Q. My elderly mother is extremely ill and has all kind of medical complications; she is now in an ICU. We told the doctors to do everything possible to extend her life even though she suffers greatly. She herself has given instructions to resuscitate if necessary. What do we do if it comes to connecting to life support equipment such as a respirator?
A. Igrois Moishe (C.M. 2:73:1) and Horav Shlomo Zalman Auerbach Zt"l (Minchas Shlomo 1:91:24, quoted in Nishmas Avrohom Y.D. 339:4) permit in certain circumstances the withholding of extraordinary procedures from a seriously ill patient who is suffering greatly and has no hope of cure. The latter (ibid.) distinguishes between treatments which fulfill a person's basic needs or are accepted as routine, and treatments which are not considered routine. For example, Halacha forbids withholding oxygen or nutrition from a patient who is suffering from cancer, which has spread throughout the body and is near death, even though the patient is experiencing great pain and is suffering terribly. If he is diabetic, one may not withhold insulin from him with the intention that he dies sooner. One may not withhold blood or antibiotics that are necessary for his care. One may not withhold these treatments even if the intention in doing so is not to hasten the patient's death. On the other hand, we are not obligated to administer non-routine and painful treatments, which serve only to lengthen life and do not cure the fundamental problem. This especially applies if the patient objects to such treatment because of the suffering he would be forced to endure as a result.
Horav Shlomo Miller"s Shlit"a opinion is that for a terminally ill patient that experiences great suffering, connecting him to life support such as a respirator is seen as an extraordinary procedure. However, situations differ and constantly change, occasionally for the better, so a competent Rabbi familiar with the case and the attending medical team should be consulted. Care is of the essence when indicating to the assisting doctors that no respirator should be employed, as they may regard this instruction as an invitation to cease the obligatory basic routine needs of the patient mentioned above. Horav Miller Shlit'a also advised that this instruction should wait until requested by the medical staff.
Rabbi a. Bartfeld as revised by Horav Shlomo Miller Shlit"a
Important Numbers
