Donate to RNS

Why even the worst cancer news won’t push me to try every treatment

(RNS) Not all potential life is equally valuable to me.

An old style of hospital bed.  Photo courtesy of Creative Commons/Matthew Perkins

(RNS) About a month and a week after the discovery that I have the brain cancer glioblastoma, I’m in a six-week program of radiation and chemotherapy.

There’s plenty of data that indicates the side effects are often real but often not terrible. And that the benefits are significant.

But it ain’t a cure.

This bumps the median survival expectation up from a few months without treatment to a bit less than a year and a half. That means I’ll be looking to try other, mostly experimental, treatment possibilities down the line.

I’m not planning to ask for some of everything, however. My philosophy is shaped partly by what I, a mostly agnostic Jew, have learned about some of the Jewish traditional teachings about medical treatments.

This Jewish point of view isn’t unanimous, of course. There’s no Jewish “pope” defining anything. So there’s little that is even close to universal. But what I’m thinking about has gotten a lot of attention over the millennia.

And it’s surely different from other religion-influenced perspectives expressed by some people.

Anybody who recalls the case of Terri Schiavo in Florida knows something about the extremes on one side. In 1990, she suffered some kind of seizure that killed most of her brain because of lack of oxygen. The part that stayed alive kept her heart and other internal organs going. But I read nothing that indicated there was real evidence she had any significant mind. Or even an insignificant mind.

Her parents wanted to keep her alive as long as possible with a feeding tube and any other technique. By 1993, her husband wanted to sign a “do not resuscitate” order preventing treatment for any infection and later he wanted doctors to remove the feeding tube and allow her to pass on. He said that’s what his wife would want.

In 2001, he won a court case that allowed him to have her feeding tube removed. She died 14 days later, shortly after her husband had her parents moved from the room.

“So his heartless cruelty continues until this very last moment,” the Rev. Frank Pavone, national director of Priests for Life, told Fox News.

After her death, the Vatican released at least two condemnations with a religious perspective.

Based on that, I should go for every treatment I can get, yes? And my wife should do the same if I lose so much mental capacity that I can’t act.

But that’s not what I plan.

I’ve already told my doctor that I want to know the details of risks and potential side effects along with possible benefits. If I’d gain time but lose all or a large portion of my mind, I’ll pass.

If I’d suffer such enormous physical side effects such as pain that it kills my quality of life in exchange for a bit more time, I’ll pass. I have limits.

The Jewish teaching that I think about here is a story in the Talmudic tractate called Ketubot.

A famous rabbi, Judah HaNasi, was dying. But his students kept him alive by continuously praying for divine mercy. The rabbi’s handmaiden agreed until she saw how much pain the rabbi was in. So she climbed to the roof and tossed a jar to the ground. The noise distracted the students for a moment. They paused praying and “the soul of the rabbi departed to its eternal rest.”

The Jewish writing does not condemn the woman. In fact, she’s presented as a hero in several high-level recent and old commentaries. For decades, medical ethicists have used the story to frame discussions about treatment withdrawal as care becomes higher tech.

For many recent years, even proponents of euthanasia have used the story.

I’m not pushing my thoughts that way — yet. (Though it’s possible I might decide I want to get my own ticket to the Egress at some point.) But I’m absolutely thinking about limiting treatment based on specific reasons. Not all potential life is equally valuable to me.

I will be ready to offer a polite “no thanks” to the medical equivalent of a successful life-extending prayer that offers the odds of neither a cure nor enough of a reduction in suffering. And I’ll get to whatever eternal rest comes next.

(Jeffrey Weiss is a longtime reporter who covered religion, faith and morality issues for more than a decade. In December, he was diagnosed with a brain cancer. He’s exploring how a likely end of life should affect his thinking about beliefs and behavior)