Texts to think about end of life issues - taking control

End of Life Issues 2 - taking control

Source Sheet by Sylvia Rothschild

See the texts from the previous sheet of the deaths of Honi HaMaagel who prays for death, of the 400 who deliberately choose it, of Hananya ben Teradyon who ultimately hastens his own death

I Samuel 31:4

(4) Saul said to his arms-bearer, “Draw your sword and run me through, so that the uncircumcised may not run me through and make sport of me.” But his arms-bearer, in his great awe, refused; whereupon Saul grasped the sword and fell upon it.

שמואל א ל״א:ד׳

(ד) וַיֹּ֣אמֶר שָׁאוּל֩ לְנֹשֵׂ֨א כֵלָ֜יו שְׁלֹ֥ף חַרְבְּךָ֣ ׀ וְדׇקְרֵ֣נִי בָ֗הּ פֶּן־יָ֠ב֠וֹאוּ הָעֲרֵלִ֨ים הָאֵ֤לֶּה וּדְקָרֻ֙נִי֙ וְהִתְעַלְּלוּ־בִ֔י וְלֹ֤א אָבָה֙ נֹשֵׂ֣א כֵלָ֔יו כִּ֥י יָרֵ֖א מְאֹ֑ד וַיִּקַּ֤ח שָׁאוּל֙ אֶת־הַחֶ֔רֶב וַיִּפֹּ֖ל עָלֶֽיהָ׃

II Samuel 1:5-10

(5) “How do you know,” David asked the young man who brought him the news, “that Saul and his son Jonathan are dead?” (6) The young man who brought him the news answered, “I happened to be at Mount Gilboa, and I saw Saul leaning on his spear, and the chariots and horsemen closing in on him. (7) He looked around and saw me, and he called to me. When I responded, ‘At your service,’ (8) he asked me, ‘Who are you?’ And I told him that I was an Amalekite. (9) Then he said to me, ‘Stand over me, and finish me off, for I am in agony and am barely alive.’-a (10) So I stood over him and finished him off, for I knew that he would never rise from where he was lying.-a Then I took the crown from his head and the armlet from his arm, and I have brought them here to my lord.”

שמואל ב א׳:ה׳-י׳

(ה) וַיֹּ֣אמֶר דָּוִ֔ד אֶל־הַנַּ֖עַר הַמַּגִּ֣יד ל֑וֹ אֵ֣יךְ יָדַ֔עְתָּ כִּֽי־מֵ֥ת שָׁא֖וּל וִיהוֹנָתָ֥ן בְּנֽוֹ׃ (ו) וַיֹּ֜אמֶר הַנַּ֣עַר ׀ הַמַּגִּ֣יד ל֗וֹ נִקְרֹ֤א נִקְרֵ֙יתִי֙ בְּהַ֣ר הַגִּלְבֹּ֔עַ וְהִנֵּ֥ה שָׁא֖וּל נִשְׁעָ֣ן עַל־חֲנִית֑וֹ וְהִנֵּ֥ה הָרֶ֛כֶב וּבַעֲלֵ֥י הַפָּרָשִׁ֖ים הִדְבִּקֻֽהוּ׃ (ז) וַיִּ֥פֶן אַחֲרָ֖יו וַיִּרְאֵ֑נִי וַיִּקְרָ֣א אֵלַ֔י וָאֹמַ֖ר הִנֵּֽנִי׃ (ח) וַיֹּ֥אמֶר לִ֖י מִי־אָ֑תָּה (ויאמר) [וָאֹמַ֣ר] אֵלָ֔יו עֲמָלֵקִ֖י אָנֹֽכִי׃ (ט) וַיֹּ֣אמֶר אֵלַ֗י עֲמׇד־נָ֤א עָלַי֙ וּמֹ֣תְתֵ֔נִי כִּ֥י אֲחָזַ֖נִי הַשָּׁבָ֑ץ כִּֽי־כׇל־ע֥וֹד נַפְשִׁ֖י בִּֽי׃ (י) וָאֶעֱמֹ֤ד עָלָיו֙ וַאֲמֹ֣תְתֵ֔הוּ כִּ֣י יָדַ֔עְתִּי כִּ֛י לֹ֥א יִֽחְיֶ֖ה אַחֲרֵ֣י נִפְל֑וֹ וָאֶקַּ֞ח הַנֵּ֣זֶר ׀ אֲשֶׁ֣ר עַל־רֹאשׁ֗וֹ וְאֶצְעָדָה֙ אֲשֶׁ֣ר עַל־זְרֹע֔וֹ וָאֲבִיאֵ֥ם אֶל־אֲדֹנִ֖י הֵֽנָּה׃

