Doctors of Death

From the July 21, 2006 Wall Street Journal:

A medical resident — we called her “Dr. Death” — at the Intensive Care Unit at Long Island’s North Shore Hospital chased us down the hallway.

“Your husband wants to die,” she told my mother, again. Just minutes before I had asked her to leave us alone.

“He can’t even talk,” I reminded her.

“He motioned with his hands when we tried to put in the feeding tube,” she said.

… A new resident appeared the next day, this one a bit more diplomatic but again urging us to allow my father to “die with dignity.” And the next day came yet another, who opened with the words, “We’re getting mixed messages from your family… [My father] was not in a “persistent vegetative state” (itself a phrase subject to broad interpretation), that magic point at which family members are required to pull the plug — or risk the accusation that they are right-wing Christians.

I complained about all the death-with-dignity pressure to my father’s doctor, an Orthodox Jew, who said that his religion forbids the termination of care but that he would be perfectly willing to “look the other way” if we wanted my father to die. We didn’t. Then a light bulb went off in my head. We could devise a strategy to fend off the death-happy residents: We would tell them we were Orthodox Jews.

My little ruse worked. During the few days after I announced this faux fact, it was as though an invisible fence had been drawn around my mother, my sister and me.…

Though my father was born to an Orthodox Jewish family, he is an avowed atheist who long ago had rejected his parents’ ways. As I sat in the ICU…the irony struck me: My father, who had long ago rejected Orthodox Judaism, was now under its protection.

As though to confirm this, there came a series of miracles. Just a week after he was rushed to ICU, my father was pronounced well enough to be moved out of the unit … A day later he was off the respirator…He still mostly slept, but then he began to awaken for minutes at a time… A day later, we walked in to find him sitting upright in a chair, reading the New York Times.

I’ve never been one of those Jews who makes facial contortions at the mere mention of the Christian Right; I actually agree with them on some matters. And this experience with my father has given me a new appreciation for the fight many evangelicals have waged against euthanasia.

I would add Agudath Israel of America and the RCA have done some very good work on this as well. So have Dr. Fred Rosner, Marvin Schick, Rabbi Dr. Moshe Tendler, and Rabbi Dr. J. David Bleich.

[Hat tip: Professor Gershon M. Ahmed.]



Filed under Bio-Ethics, Haredim, Modern Orthodoxy

12 responses to “Doctors of Death

  1. I am glad you presented this information. It is important that our community understand this is not just a “Christian” concern.

  2. duvidMeir

    What information exactly? The story of 1 person who was written off but got back up? For every story like this, there’s 300 who didn’t.

  3. The information from one family (among many) who confirm yet again that the medical establishment is pressuring families to kill their loved ones by denying basic care (food and water), rather than respecting the needs and wishes of patients or their families.

    For every assumption that a patient wants to “die” (that is, have his or her death hastened) we find more who live and confirm that they would have chosen continued care, or in fact had expressed such wishes which were ignored.

  4. Neo-Conservaguy

    Having been through this situation with a parent that didn’t make it, I can assure you that a patient can be in their “right mind” and make a choice to stop agonizing medical intervention that has zero chance of reversing the terminal damage caused by a disease. Qavod to a parent trumps many things, including the opinions of those who offer opinions without having been there and done that.

  5. Yochanan Lavie

    A lack of concern for the idea of tzelem elohim, combined with intense pressures to cut costs, has lead to a culture of death. If the US becomes like Europe (ultra-secular, with liberal euthanasia laws) , I can see our HMO’s insisting upon death as the customary treatment for many ailments. (Not to worry though. When Sharia becomes the law of Europe in 50 years, all this will be reversed).

  6. Neo-Conservaguy:

    I agree that a patient can be in his or her right mind and make a decision. Of course.

    Now, may I assume that you would be resolute in defending the rights of patients and families who indicate they wish to continue care?

    In the above situation, staff was being coercive, chasing after the family to terminate care. Also, where did the resident get the “die with dignity” statement from? Since the patient could not speak, clearly the staff member imposed his own values, not the patient’s opinion.

    You suggest others have not “been there, done that.” Yet, the most vocal supporters of patient care and against mis-named right-to-‘die’ policies are disability and patient rights advocates whose constituents have a direct interest.

    These having personal experience still take issue with policies that presume to choose death for a patient. As a medical consumer I agree with this position.

    As for kavod, I believe it should be held in balance, to include decisions to care for parents and not just carry out death wishes.

