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This protocol evolved in response to the very real problem of futile care and continuation of life support solely to avoid the violation of Jewish law (halacha). But it is open to question for several reasons. (1) The lack of direct disconnecting a respirator may cause the decisions to be made with less debate and consideration than would otherwise take place. (2) Not all Jewish religious authorities would agree that a device which merely delays an action is therefore considered a "grama" (Jewish legal designation of a causation). This has been hotly contested by contemporary scholars with regard to the acceptability of a delayed turn-off of a kitchen stove on the Jewish holidays when direct turn-off is not allowed. (3) Orthodox Jewish legal opinion is not monolithic, and follows multiple approaches even though all affirm the same tenets. While some opinions may object to withdrawing life support because the act of removal of respiratory equipment is considered to be terminating a life, an objection which could be resolved with an indirect removal; others would object because of the unlimited value of human life, and a belief that life and death decisions are to be reserved for a higher power. They would find delayed disconnection to be equally objectionable.
Perhaps these issues explain why this paper was originally presented by its lay author in 2005, and despite the availability of electronic timers and delay mechanisms, has still not been but into action.
Competing interests:
No competing interests
20 December 2013
Avrohom A Marmorstein
rabbi
Hackensack University Medical Center; Union Graduate College/Mount Sinai School of Medicine graduate student
I was surprised to read that the Israelis require legislation to
enable them to turn off the ventilator of a dying patient.
Switching off a ventilator and allowing a patient to die of his/her
underlying, overwhelming disease should not be classed as euthanasia. The
concept of 'passive' euthanasia is a very unhelpful one--leading to
confusion and blurring around the true euthanasia debate.
Re: Israelis turn to timer device to facilitate passive euthanasia
This protocol evolved in response to the very real problem of futile care and continuation of life support solely to avoid the violation of Jewish law (halacha). But it is open to question for several reasons. (1) The lack of direct disconnecting a respirator may cause the decisions to be made with less debate and consideration than would otherwise take place. (2) Not all Jewish religious authorities would agree that a device which merely delays an action is therefore considered a "grama" (Jewish legal designation of a causation). This has been hotly contested by contemporary scholars with regard to the acceptability of a delayed turn-off of a kitchen stove on the Jewish holidays when direct turn-off is not allowed. (3) Orthodox Jewish legal opinion is not monolithic, and follows multiple approaches even though all affirm the same tenets. While some opinions may object to withdrawing life support because the act of removal of respiratory equipment is considered to be terminating a life, an objection which could be resolved with an indirect removal; others would object because of the unlimited value of human life, and a belief that life and death decisions are to be reserved for a higher power. They would find delayed disconnection to be equally objectionable.
Perhaps these issues explain why this paper was originally presented by its lay author in 2005, and despite the availability of electronic timers and delay mechanisms, has still not been but into action.
Competing interests: No competing interests