Wednesday, April 26, 2006

Is a DNR permitted?

CJN: Whether or not to continue a patient’s treatment is one of a number of halachic issues related to end of life, says Rabbi Eliezer Breitowitz, rosh yeshiva of Yeshiva Darchei Torah. Speaking at a recent panel discussion sponsored by Useful Ideas, a firm of financial security advisers, Rabbi Breitowitz said that one of the factors to take into consideration is the definition and time of death. “Obviously, beyond this point there is no need to continue treatment, yet an issue arises when the person is still alive and the caregivers want to discontinue treatment. Halachah says we cannot actively do something to shorten life.” Halachah does not recognize the right to die, he said, “because a person is not considered a master of his own life. At best he is a trustee. It is not his prerogative to squander his life. “On what basis do we make our decision? If the patient cannot decide himself, we [could] concoct the scenario in which he is committed to Halachah, yet his caregivers are not.” Time of death, said Rabbi Breitowitz, is the cessation of breathing, “but with the development of technology that can take over respiration, a person can be dead but still breathe with a machine.” In hospitals, he said, there is tremendous pressure put on families to withdraw life support. “It frees up equipment and it facilitates organ donation. They consider it the moral choice.” The time is coming when OHIP will refuse to administer care to patients who are brain dead, “and that will put additional pressure on families because the cost will be too much,” he said. Halachah does not describe a certain course when we talk about withholding treatment, he said, but there are situations when it is best not to initiate treatment. This includes when a person is terminally ill and his life expectancy is less than one year, the underlying condition is irreversible, or else a person is in great pain and the only possible consequence of treating him would be to extend his life in a painful state, Rabbi Breitowitz said.........
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