A Jewish perspective on Initiative 1000 - Opinion: "A Jewish perspective on Initiative 1000
Rabbi Anson Laytner
Issue: 10/22/08 Section: Opinion
Let me state at the outset that most people, certainly everyone I've ever met regardless of their religion or culture, is pro-life. None of us want to see someone in the end stages of a terminal disease suffer. We share the same core values, yet I end up with a different conclusion because I support Initiative 1000. But to begin with, we need to recognize the values we share and judge one another on the side of merit.
Perhaps the hardest thing for people from authority-based religions to understand is in our world today there are legitimate multiple points of view on many controversial issues. Gone are the days when the Church, or a great rabbinic scholar, or a revered imam could set forth a ruling and have it obeyed by all subjects as God's own word. The fact is we live in a pluralistic society in which diverse points of view co-exist equally and even compete for support in the public arena.
Such is the case with I-1000.
Jewish law draws a distinction between prolonging life and hastening death. We are taught to"
Here is the beginning of my post. And here is my reply: Despite Rabbi Laytner's ordination has, he seemingly has not read or tho0ught through the initiative and seems to me to misconstrue Jewish traditions.
First, if he is aware of the oaths of Maimonides and Hippocrates, he is also aware that physicians are supposed to always and first avoid harm. I-1000, of course, endangers this tradition by opening a door that includes helping people die under the umbrella of not doing harm. If he does not mind, I will quote a few lines of Maimonides' oath* for the Rabbi:
Grant that my patients have confidence in me and my art and follow my directions and my counsel. Remove from their midst all charlatans and the whole host of officious relatives and know-all nurses, cruel people who arrogantly frustrate the wisest purposes of our art and often lead Thy creatures to their death.
Second, if the Rabbi understands medical practice, he knows that under current law it is totally legal for a physician to prescribe these drugs, even if they lead to death, as a means to relive pain and suffering. Indeed this is done every day. Indeed the decisions by an individual and his or her family with their physician to use these drugs is one of the most personal and difficult experiences in modern medicine. I know, and I am sure he does too, of observant Jewish physicians who will use such drugs to relieve pain and suffering even if this leads to death. Unless the end justifies the means, it seems to me that this is a terribly important moral distinction.
Third, I-1000 may endanger this delicate part of current practice by forcing patients to seek a second opinion and, ..if there is evidence of depression, to get approval from a psychologist. With all due respect to psychologists, the idea that anyone has the skills to distinguish between the reactive depression associated with terminal disease and some other kind of depression is absurd. In effect, the psychologist is being asked to function as a judge. May I suggest to the Rabbi, that rather than increasing the patient's freedoms, I-1000 offers a new and disturbing level of state involvement in a very private process.
Fourth a lot of the appeal of I-1000 is on behalf not of the terminally ill but of people with terrible chronic diseases like Alzheimer's, Gherig's Disease, quadriplegia, or multiple sclerosis. Many of these patients enter a prolonged period where their disease prevents them from communicating with others. Even knowing what pain they suffer is impossible. Patients faced with such a prospect, in my opinion as a physician, scientist, and a Jew, should have the right to end their lives but I-1000 only applies to those with six months to live.
Finally, while the proponents claim there have been no abuses of Oregon's law, this is not correct. There already has been at least one instance in Oregon of a woman told that she could save money by choosing suicide over prolonged care. While the response was to reprimand the bureaucrat who wrote that letter, under I-1000 that terrible choice becomes all to real. Until we change the way we give health care, care of the terminally ill is terribly expensive and does routinely lead to impoverishment. Middle class patients especially, are often enouraged by social workers to impoverish themselves so as to qualify for medic aid. Putting the healthcare provider in a position where she or he gets to choose between incurring the $40,000 costs of expensive terminal care vs. offering a patient a $50 cocktail, represents an all t real and, in my opinion, frightening prospect.
Finally, with all due respect to Rabbi Laytner, I think he is raising a red herring by blaming the opposition on people with religous convictions. If religion means anything at all, it should mean that one has a guide to morality and we should all resoect each other's ideas about this even when we need, under our shared commitment o live in a social contract, agree to live by the rule of the majority.
I suggest the Rabbi is misusing Jewish tradition. It is interesting to me that very few people in Oregon, about 20 last year, have taken this option. Moreover, most Oregon doctors have refused to write the prescriptions. Why? I suspect that the reason is that most people needing terminal care have many other worries, want to trust their doctor to do all she can to save life, and certainly do not want the state interferring with such a personal and private affair. That, is in the finest traditions of our people.
*this version is believed to have evolved and was finalized by a follower of Emmanuel Kant in the 1800s. The Oath is widely used in medical schools as an alternative to the oath of Hippocrates which has na even stronger prohibition against physicians assisting in death.