Tur HaArokh, Genesis 9:5:4

(4) ואך את דמכם, “however your blood, etc.” It is possible that when King Sha-ul committed suicide by telling his arms bearer to finish him off (Samuel I 31,4) he thought that he committed a meritorious act denying the Philistines the boast that they had killed the anointed one of G’d. This is why the Torah uses the diminutive word אך, when writing this legislation, to tell us that there are situations, such as when Chananyah, Mishael and Azaryah agreed to be thrown into the fiery furnace, that this was not considered suicide but [after consultation with the prophet Ezekiel Ed] an act of sanctifying the name of the Lord. .

הטור הארוך, בראשית ט׳:ה׳:ד׳

(ד) ואך את דמכם וגו'. יכול כשאול שהרג את עצמו לשם שמים ת"ל אך יכול כחנני' מישאל ועזריה ת"ל אך. ומקשים מה צריך קרא לחנני' מישאל ועזריה והלא מק"ו נפקא כדאמרינן מצפרדעים ומתרצים דמק"ו לחוד לא נפקא דפריכא הוא דאיכא למיפרך מה לצפרדעים שאינן מצווים שלא לחבול בעצמם ומאך לחוד בלא ק"ו נמי לא נפקא אלא שאינו נענש אם מוסר עצמו למות לכך צריך ק"ו לומר שהוא חייב למסור עצמו על קדוש השם:

Ketubot 104a:2-4

§ It is related that on the day that Rabbi Yehuda HaNasi died, the Sages decreed a fast, and begged for divine mercy so that he would not die. And they said: Anyone who says that Rabbi Yehuda HaNasi has died will be stabbed with a sword. The maidservant of Rabbi Yehuda HaNasi ascended to the roof and said: The upper realms are requesting the presence of Rabbi Yehuda HaNasi, and the lower realms are requesting the presence of Rabbi Yehuda HaNasi. May it be the will of God that the lower worlds should impose their will upon the upper worlds. However, when she saw how many times he would enter the bathroom and remove his phylacteries, and then exit and put them back on, and how he was suffering with his intestinal disease, she said: May it be the will of God that the upper worlds should impose their will upon the lower worlds. And the Sages, meanwhile, would not be silent, i.e., they would not refrain, from begging for mercy so that Rabbi Yehuda HaNasi would not die. So she took a jug [kuza] and threw it from the roof to the ground. Due to the sudden noise, the Sages were momentarily silent and refrained from begging for mercy, and Rabbi Yehuda HaNasi died.

כתובות ק״ד א:ב׳-ד׳

הָהוּא יוֹמָא דְּנָח נַפְשֵׁיהּ דְּרַבִּי, גְּזַרוּ רַבָּנַן תַּעֲנִיתָא, וּבְעוֹ רַחֲמֵי, וְאָמְרִי: כֹּל מַאן דְּאָמַר ״נָח נַפְשֵׁיהּ דְּרַבִּי״ — יִדָּקֵר בַּחֶרֶב. סְלִיקָא אַמְּתֵיהּ דְּרַבִּי לְאִיגָּרָא, אָמְרָה: עֶלְיוֹנִים מְבַקְּשִׁין אֶת רַבִּי, וְהַתַּחְתּוֹנִים מְבַקְּשִׁין אֶת רַבִּי. יְהִי רָצוֹן שֶׁיָּכוֹפוּ תַּחְתּוֹנִים אֶת הָעֶלְיוֹנִים. כֵּיוָן דַּחֲזַאי כַּמָּה זִימְנֵי דְּעָיֵיל לְבֵית הַכִּסֵּא וְחָלַץ תְּפִילִּין וּמַנַּח לְהוּ וְקָמִצְטַעַר, אֲמַרָה: יְהִי רָצוֹן שֶׁיָּכוֹפוּ עֶלְיוֹנִים אֶת הַתַּחְתּוֹנִים. וְלָא הֲווֹ שָׁתְקִי רַבָּנַן מִלְּמִיבְעֵי רַחֲמֵי. שָׁקְלָה כּוּזָא, שָׁדְיָיא מֵאִיגָּרָא [לְאַרְעָא], אִישְׁתִּיקוּ מֵרַחֲמֵי, וְנָח נַפְשֵׁיהּ דְּרַבִּי.