  7. Neo-Conservaguy

    Do you really believe the story that someone was chasing her down the hallway yelling and trying to get her to sign the order? I don’t. It certainly wasn’t my family’s experience.

    Fifty years ago this supposed ethical/halachic problem didn’t exist; people got old, sick or injured and most likely died soon after. Now, everything has been thrown into a tizzy because we, barukh haShem, have invented medical care and devices that can effective prolong life long after it would have naturally ended. It doesn’t seem unreasonable to propose that there is a balance between the extension of life and the quality of that extended life. Terminal sickness can’t be cheated – a few more days/weeks of agonizing medical “care” doesn’t make for a “life” some would choose.

    My parent’s life was extended several years because these days many “heart attacks” are recoverable, and I’m thankful to God and the doctors for that time. But the same medical technology couldn’t replace lung function that simply no longer existed.

  8. Neo-Conservaguy:

    You are very fortunate if you had a positive experience.

    However, yes, I absolutely believe the above because I have observed it. I used to also work with patients, and they shared first-hand the coercion they faced to decline treatment.

    A nurse has shared with me the lengths family and staff she witnessed who attempted to circumvent patient wishes and undermine the patient’s true dignity. This nurse supports liberalized choice in dying, so she has no reason to make this up or exaggerate.

    Just Google search Leslie Burke, a man in England who right now is fighting doctors who actually went to court to oppose his expressed wishes for continued treatment when his illness progresses.

    Good grief, doctors going to Court to impose their values on a patient? That makes harassment in a hallway seem like a walk in the park.

    Technology certainly has created challenges, and there IS a balance. I should know, because I hold it. In fact, I support the new Israel law allowing certain terminal patients — at THEIR expressed choice — to be removed from respirators at end stages of illness.

    I ask again: where do you hold with the reverse situation, that of the right of patients to choose to continue care? You did not answer that. Are you sure you are so ‘balanced’?

  9. Neo-Conservaguy

    There was very little positive about watching a parent die in my arms. I know you didn’t mean your statement that way, but it needs to be stated. Barukh haShem I should merit half of the strength and dignity of my departed parent when it’s my time to face the heavenly tribunal.

    Your original question was:

    “Now, may I assume that you would be resolute in defending the rights of patients and families who indicate they wish to continue care?”

    But, that’s actually two questions. First, what is the right of the patient to continue care? Few would argue they have 100% right to make that choice.

    Second, what is the right of the family when the patient cannot make that choice. And that, unfortunately, is a gray area indeed. Which is why in every hospital situation related to my beloved departed parent the staff was always careful to record the patients wishes while it was still possible – we signed several DNR (Do Not Resuscitate) forms that specified intervention choices; prevention, in a wry way, is the best cure for the problematic situation in which the patient cannot communicate their desires.

    I do believe that I am, indeed, balanced. But, that may not be possible to measure from within the system, per our friend Heisenburg.

  10. Isa

    Who manages your health insurance?
    Mutiple choice pick one
    1. Dr Kevokian
    2. Dr Frankenstein
    3 Dr StrangeLove
    4 Dr Mengele

    There is more truth here than joke.
    Quess why you got laid off?
    Your age!!
    The more old people that a company has, the higher health insurance premiums are.
    Health isurance is like car insurance.
    The more old people/ accidents that one has the higher the insurance is.

  11. I meant “positive” in that you indicated your family felt it had at least some control within what what was a difficult situation.

    Your last post suggests more of the same, that for good or bad, you had some choice and a supportive environment to make those decisions.

    Now, I ask that you consider the other side of it. For the sake of those who want the same compassion, support and choice to make life affirming medical decisions.

    By the way, my own family cared for two relatives, each suffering multiple strokes and one having alzheimers. I am not making light of any of this, and my presumption in favor of life remains. Sadly, I guess we will have to agree to disagree on that point.

  12. “B…what is the right of the patient to continue care? Few would argue they have 100% right to make that choice.”

    Neo –

    Actually, the patient’s right to continue care is supported by all major halakhic opinions, including those of the Conservative Movement.

    Once treatment is started, it must be allowed to continue, unless that treatment is completely futile or very painful or risky with no real chance of a cure. Even then, treatment continues unless the patient opts out. (This is a very condensed explanation. No one should follow this as if it were halakha. Ask your rabbi if you need a pesak.)

    The Reform Movement generally agrees with this as well.

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