This You Call a Dilemma?
One night I found myself in discussion with a student who argued that weighing an argument from the perspective of Torah without giving equal credence to chemistry, science and nature is shortsighted. I agreed with him, but insisted that considering science and chemistry without considering Torah is a far worse proposition.
Twenty-four hours later, I received graphic confirmation of my position. A radio talk show host in Toronto presented a story about an elderly patient who had spent fourteen months at Oakville Trafalgar Memorial Hospital suffering from dementia, pneumonia and bedsores, among other ailments. The doctors had asked the family for permission to move him to palliative care, a nice way of suggesting that the patient be permitted to die—albeit comfortably.
| Had we now reached the point of recommending euthanasia for mentally ill patients? |
The family objected, because of his deep religious beliefs, and appealed to the Provincial Panel of Consent and Capacity, which instructed the doctors to stay on course with the aggressive treatment. Many health professionals disagreed with the ruling. One doctor said he couldn't imagine someone wanting to live with irreversible non-communicative dementia. Another had the temerity to suggest that it takes a great deal of love to fight for a loved one's life, but even more love to let him go.
I was aghast. This man was taken off the ventilator and was breathing spontaneously. His heart and brain were in perfect working condition. Why was he being put out to pasture on account of dementia? Had we now reached the point of recommending euthanasia for mentally ill patients?
The radio host went so far as to categorize the choice of life selfish, because it put the family through the emotional roller coaster of watching him die slowly and painfully. I was shocked. Should a teenager addicted to drugs commit suicide, since the odds are against his kicking the habit, and his family will be subjected to an emotional wringer? I could not but shake my head. How did we get so far down this road?
When someone pointed out that the man was breathing on his own and was alive, the host replied, "How long could that possibly last?" I couldn't believe it. How long will my breathing last? No one really knows.
A Little Background
When medical technology evolved and the possibility of heart transplantation was discovered, doctors faced a dilemma. A heart is viable for transplant only while it is beating; once it dies, it cannot be rehabilitated. One cannot harvest a heart from a dead patient, because a dead heart is not viable for transplantation; but harvesting a heart from a living patient is tantamount to murder.
It became necessary to create a criterion of death that begins before the cessation of cardiac activity. A Harvard ad hoc committee solved the problem by crafting the term brain death. This criterion stops short of calling the patient dead; it merely states that the brain stem has ceased to function. But it did not take long to take the leap to actual death. Because the brain is the nerve center and control box of the entire body, it is not a stretch to view a brain-dead patient as effectively dead.
| Life is an ethereal, nay spiritual, quality that can be defined only by moral or religious considerations. |
It thus became legal to harvest a beating heart from a patient whose brain stem ceased to function. This met with stiff resistance from many quarters, but the standard medical criteria of brain death held.
In his extensive essays on this subject, Rabbi J. David Bleich often wrote that science is capable of measuring an observable physiological condition, but not of defining the precise nature of life. Science can tell us whether brain function, cardiac activity or respiration has ceased; but science cannot pin down, let alone define, the nature or even the precise moment of death. Life is an ethereal, nay spiritual, quality that can be defined only by moral or religious considerations. A believing Jew must turn to the Torah rather than science for a definition of life and, therefore, death.1
The brain death criterion is one of healthy and rigorous debate in contemporary halachic writings. But, irrespective of where one stands on this subject, one must be horrified by the position espoused above. 2There is a mountain of difference between a patient with irreversible brain-stem cessation and a patient with dementia and bedsores. Yet it appears that once the door opened to rendering a breathing person dead, it became possible to consider even repugnant examples of living death.
The doctors quoted above are reasonable people. Their logic is perhaps macabre, but it is sound. When I listen to them, I wonder why we were so horrified by the Nazi program to exterminate the mentally retarded. Using the logic of these doctors, one could hear the argument that long-term patients use up resources that could be allocated to patients with better prognoses. Besides, if we won't kill them, they will have to live with bedsores and put their family through the horrors of a demented grandfather.
This is where science, logic and chemistry fail to satisfy. This is where we must turn to our convictions and belief systems. One who believes the Torah dictum that a moment of life is of infinite value can never be swayed by macabre argumentation that stops just short of advocating homicide for patients with irreversible medical conditions.
The Eighth
| If the natural revolves around the seven-day week, the number eight represents the supernatural. |
This is why the Tabernacle was inaugurated in the desert on the eighth day, after a seven-day practice run. Jewish thinkers have suggested that the number eight is instructive: if the natural revolves around the seven-day week, the number eight represents the supernatural.
3 To welcome G‑d, to cherish sanctity and to be suffused with reverence for life, one must learn to transcend the limitations of human logic and embrace a higher order. It entails an acceptance of ironclad values, not subject to negotiation. It requires that we reach beyond seven and grasp for the number eight.
My response to the student, who argued that Torah without science is incomplete, is that science without Torah is tragic. When we first deviate from proper practice, the movement is slight and difficult to identify. But with time, the human mind winds its way through a labyrinth of ideas and arrives at conclusions that boggle the observer but seem perfectly valid to the logician who made the journey.
The only way to protect against such wanderings is to hold fast to the values that anchor and guide us. When we hold fast to the eight, we can navigate the seven with confidence. If we hold fast to our beliefs, we can apply logic in the pursuit of scientific discovery without fear of wandering too far afield.
By Lazer Gurkow 
