c. 1997 Religion News Service

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

UNDATED _ Two recent court decisions dealing with the complex and emotional subject of physician-assisted suicide have raised profound issues for America’s religious communities _ issues many Jewish and Christian leaders are not prepared to face.

Last year, federal courts struck down laws in the states of Washington and New York banning doctor-aided suicides. While 32 states currently have legislation forbidding assisted suicides, the two rulings have placed all such laws in legal jeopardy. The U.S. Supreme Court is currently debating the constitutionality of the two laws, and a decision is expected this spring. As a member of the New York State Task Force on Life and Law, an official body that deals with bioethical questions, I have come to have serious problems with any attempt to legalize assisted suicide.

The lower court rulings were based on a reading of the Constitution that gives individuals the right to make decisions about terminating their own lives. In the New York ruling, however, it was stipulated that only mentally competent patients who are terminally ill are entitled to make such momentous decisions.

The reasoning, however, leaves a host of questions unanswered.

Who, for example, will decide whether a person is truly competent to make life-ending decisions about oneself? Because critically ill people are often severely depressed and in acute pain, it is not difficult for a family member or a physician to extract the patient’s wish to end it all.

But is such an irreversible decision made by a truly mentally competent person? Many doctors have found their patients’ desire to die often end when they are effectively treated for depression and when severe pain is eased.

Also unanswered is the question of what exactly is a terminal medical condition? Is it a seriously ill person who has only 6 hours, 6 days, 6 weeks, or 6 months to live? Who can guarantee the accuracy of these precise time frames?

As health costs continue to soar, insurance companies and hospitals will increasingly seek the most cost-efficient means of treating patients. Clearly, it is more expensive to treat an individual’s physical pain and mental depression than it is to assist a person to die. The financial bottom line will usually favor assisted suicides over more costly treatment for pain and depression.

What about those family members who are overly eager to receive inheritance money from an acutely ill relative? We can easily guess their views about assisted suicide.

The recent court decisions presuppose careful deliberation by all interested parties: patients, physicians, hospitals or nursing homes, and families. But such ideal circumstances rarely exist in intensive care units.

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

There is another chilling aspect to all this. Everyone knows that some doctors sometimes covertly aid their patients to die. Often this is done by acts of commission like prescribing certain medications to hasten death. But frequently death comes through acts of omission when doctors do not aggressively treat problems such as pneumonia and other deadly infections when they strike seriously ill patients.

This furtive behavior has placed enormous strain upon the medical community, and no wonder many physicians are looking for a legal remedy for their ethical predicaments. While fully recognizing the torment of both physician and patient, I am fearful that legalizing assisted suicides will permanently replace the traditional role of doctors 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 must not be hastened in any way. Indeed, according to the tradition, if an individual performs any act that may inadvertently hasten death, such a person is regarded as one who sheds innocent blood.

It is clear that the hospital room has become a new frontier in addressing the moral and spiritual questions that are usually discussed only in the abstract within synagogues and churches.

Today, clergy must be centrally involved as difficult bioethical questions increase in number and complexity, and as advances in medical technology demand more and more choices from us.

And if clergy are not prepared to confront the dilemmas _ including assisted suicides _ that exist in our hospitals, the critical bioethical decisions about life and death will surely be made by others. And that would be a tragedy.

MJP END RUDIN