Tractate Semachot 2:1-6

1. For a suicide (lit. "one who kills himself intentionally"), no rites whatsoever should be observed. Rabbi Yishmael said, "He may be lamented: 'Alas, misguided fool! Alas, misguided fool!'" Whereupon Rabbi Akiva said to him, "Leave him to his oblivion; neither honour him nor curse him." Clothes are not rent for him, nor are shoulders bared, nor is he eulogized, but people should line up for him and the mourner's blessing should be recited over him, since this displays respect for the living. The general rule is that whatever is performed out of respect for the living should be observed for him; anything that is not performed out of respect for the living (but rather out of respect for the deceased) should not be observed for him by the community.

2. Who is to be accounted a suicide? Not someone who climbs to the top of a tree or to the top of a roof and falls to his death, but rather one who says, "Behold, I am going to climb to the top of the roof or to the top of the tree and then throw myself down to my death," and he is (thereupon) observed climbing to the top of the tree and fallng to his death. Such a person is presumed to be a suicide, and for a suicide no rites whatsoever are to be observed.

3. If a person is found strangled and hanging from a tree, or slain and impaled upon a sword, he is presumed to have taken his own life unwittingly, and no rites are denied him.

4. It once happened that the son of Gorgos of Lod ran away from school. His father threatened to box his ears. In terror of his father he went off and cast himself into a cistern. The incident was brought before Rabbi Tarfon, who ruled, "No rites are to be denied him."

5. Another incident concerns a child from Bnei Berak who broke a flask on Shabbat. His father threatened to box his ears. In terror of his father the child went off and cast himself into a cistern. The incident was brought before Rabbi Akiva, who ruled, "No rites are to be denied him." מסכת שמחות ב\א-ו

הלכה א

המאבד עצמו לדעת אןי מתעסקין עמו בכל דבר. רבי ישמעאל אומר קורין עליו "הוי נטלה הוי נטלה". אמר לו רבי עקיבא הנח לו בסתמו. אל תכבדהו ואל תקללהו. אין קורעין עליו ואין חולצין עליו ולא מספידין עליו. אבל עומדין עליו בשורה ואומרין עליו ברכת אבלים מפני שהוא כבוד חיים.

כללו של דבר: כל שהוא כבוד של חיים מתעסקין בו. כל שאין כבוד של חיים אין הרבים מתעסקין עמו לכל דבר.

הלכה ב

איזהו המאבד עצמו לדעת? לא שעלה בראש האילן ונפל ומת; בראש הגג ונפל ומת. אלא זה שאמר "הריני עולה לראש הגג או לראש האילן ואפיל עצמי ואמות", ורואין אותו שעלה לראש האילן ונפל ומת -- הרי זה בחזקת המאבד את עצמו בדעת, וכל המאבד את עצמו לדעת אין מתעסקין עמו בכל דבר.

הלכה ג

מצאהו חנוק ותלוי באילן, הרוג ומושלך על גבי הסייף -- הרי זה בחזקת המאבד את עצמו שלא בדעת ואין מונעין הימנו כל דבר.

הלכה ד

מעשה בבנו של גורנוס(?) בלוד שברח מבית הספר והראה לו אביו באזנו ונתירא מאביו והלך ואבד עצמו בבגד ובאו ושאלו את רבי טרפון ואמר אין מונעין הימנו כל דבר.

הלכה ה

מעשה בתינוק אחד מבני ברק ששבר צלוחית בשבת והראה לו אביו באזנו ונתירא מאביו והלך ואבד עצמו בבור ושאלו את רבי עקיבא ואמר אין מונעין הימנו כל דבר.

Arukh HaShulchan, Yoreh De'ah 345:5

Guiding principle: where one ends one’s life intentionally, we attribute it to any possible reason, such as fear, or mental suffering, or mental incapacity, or or a mistaken belief that this avoids another transgression, and so forth. Because truly this despicable act is something far from the mind of one who is in possession of clear thought. Go and learn from Saul the righteous, who fell on his sword in order to avoid torture at the hands of the Philistines. Cases such as these are considered the result of persecution. How much for so the case of a minor who ends their life intentionally, this is considered involuntary....

ערוך השולחן, יורה דעה שמ״ה:ה׳

(ה) כללו של דבר: במאבד עצמו לדעת – תלינן בכל איזה תלייה כל שהוא; כגון לתלות ביראה, או בצער, או שיצא מדעתו, או שסבור היה שזה מצוה לבלי להכשל בעברות אחרות, וכיוצא באלו הדברים, מפני שזהו באמת דבר רחוק שאדם יעשה נבלה כזו בדעת צלולה. צא ולמד משאול הצדיק שנפל על חרבו לבלי יתעללו בו הפלשתים, וכיוצא בזה מקרי אנוס. וכל שכן קטן המאבד עצמו לדעת, דחשוב כשלא לדעת.

