ISSUE #7
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END-OF-LIFE ISSUES:
COMMON EXAMPLES THAT REQUIRE EXPERT RABBINIC GUIDANCE (2)

QUESTION
Last week's journal issue enumerated seven examples of complex end-of-life issues wherein it is crucially important for patients and families to gather the relevant information from their doctor and then seek in-depth guidance from an expert Rabbi who has experience in the field. Those examples touched upon issues concerning hospice care, life support machines, feeding tubes, pain medication, the status of "Goses" (actively dying), and termination of a fetus. Can you give some additional examples?

ANSWER

Certainly! The following five additional examples of end-of-life issues all raise very complex questions concerning which patients and families must seek guidance from an expert Rabbi with experience in the field:

  • A cancer patient (for example) is told by doctors that: a) If the cancer (or other illness) is left to run its course without any intervention, then the patient may have only a short time (such as a limited number of months) left to live; b) However, a successful operation could likely prolong the patient's life very significantly (perhaps by many years or potentially even decades); c) On the other hand, if the operation is performed unsuccessfully, this might cause the patient to die immediately. How does the Torah guide a patient when facing such an inscrutably difficult choice?
  • In an end-of-life situation wherein an operation is anticipated to (probably) prolong a patient's life, but is also predicted to (probably) cause the patient to suffer from significantly reduced function, and/or lifestyle changes, is the patient obligated to undergo the operation?
  • What if the patient (in the situation described above) is already (i.e. even without the operation) suffering from severely reduced function (e.g. the patient is wheelchair-bound, chronically bedridden, suffers from paralysis/amputation or other severely debilitating conditions) - is such a patient obligated to undergo a life-prolonging operation even in the absence of a desire to do so?
  • Regarding a patient whose near-term ability to survive depends upon continuing to receive treatments that can be physically difficult and emotionally overwhelming (e.g. dialysis, chemotherapy, etc.): If the patient wishes to reduce or completely withdraw from the doctor-recommended level of treatment, is s/he obligated to continue the treatments anyway? 
  • Regarding situations that raise end-of-life issues, how much consideration (if any) should be given to factors such as the patient's age (e.g. "the patient is now elderly and has already lived a long life"), cognitive ability (e.g. the patient has dementia and is suffering deficits in their understanding, memory, or ability to communicate), or mental health (e.g. psychosis, severe depression, anxiety or paranoia, etc.)?
 
For over two decades, CMC has been counseling patients and family members throughout the Chicago area concerning end-of-life issues such as those mentioned above. CMC connects patients and families with local Rabbonim who are expert in the end-of-life field, so that they may be reassured of having authoritative halachic answers that are tailored to their specific individual circumstances.

To request CMC guidance and/or support regarding an end-of-life issue or for any patient and/or family member struggling with illness, please call CMC or click this link to visit CMC's website.
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Rabbi Aron Wolf
Chicago Mitzvah Campaign
2939 W Touhy Ave
Chicago, IL 60645
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