Q: If one has a disease which, if left untreated, will result in death, is it a sin? Is it suicide to refuse treatment? What is your opinion about right-to-death issues (euthanasia) for terminal patients? — Name withheld
A: What a person who is terminally ill (I am going to assume that the person in your question is you) decides to do about medical treatment depends upon one big question: Can I be cured?
If medical science still offers you hope, it is wrong to throw away that therapeutic hope. If medicine can heal you, you should let it heal you. If the therapeutic protocol causes you pain, the pain can be treated. If the therapy causes you to lose some of your previous abilities, try to focus on what you still can do.
However, if your doctors tell you that there is nothing more that medical science can do to heal you, you are under no obligation, theological or ethical, to submit to medical procedures that have no medical point. This is the time to involve hospice care. Hospice care provides palliation, which means it treats the pain not the disease; it allows the patient to die in peace and comfort, surrounded by loved ones. Hospice provides the only type of "good death" (the meaning of euthanasia) that faith can endorse. Hospice care does not prematurely kill dying people. Hospice care merely removes external impediments to death. If you think of your life now like a sputtering candle at the end of its burn, hospice does not blow out the candle. Hospice allows the candle to burn out naturally. This is not only not a sin, it is holy work and the people who work in hospice care are angels to me.
When you think about it, killing people is justified only by two things, and neither has any moral or spiritual value.
The first is that it is more convenient and economical to kill dying people. Caring for the dying can be expensive and can impose a great burden of care on the patient's family. For this economic and self-centered reason, what is often presented as putting the dying person out of his or her misery as an act of mercy can be, in certain cases, just a hypocritical justification for a selfish family to keep them out of misery and to preserve more of the dying person's estate for themselves. I do not want to cast aspersions on all families or all patients who are open to killing dying patients early in their diagnosis. Some no doubt are motivated by mercy and love, but I remember a woman begging me to tell her doctors to keep her alive. "My kids just want my furniture!" she sobbed. Visiting dying people for 40 years can make one cynical; I plead guilty to that at times.
I believe that one of the main reasons to let the dying fade from life in a natural unhurried way is that caring for the dying is one way love can be repaid. I never understood how one woman could raise six kids, but six kids could not care for one mother. Love is freely given and should be freely returned at the end of life.
The second reason often offered up to kill the sick and dying is pain. This is a powerful reason because pain is the one human emotion we cannot feel in others. Sometimes even with palliative care, pain is excruciating for dying patients. Even so, pain is not enough of a reason to end a life that will in its natural course soon come to a natural end. Pain can be ameliorated. For Christians, the example of Christ's suffering is a model of the sanctity of pain. I have seen people suffer and I understand their desire to end it, but I do not believe we were put here to manage our own life's boundaries. I believe that God is with us to the end.
A nun wrote to me describing a conversation with a young boy who was dying of AIDS. The boy asked the nun, "What is it like to die?" The nun asked the boy, "What do you think?" The boy answered her, "I think dying is like falling asleep and then waking up in God's arms." I think so, too. Do not hasten death. Do not try to fall asleep before your time. God is waiting to embrace your soul. You should wait just a little while longer to embrace God.
SEND QUESTIONS AND COMMENTS to The God Squad at firstname.lastname@example.org or Rabbi Marc Gellman, Temple Beth Torah, 35 Bagatelle Rd., Melville, NY 11747.