Tractate Semachot 1:1-4

A dying man is regarded as a living entity in respect of all matters in the world: he holds [his brother’s wife] tied to the leviratical marriage, he frees [his mother] from the obligation of a leviratical marriage and enables her to eat terumah, and he [may also] disqualify her from eating terumah; he inherits and transmits; if one of his limbs is severed, it is regarded as a limb cut off from the living; if [part of his] flesh [is severed], it is regarded as flesh cut off from the living; and the blood of his sin-offering and guilt-offering is sprinkled for him until the time he dies. We do not tie up his cheek-bones, or stop up his apertures, or place a metal vessel or anything which chills on his navel; as it is stated, Before the silver cord is snapped asunder and the golden bowl is shattered, and the pitcher is broken at the fountain. We may not move him, or place him on sand or salt until he dies. We may not close the eyes of a dying man. Whoever touches and moves him is a murderer. For R. Meir used to say: He can be compared to a lamp which is dripping; should a man touch it he extinguishes it. Similarly whoever closes the eyes of a dying man is considered as if he had taken his life.

מסכת שמחות א׳:א׳-ד׳

הגוסס הרי הוא כחי לכל דבר לעולם (זקוק) [זוקק] ליבום ופוטר מן היבום ומאכיל בתרומה ופוסל בתרומה ונוחל ומנחיל פרש ממנו אבר כאבר מן החי בשר כבשר מן החי וזורקין על ידו דם חטאתו ודם אשמו עד שימות: אין קושרין את לחייו *ואין פוקקין את נקביו ואין נותנין כלי של מתכות ודבר שהוא מיקר על טיבורו עד שעה שימות שנאמר (קהלת י״ב:ו׳) עד אשר לא ירתק חבל הכסף: אין מזיזין אותו ואין מטילין אותו על גבי החול ולא על המלח עד שעה שימות: אין (מעמידין) [מעמצין] את עיני הגוסס הנוגע בו ומזיזו הרי זה שופך דמים שהיה רבי מאיר אומר משל לנר שהוא מטפטף כיון שנגע בו אדם מכבהו כך כל המעמץ את עיני הגוסס מעלין עליו כאילו הוא נוטל נשמתו:

Shabbat 151b:6-8

MISHNA: One may not shut the eyes of the dead on Shabbat because the body is set-aside. And one may not shut the eyes even on a weekday while the soul departs. One must wait until the person has died. And one who shuts the eyes while the soul departs is a murderer because he has hastened the person’s death. GEMARA: The Sages taught: One who shuts a person’s eyes while the soul departs is a murderer. This is analogous to a lamp that is gradually becoming extinguished but could continue to burn a little longer. If a person places his finger on it, it is immediately extinguished. It was taught in a baraita that Rabban Shimon ben Gamliel says: One who wants the eyes of a corpse to close should blow wine up its nose, and place oil between its eyelids, and grab hold of its two big toes, and its eyes will shut by themselves. Incidental to the Gemara’s discussion of corpses, it cites that which was taught in a baraita: Rabban Shimon ben Gamliel says: For a living day-old baby, one desecrates Shabbat to save his life. Yet for the deceased David, king of Israel, one does not desecrate Shabbat. For a day-old baby we desecrate Shabbat because the Torah says: Desecrate one Shabbat for him so that he can observe many Shabbatot. But for the deceased David, king of Israel, one does not desecrate Shabbat, as once a person dies he is idle from mitzvot.

