Q: Thank you for writing your column, I read it regularly. I am an agnostic. Most of my family are believers. My mother and I have discussed this issue many times. She agrees with you that it is not our choice to decide when we are taken from this earth. She believes that it is God's decision alone. I have a couple of issues with this.
Why would we allow our loved ones to suffer? Not only physical suffering, but emotional suffering as well. It is demoralizing to the extreme to have your loved ones look at you with pity and sadness as the body deteriorates (I have been told). Pride and dignity are feelings that all people should be allowed to take with them when they die. A prolonged illness can strip these away. We will end the suffering of our four-legged family members. Having the same mercy for our loved ones who walk on two legs seems the right thing to do. This has to be a decision made by the person suffering. If there is a God who welcomes his people after they die, I think he would still welcome them if they decided to end their pain and suffering early. Thank you. — J
A: I do agree with you, dear J, that God welcomes into the world to come (Heaven) all those who have passed through life. Those who died by despair will find, I believe with all my soul, a place of hope and solace near to God. They have taken their own lives, but they are not murderers. They are just people who have found that hope has eluded them. God will forgive them and so must all of us who failed to hang onto them. However, ethics on the edge of life can be discussed and important distinctions can be made. These are agonizing questions, but if we approach them with humility and faith, they do have answers. Those questions and those answers depend upon making important distinctions.
There is a difference between killing someone (or killing yourself) and not interfering with the natural course of death. The first is an active act of euthanasia. The second is a passive act of accepting the inevitability of approaching death. Hastening death is wrong. Blocking external impediments to death that have no therapeutic value is right. One is an act of willfulness, and the other is an act of acceptance.
If we do not kill ourselves, or those we love, to spare suffering from a prolonged illness, we are providing time for several things to happen, all of which are good. It provides time for us or them to change their minds about giving up on life. It provides time for medicine to discover some new cure. It provides time to tie up loose ends in life and reconcile with those who have misunderstood or hated us.
Killing ourselves distorts the medical profession. Physicians are trained to heal not kill, and by asking a physician to assist in suicide or active euthanasia puts them in a position to violate their Hippocratic oath, the essence of which is, primum non malere, "First, to do no harm."
The alternatives of intractable pain or being killed by your doctor is a false choice. Palliative care is the art and science of pain management, and great strides have been made in palliative care. Patients can now face death with realistic hope that even though medicine cannot cure them, it can help them cope with their pain. Unbearable pain versus assisted suicide is often an incorrect and misleading choice.
What we do to animals is not and cannot be the same thing we do to people. Animals have no free will and are totally in our care. They cannot express their desires, and we cannot imagine that they are human beings. However, there is one aspect of the care of animals that is the same as our care of human beings. The first impulse must be to heal. The second is to alleviate pain if healing is impossible, and the third is to allow death to take its course when our wisdom must yield to the facts of life and death.
If you are a religious person, taking your life or the life of a sick loved one violates one of the fundamental beliefs of all three Abrahamic faiths — the belief that God owns your body. God created us, and God will decide when it is time for us to join God in a place where there is no pain. Listen to your mother and listen to God. That is a tough combination to overrule.
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