prepared to face.


In March, a Washington state law banning medical suicides was struck down; in early April a similar New York State law also was struck down. While 32 states currently have legislation forbidding assisted suicides, the two court rulings have placed all such laws in legal jeopardy, and it is likely that the U.S. Supreme Court will eventually rule on the matter.

Suddenly, the hospital room has become the locus for moral and spiritual questions once discussed in abstraction within synagogues and churches. Ministers, rabbis, priests and other religious authorities are going to have to learn to function as effectively in this moral arena as they do in their own houses of worship.

The rulings turned on the judges’ opinions that mentally competent individuals have a constitutional right to make decisions about terminating their lives. The courts also protected physicians from criminal prosecution if they assist patients in ending their lives.

This may sound logical enough, particularly to proponents of the so-called”death with dignity”movement. But the rulings raise a number of troubling questions for clergy and laity alike.

-Who, after all, will decide whether a person is truly competent to make life-ending decisions?

-Can a dying person in great pain be considered mentally competent to make such an irreversible decision?

-What, exactly, is a terminal medical condition? Is a seriously ill person one who has only 6 hours, 6 days, 6 weeks, or 6 months to live? Who can guarantee the accuracy of such time frames?

-What about pressure from family members who are eager to receive their inheritance money as quickly as possible from an acutely ill relative?


The court decisions presuppose careful deliberation of assisted suicide by all interested parties: patients, their families, physicians, hospitals and nursing homes-and, one hopes, religious authorities. But such circumstances rarely exist in intensive-care units or bustling hospital corridors.

As health costs continue to soar, insurance companies and hospitals will increasingly seek the most cost-efficient means of treating patients. Clearly, it takes more time and money to treat physical pain and mental depression than to help a person die. The financial bottom line will always prefer assisted suicides over the more costly treatments for pain and depression.

And in the real medical world, the first people who will be assisted into death will likely be the poor, those without family or friends, the elderly, the disabled, and uninsured patients who cannot pay for their medical treatment.

There is another chilling aspect. Everyone knows that some physicians covertly ease their patients through death’s door. Sometimes this is done by acts of commission, such as prescribing certain medications to hasten death. But often death comes through a doctor’s act of omission, such as choosing not to aggressively treat the terminally ill when complications like pneumonia and other deadly infections occur.

This furtive behavior puts enormous strain upon the medical community. No wonder many physicians are looking for a legal remedy for their ethical dilemmas. While fully recognizing the torment of both physician and patient, I am fearful that legalizing assisted suicides will permanently replace the traditional role of the physician as healer with that of potential killer.

Judaism stresses the natural aspect of death and teaches we should not fear the end of our lives. And since God alone determines death, it cannot be hastened in any way. Indeed, according to the tradition, anyone who performs any act that may inadvertently hasten death is regarded as a shedder of innocent blood.


But I wonder how many people, in the duress of making treatment decisions for a terminally ill loved one, are aware of teachings such as these?

We clergy are very good at visiting the sick, burying the dead and consoling the bereaved. But with few exceptions, when family members seek counsel on treatment decisions for a patient nearing death, clergy refrain from becoming involved, preferring to leave such matters to family and physician. Clergy are not as well educated as they should be on the latest advances in medical technology, in the nuances of bioethics or in counseling techniques that will help people resolve these moral dilemmas.

As advances in medical technology provide us with more and more choices and bioethical issues increase in number and complexity, the clergy must not only become better educated on this subject, they must become fully engaged.

If clergy are not prepared to confront the moral and ethical dilemmas in our hospitals-including assisted suicide-critical bioethical decisions about life and death will be made solely by others. Religion would be cut out of the process. And that would compound the tragedy.

MJP END RUDIN

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