שבת קנ״א ב:ו׳-ח׳

מַתְנִי׳ אֵין מְעַצְּמִין אֶת הַמֵּת בַּשַּׁבָּת, וְלֹא בַּחוֹל עִם יְצִיאַת נֶפֶשׁ. וְהַמְעַצֵּים עִם יְצִיאַת הַנֶּפֶשׁ — הֲרֵי זֶה שׁוֹפֵךְ דָּמִים. גְּמָ׳ תָּנוּ רַבָּנַן: הַמְעַצְּמוֹ עִם יְצִיאַת הַנֶּפֶשׁ — הֲרֵי זֶה שׁוֹפֵךְ דָּמִים. מָשָׁל לְנֵר שֶׁכָּבָה וְהוֹלֶכֶת, אָדָם מַנִּיחַ אֶצְבָּעוֹ עָלֶיהָ — מִיָּד כָּבְתָה. תַּנְיָא, רַבָּן שִׁמְעוֹן בֶּן גַּמְלִיאֵל אוֹמֵר: הָרוֹצֶה שֶׁיִּתְעַצְּמוּ עֵינָיו שֶׁל מֵת — נוֹפֵחַ לוֹ יַיִן בְּחוֹטְמוֹ, וְנוֹתֵן שֶׁמֶן בֵּין רִיסֵי עֵינָיו, וְאוֹחֵז בִּשְׁנֵי גּוּדְלֵי רַגְלָיו, וְהֵן מִתְעַצְּמִין מֵאֲלֵיהֶן. תַּנְיָא, רַבָּן שִׁמְעוֹן בֶּן גַּמְלִיאֵל אוֹמֵר: תִּינוֹק בֶּן יוֹמוֹ חַי — מְחַלְּלִין עָלָיו אֶת הַשַּׁבָּת, דָּוִד מֶלֶךְ יִשְׂרָאֵל מֵת — אֵין מְחַלְּלִין עָלָיו אֶת הַשַּׁבָּת. תִּינוֹק בֶּן יוֹמוֹ חַי מְחַלְּלִין עָלָיו אֶת הַשַּׁבָּת, אָמְרָה תּוֹרָה: חַלֵּל עָלָיו שַׁבָּת אַחַת, כְּדֵי שֶׁיִּשְׁמוֹר שַׁבָּתוֹת הַרְבֵּה. דָּוִד מֶלֶךְ יִשְׂרָאֵל מֵת אֵין מְחַלְּלִין עָלָיו, כֵּיוָן שֶׁמֵּת אָדָם בָּטֵל מִן הַמִּצְוֹת.

Mishneh Torah, Mourning 4:5

(5) A person in his death throes is considered as a living person with regard to all matters. We do not tie his cheek, stuff his orifices, nor do we place a metal utensil or a utensil that cools on his navel so that his body will not bloat. We do not anoint it or wash it or place it on sand or on salt until the person dies.

One who touches him is considered as shedding blood. To what can the matter be compared? To a candle that is flickering, were a person to touch it, it will be extinguished. Similarly, anyone who closes a dying person's eyes as his soul expires is considered as shedding blood. Instead, they should wait some lest he have fainted.* Similarly, we do not rend our clothes because of him, uncover our shoulders, recite eulogies, or bring a coffin or shrouds into the house until the person dies.

משנה תורה, הלכות אבל ד׳:ה׳

(ה) הַגּוֹסֵס הֲרֵי הוּא כְּחַי לְכָל דָּבָר. אֵין קוֹשְׁרִין לְחָיָיו וְאֵין פּוֹקְקִין נְקָבָיו וְאֵין מַנִּיחִין כְּלִי מַתָּכוֹת וּכְלִי מֵיקֵר עַל טַבּוּרוֹ שֶׁלֹּא יִתְפַּח. וְלֹא סָכִין אוֹתוֹ. וְלֹא מְדִיחִין אוֹתוֹ. וְלֹא מְטִילִין אוֹתוֹ עַל הַחוֹל וְלֹא עַל הַמֶּלַח עַד שָׁעָה שֶׁיָּמוּת. וְהַנּוֹגֵעַ בּוֹ הֲרֵי זֶה שׁוֹפֵךְ דָּמִים. לְמָה זֶה דּוֹמֶה לְנֵר שֶׁמְּטַפְטֵף כֵּיוָן שֶׁיִּגַּע בּוֹ אָדָם יִכְבֶּה. וְכָל הַמְאַמֵּץ עֵינָיו עִם יְצִיאַת נֶפֶשׁ הֲרֵי זֶה שׁוֹפֵךְ דָּמִים אֶלָּא יִשְׁהֶא מְעַט שֶׁמָּא נִתְעַלֵּף. וְכֵן אֵין קוֹרְעִין עָלָיו. וְלֹא חוֹלְצִין כָּתֵף. וְלֹא מַסְפִּידִין. וְלֹא מַכְנִיסִין עִמּוֹ אָרוֹן וְתַכְרִיכִין בַּבַּיִת עַד שֶׁיָּמוּת:

The problem of when death actually occurs continues to this day - there is no certain moment - brain stem death / cessation of heart beat / cessation of breathing - all are used differently

