NEW YORK (Mar. 22)
As a U.S. federal court considers whether to reconnect Terri Schiavo’s feeding tube, Jewish scholars are turning to halachah, or Jewish religious law, for guidance on the issue. Schiavo, the severely brain-damaged Florida woman whose parents and husbands have been in battling in state and now federal courts for more than a decade, is the insensate center of a swirl of emotion and legal action. Religious leaders have been involved as well; Terri Schiavo and her parents, Mary and Robert Schindler, are Roman Catholic, and many of their most fervent supporters are fundamentalist Protestants.
The Schindlers want to keep their daughter’s feeding tube in; Michael Schiavo wants it removed so his wife can die a natural death.
Jews, like others caught up in the debate, have a range of beliefs, and their understanding of how to apply halachah varies accordingly. Virtually all the rabbis interviewed, though, told JTA that they did not agree with attempts by some conservative Christians to tie Schiavo’s case to the public debate about abortion.
At the traditional end of the spectrum, Rabbi Avi Shafran of the fervently Orthodox Agudath Israel of America said the Schiavo case is “straightforward from a Jewish perspective: The most important point from a halachic standpoint is that a compromised life is still a life.”
“In the Schiavo case, you’re not dealing with a patient in extremis,” he said, noting that until her feeding tube was removed, Schiavo was not dying.
In halachah, there is a category for a person at the edge of death; the rules for such a person, called a goses, are complicated.
“There are times when certain medical intervention is halachically contraindicated,” Shafran said. “There may be times when it’s OK not to shock a heart back into beating, not to administer certain drugs. You do not prolong the act of dying.”
But Schiavo was not a goses, Shafran said. Instead, before the tube was removed she “had the exact same halachic status as a baby or a demented person. Like a baby, she was helpless, could not feed herself and was not able to communicate in any meaningful way. But a life is a life.”
Rabbi Tzvi Hersh Weinreb, executive vice president of the Orthodox Union, the central arm of modern Orthodoxy, agreed that from a halachic perspective the Schiavo case is straightforward.
“It’s not permitted to do anything actively that would stop the process of a person’s staying alive,” he said. “In this case, that would be withdrawing a feeding tube, which is tantamount to starving a person to death.”
Like Shafran, Weinreb said the wishes of the patient or the family are not relevant.
“It might have a bearing on whether new measures are undertaken, but once a person is on a support system, removing it is not possible,” Weinreb said.
“Doing something to actively interfere with a person’s ability to continue to live technically is murder,” he said. “I can’t imagine a scenario that would make removing the feeding tube permissible.”
Rabbi David Feldman, who had an Orthodox ordination and defines himself as “traditional,” is rabbi emeritus of the Conservadox Jewish Center of Teaneck, N.J.
“There’s a dispute here between a husband and parents, but none of that makes any difference as far as halachah is concerned,” said Feldman, the author of “Birth Control and Abortion in Jewish Law” and the dean of the Jewish Institute of Bioethics. “You can’t hasten death yourself, with your own hands. If death comes, you can thank God because it’s a relief, but you can’t decide yourself that it has to be done.”
The only time it would be acceptable to remove a medical device, Feldman said, would be if “something worse would happen — if leaving it in would cause infection, or more pain.
“You can kill someone pursuing you, you can kill the soldier in the enemy army, maybe very cautiously you can kill if there is a death penalty, but you can’t kill an innocent person because of illness,” he said.
Rabbi Joel Roth is a member of the Conservative movement’s Rabbinical Assembly’s law committee. In 1990, when he was the committee’s chair, the group studied end-stage medical care and accepted two opposing positions on artificial nutrition and hydration.
One, by Rabbi Elliot Dorff, “would permit withholding and withdrawing” the tube; the other, by Rabbi Avraham Reisner, would not.
The divide comes from how the tube that provides food and water is defined. If it is seen as a medical device, as Dorff does, it may be removed, Roth said. If it is seen as a feeding device, as Reisner does, it may not be removed.
Dorff puts a person dependent on a feeding tube “in the halachic category of ‘treifah,’ which, he argues, is a life that does not require our full protection — an animal that is treifah is one that has some kind of physical defect that will prohibit it from having a prolonged life. So he argues that a treifah is a life that does not require our full protection,” Roth said.
Reisner, on the other hand, “treats these people as goses,” Roth said.
“And even in the end stage,” he noted, “there is the value of ‘chaya sha’ah,’ the life of the hour.” In other words, Roth said, even when there is very little life left, that life still matters.
The Conservative movement accepts both decisions, but Roth, a professor of talmud and Jewish law at the Jewish Theological Seminary in New York, sides with Reisner, and with Schiavo’s parents.
“She should be kept on the feeding tube,” he said. “She’s not being medicated and she’s breathing on her own.”
Rabbi Mark Washofsky teaches rabbinics at the Reform movement’s Hebrew Union College Jewish Institute of Religion in Cincinnati, and he sits on the movement’s responsa committee.
The movement does not speak with one voice on the issue, Washofsky said, but in 1994 it issued a responsa on the treatment of terminally ill patients.
Like the Conservative decisors, the Reform rabbis base their view of whether a feeding tube can be removed on their understanding of the tube’s function.
“We cannot claim that Jewish tradition categorically prohibits the removal of food and water from dying patients,” Washofsky said. “But we consider food and water, no matter how they are delivered, the staff of life. So what we ultimately do is express deep reservations about their withdrawal, but in the end we say nonetheless that because we cannot declare that the cessation of artificial nutrition and hydration is categorically forbidden by Jewish moral thought, the patient and the family must ultimately let their consciences guide them.”
Rabbi David Teutsch, director of the Center for Jewish Ethics at the Reconstructionist Rabbinical College in Philadelphia, agrees that the question is how a feeding tube is defined.
“If it were a form of eating, a position held by a number of more traditional halachic authorities, then you’re required to feed those who are hungry,” Teutsch said. “But if it’s medicine — a position held by Conservative authorities like Rabbi Elliott Dorff, and by me as well — then you serve the interests of the patient, which may involve not providing medicine.
He believes that a feeding tube is a medical device, and so it can be removed, Teutsch said.
“It’s pretty clear that it’s closer to regular intervention than to eating,” he said.