Jewish Medical Ethics: Part of a Sacred Jewish Conversation

Advanced planning and end-of-life care are more complex than ever before, reflective of emerging medical technologies, which can often prolong life in ways that we could only imagine in previous generations. As a result, the role of ethics in medicine will continue to expand. However, what we can do is not necessarily what we should do.

What is ethics? Unlike what many people think, ethics is not the study of what is “good” and “bad.” Rather, ethics is the deliberative process where we decide between two “goods.” For example, it is good to save a life, but it is also good to prevent suffering. But what are the repercussions when saving a life inflicts suffering? This is an ethical dilemma and we must weigh the costs of these various “goods” while making a decision. There rarely is a “right” or “wrong” answer.

The only thing that is not good is to avoid the decision-making process in its entirety.

While in previous generations physicians would make decisions based upon their own values, particularly their mandate to save lives, today, medical ethics prioritizes patient autonomy as the most important value. This practice also places more responsibility on family members to consider life and death issues and medical procedures. Without proper education or communication, it’s easy for families to feel that they are making these monumental decisions alone.

In this way, Jewish tradition can be seen as a resource and guide, helping to identify other important values. Jewish medical ethicists are in dialogue with the sources and values of the past as well as the current medical technologies of the present.

For example, values such as physician-assisted death, which is legal in certain states, are universally disapproved of among virtually all Jewish ethicists. According to Jewish tradition, we do not have absolute autonomy, as we are created by G-d. Furthermore, to be the direct cause of the death of another is an act of manslaughter in Jewish law.

However, this does not mean that we must always take extraordinary, and sometimes invasive, measures to prolong life, especially when they may inflict unreasonable suffering. Sensitive Jewish medical ethicists and legal authorities have outlined general parameters, which make a subtle distinction between withdrawing life-sustaining technologies (which could be considered manslaughter) and withholding further treatments (permitted in certain situations). Of course, which type of treatment is considered withdrawing and which type of treatment is called withholding is a matter of discussion among Jewish medical ethicists.

Our program does not advocate for a specific position. However, we believe that understanding various Jewish approaches will enrich our conversations. At the same time, we recognize the diversity of our community and that people will need to make decisions according to their own values. However, the more we can educate ourselves and our families, the more we will be able to clarify our feelings.

If you have a relationship with trusted clergy, we encourage you to have a conversation with them. They will help you consider issues you may not have thought about.

For a basic overview, see Jewish Perspectives on End-of-Life Care: Terminology and Resources.

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