Shulchan Arukh, Yoreh De'ah 339

(1) One in a dying condition is considered a living being in all respects. We may not tie up his jaws, nor may we annoint him with oil, nor wash him, nor stop off his organs of the extremities, nor may we remove the pillow from under him, nor may we place him on sand, clay-ground or earth, nor may we place on his stomach a dish, a shovel, a flask of water or a globule of salt, nor may we summon the towns on his behalf, nor may we hire pipers and lamenting women, nor may we close his eyes before his soul departs. And whosoever closes [the dying person's] eyes before death is regarded as one who sheds blood. One may not rend garments, nor bare the shoulder in mourning, nor make a lamentation for him, nor bring a coffin into the house in his presence before he dies, nor may we begin the recital of Ẓidduk Haddin before his soul departs. Gloss: Some say that we may not dig out a grave for him. although it is not [done] in his presence, [i.e.,] in the house, — before he dies. It is [likewise] forbidden to dig out any grave to be [left] open until the next day, in which the corpse will not be buried the same day, and there is danger in this. It is likewise forbidden to cause [aught] to hasten the death of one who is in a dying condition, e.g., one who has been in a dying condition for a long time, and could not depart, — [the law is that] we may not remove the pillow or the mattress from under him [just] because some say that there are feathers from some fowl which cause this [prolongation of death]. He may likewise not be moved from his place. It is also forbidden to place the Synagogue keys under his head in order that he may depart. However, if there is aught which causes a hindrance to the departure of the soul, e.g., [if] near that house there is a knocking sound, viz., a wood-cutter, or there is salt on his tongue, and these hinder the departure of the soul, it is permitted to remove it therefrom, for there is no [direct] act [involved] in this, since he merely removes the hindrance.

(2) One who is informed, 'We saw your relative in a dying condition three days ago,' is bound to mourn for him, For it is certain that he has already died.

(3) Ẓidduk Haddin is recited when the soul departs, and when he reaches [the words] 'Judge of Truth,' the mourner rends his garments.

(4) As soon as he feels death approaching, they should not separate themselves from him, lest his soul depart whilst he is alone. And it is a religious duty to stand near the [dying] person during the departure of the soul, as it is written, 'That he should still live alway; that he should not see the pit. For he seeth that wise men die, the fool and the brutish together perish etc.'

שולחן ערוך, יורה דעה של״ט

(א) דיני הגוסס (ואמירת צידוק הדין) ומה הם הסימנים היפים [מהסימנים נשמטו בשו"ע ונמצאו בטור יו"ד ע"ש]. ובו ה"ס:

הגוסס הרי הוא כחי לכל דבריו אין קושרין לחייו ואין סכין אותו ואין מדיחין אותו ואין פוקקין את נקביו ואין שומטין הכר מתחתיו ואין נותנין אותו על גבי חול ולא על גבי חרסית ולא על גבי אדמה ואין נותנין על כריסו לא קערה ולא מגריפה ולא צלוחית של מים ולא גרגיר של מלח ואין משמיעין עליו עיירות ואין שוכרין חלילין ומקוננות ואין מעמצין עיניו עד שתצא נפשו וכל המעמץ עם יציאת הנפש ה"ז שופך דמים ואין קורעין ולא חולצין ולא מספידין עליו ולא מכניסין עמו ארון לבית עד שימות ואין פותחין עליו בצדוק הדין עד שתצא נפשו: הגה וי"א דאין חוצבין לו קבר אע"פ שאינו עמו בבית עד אחר שימות (ריב"ש סי' קי"ד) ואסור לחצוב שום קבר להיות פתוח עד למחר שלא יקברו בו המת באותו היום ויש סכנה בדבר (רבינו ירוחם בשם ר"י החסיד ז"ל) וכן אסור לגרום למת שימות מהרה כגון מי שהוא גוסס זמן ארוך ולא יוכל להפרד אסור להשמט הכר והכסת מתחתיו מכח שאומרים שיש נוצות מקצת עופות שגורמים זה וכן לא יזיזנו ממקומו וכן אסור לשום מפתחות ב"ה תחת ראשו כדי שיפרד אבל אם יש שם דבר שגורם עכוב יציאת הנפש כגון שיש סמוך לאותו בית קול דופק כגון חוטב עצים או שיש מלח על לשונו ואלו מעכבים יציאת הנפש מותר להסירו משם דאין בזה מעשה כלל אלא שמסיר המונע (הכל בהגהת אלפסי פ' אלו מגלחין):

(ב) מי שאמרו לו ראינו קרובך גוסס היום שלשה ימים צריך להתאבל עליו (דודאי כבר מת) :.

