Halakhic Questions from a

Senior Citizen’s Home

 

To the editor:

I am the Rav of the Baycrest Center for Geriatric Care. Our Center provides for residential, hospital and recreational care serving a population of the elderly and especially the very frail elderly. I am turning to you with a number of significant she’elos that have arisen at our center. I would be most grateful for your teshuvos to the following concerns:

1. Would a patient, family member, or legal guardian be contracted in order to grant permission for a D N R* status, to be indicated on a patient chart? 

2. May a patient, family member, or legal guardian be contacted in order to grant permission for a D N R status, to be indicated on a patient chart?  

3. Are there halachic circumstances under which IV’s, medications, food and water may be withheld from a terminally ill patient approaching extremes?

4. What decisions may a surrogate decision maker offer for an incompetent person?

5. May a terminally ill patient halachically request cessation of medication, therapy, IV’s, food and water.

I thank you in advance for your kind consideration of these questions and I eagerly await your reply.

 

Rabbi Dr. Nathum Berlat  

Director, Pastoral Care

 

 

Editor’s response:

Thank you for your letter dated July 16, 1990. The problems you raise are by no means new and are difficult for the practicing physician. The many different situations that may possibly confront the physician in any given case must be handled on an individual  basis, medically and halachically. Even if a D N R order on a particular patient receives a halachic sanction, this does N OT imply D N T - do not treat.

It is therefore our opinion that each individual problem in these life and death situations must be discussed with local competent halachic authority, in order to decide what may, or may not, be done in a given case.

For further general guidelines: see Professor Abraham’s article on Euthanasia (Assia-Jewish Medical Ethics, vol. 1 No. 2 May 89: pp. 36-99 and Letter to Editor, ibid: p. 56) and his book, The comprehensive Guide to Medical Halachah, Feldheim Publ, Jer. 1990: pp. 178-180.

 

* D N R (Do Not Resuscitate) is an instruction to the medical staff not to resuscitate a moribund patient