(ג) אומרים צידוק הדין עם יציאת נשמה וכשמגיע לדיין אמת קורע האבל:

(ד) כיון שנטה אדם למות אין רשאין ליפרד ממנו כדי שלא תצא נפשו והוא יחידי. (ומצוה לעמוד על האדם בשעת יציאת נשמה שנאמר ויחי עוד לנצח לא יראה השחת כי יראה חכמים ימותו וגו') (תהלים מ"ט) (הגהות אלפסי שם):

(

Removing an impediment to the departure of the soul is a critical theme for managing the dying process. The general principle is that removing the impediment will not be interrupting life, but shortening the process of death. How this is interpreted and understood remains fluid. Is life support machine keeping someone alive, or is it lengthening the dying process? SR

Mishnah Yoma 8:6-7

(6) In the case of one who is seized with the life-threatening illness bulmos, causing him unbearable hunger pangs and impaired vision, one may feed him even impure foods on Yom Kippur or any other day until his eyes recover, as the return of his sight indicates that he is recovering. In the case of one whom a mad dog bit, one may not feed him from the lobe of the dog’s liver. This was thought to be a remedy for the bite, but the Rabbis deem it ineffective. And Rabbi Matya ben Ḥarash permits feeding it to him, as he deems it effective. And furthermore, Rabbi Matya ben Ḥarash said: With regard to one who suffers pain in his throat, one may place medicine inside his mouth on Shabbat, although administering a remedy is prohibited on Shabbat. This is because there is uncertainty whether or not it is a life-threatening situation for him, as it is difficult to ascertain the severity of internal pain. And a case of uncertainty concerning a life-threatening situation overrides Shabbat.

(7) Similarly, with regard to one upon whom a rockslide fell, and there is uncertainty whether he is there under the debris or whether he is not there; and there is uncertainty whether he is still alive or whether he is dead; and there is uncertainty whether the person under the debris is a gentile or whether he is a Jew, one clears the pile from atop him. One may perform any action necessary to rescue him from beneath the debris. If they found him alive after beginning to clear the debris, they continue to clear the pile until they can extricate him. And if they found him dead, they should leave him, since one may not desecrate Shabbat to preserve the dignity of the dead.

משנה יומא ח׳:ו׳-ז׳

(ו) מִי שֶׁאֲחָזוֹ בֻלְמוּס, מַאֲכִילִין אוֹתוֹ אֲפִלּוּ דְבָרִים טְמֵאִים, עַד שֶׁיֵּאוֹרוּ עֵינָיו. מִי שֶׁנְּשָׁכוֹ כֶלֶב שׁוֹטֶה, אֵין מַאֲכִילִין אוֹתוֹ מֵחֲצַר כָּבֵד שֶׁלוֹ, וְרַבִּי מַתְיָא בֶן חָרָשׁ מַתִּיר. וְעוֹד אָמַר רַבִּי מַתְיָא בֶן חָרָשׁ, הַחוֹשֵׁשׁ בִּגְרוֹנוֹ, מַטִּילִין לוֹ סַם בְּתוֹךְ פִּיו בְּשַׁבָּת, מִפְּנֵי שֶׁהוּא סְפֵק נְפָשׁוֹת, וְכָל סְפֵק נְפָשׁוֹת דּוֹחֶה אֶת הַשַּׁבָּת:

(ז) מִי שֶׁנָּפְלָה עָלָיו מַפֹּלֶת, סָפֵק הוּא שָׁם סָפֵק אֵינוֹ שָׁם, סָפֵק חַי סָפֵק מֵת, סָפֵק נָכְרִי סָפֵק יִשְׂרָאֵל, מְפַקְּחִין עָלָיו אֶת הַגַּל. מְצָאוּהוּ חַי, מְפַקְּחִין עָלָיו. וְאִם מֵת, יַנִּיחוּהוּ:

Yoma 85a:9

The Rabbis taught: If a person is buried under a collapsed building, until what point does one check to clarify whether the victim is still alive? Until what point is he allowed to continue clearing the debris? They said: One clears until the victim’s nose. If there is no sign of life, i.e., if he is not breathing, he is certainly dead. And some say: One clears until the victim’s heart to check for a heartbeat. If several people are buried and one checked and found the upper ones under the debris dead, he should not say: The lower ones are likely also already dead, and there is no point in continuing to search. There was an incident where they found the upper ones dead and the lower ones alive.

יומא פ״ה א:ט׳

תָּנוּ רַבָּנַן: עַד הֵיכָן הוּא בּוֹדֵק? עַד חוֹטְמוֹ. וְיֵשׁ אוֹמְרִים: עַד לִבּוֹ. בָּדַק וּמָצָא עֶלְיוֹנִים מֵתִים, לֹא יֹאמַר: כְּבָר מֵתוּ הַתַּחְתּוֹנִים. מַעֲשֶׂה הָיָה וּמָצְאוּ עֶלְיוֹנִים מֵתִים וְתַחְתּוֹנִים חַיִּים.

Generally today halacha requires not just the end of respiration but also cessation of heartbeat and brain activity. Rabbi Moshe David Tendler introduced the idea of brain stem death as an acceptable criterion, based on the idea that the lack of connection between brain and body meant the person was functionally the same as a person who was decapitated and therefore dead. This is supported in the responsa of Moshe Feinstein (Igrot Moshe Yoreh Deah 3 #132) But not supported by many others (eg Aaron Soloveitchik_. Classically death is described as being when 3 observable things happen - cessation of breath, heartbeat and movement of any kind

Questions to consider - Does one have the "right" to die?

Is physician assisted dying a poor response to distress and fear of pain/ prolonged illness?

Does it normalise euthanasia? Do we seriously question why people want to do this? Will we make proper changes to society / medical support / individual support if the quicker and easier solution is to assist death.

Will dementia / depression / non terminal conditions become part of the autonomy of the person in the right-to-die framework?

Does personal autonomy trump the idea that all life has value / is given by God which is a core Jewish value

in supporting physician assisted dying, are we prioritising of the individual autonomy and “right” over the rights and protections of society?

Elliott Dorff wrote :In Judaism's perspective, then, it is not a compassionate act at all to assist a person in taking his or her own life because doing that would make both oneself and the person committing suicide violators of some of the most fundamental values and laws of Judaism, namely, those insisting that we not murder and that, on the contrary, we set aside virtually all of Jewish law in order to save lives."

Bioethicists have identified the factors that trigger the demand for euthanasia and its surrogates in four different contexts [6] (p. 628‒629):

(1) medical – some people choose euthanasia because of suffering and pain caused by a disease ;

(2) psycho-social – the poor condition of health accompanied by a weakened mental state greatly influences the social status of the person ;

(3) psycho-emotional – patients under the burden of severe suffering develop suicidal thoughts due to underestimated factors such as depression, feelings of worthlessness, condemnation and guilt, isolation or loneliness, unbearable pain, or other forms of psychological disturbance that profoundly compromise deliberate choice , but once treated and with improved health, suicidal intention disappears, and

(4) existential – the experience of life which includes pleasant events until the disease occurs becomes the existential burden of the patient, caused by futility, the lack of hope for recovery, the bad intentions of relatives for inheritance, the costs of treatments, the insurers’ pressures, etc.

(Sorin Grigore Vulcănescu “Euthenasia in the contemporary world Trivent Publishing 2019)

. Assisted Dying is seen as a response to existential suffering – interestingly fear of facing pain/ actual pain is the least often given response to why people want this.

But existential suffering is a vague concept and hard to quantify. The Swiss qualitative study writes

“The twenty-six participants described existential suffering in a multiplicity of individual ways. In total, 63 stories were recounted. Their representations were grouped into eight categories: physical decline and its consequences, loneliness, fear of the future, life is over, loss of social significance, loss of hope for a better future, being a financial burden and loss of pleasurable activities. According to all participants, suffering coming from the loss of self-identity was always linked to physical decline, as if one’s image completely defined someone’s identity. Society’s perception of old people and vulnerable people were also often questioned. Another interesting point was that only four stories referring to a “pure” existential suffering were found. This suffering was related to a feeling that life has come to an end, without identification of any other related restriction or suffering.

Conclusions: Existential suffering is multifaceted. Legislators and right-to-die organisations have to address the question of what make a AS acceptable. The plurality of existential suffering implies the need of a very personalized care. A better understanding of what it is made of could provide a “toolbox” to people concerned by these requests, helping them to explore it in order to offer suffering people a wider range of alternatives.”

The membership of the Assembly of Reform Rabbis and Cantors UK reflects a range of views on the proposed legislation to give terminally ill, mentally competent adults the right to opt to end their life.

If it should become legal in this country, then we would support individuals who make a free-will choice for themselves, either offering pastoral care for both them and their families, or referring them to a colleague who can do so. This is based on a regard for the preciousness of life balanced with the right to personal autonomy, along with the overriding Jewish principle of compassion.

We would also encourage better palliative care for those in need, as well as better health literacy to enable individuals to understand the options facing them. September 2021

Source Sheet created on Sefaria by Sylvia Rothschild