Thursday, 22 August 2019

Suicide and Euthanasia


The euthanasia debate has existed for decades in most of the world. In most countries, it remains illegal to assist even the terminally ill to put an end to their pain once and for all. However, some surveys show that most doctors believe that these laws are unethical and need to undergo significant reform.[1] Religious leaders and the conservative tend to remain opposed to these changes; here we will examine halachic sources to determine whether this position is so straightforward.

The value of life and the prohibition on suicide

It is no secret that the Torah views life as one of the greatest values, and commands us to guard life at almost any price. As we know, the vast majority of mitzvos are deferred when a life is in danger. The obligation to preserve life is a clear precursor to this rule and it goes without saying that suicide is forbidden. The Torah tells us almost at the outset that man was made in the image of G-d.[2]

For this reason, it appears that the Torah did not need to write the prohibition to take one's own life explicitly. However, Chazal explain that the command given to Noach "But I will seek (vengeance) for the blood of your souls" (Bereishis 9:5), includes the message that "I will seek vengeance for your blood from your own souls."[3]

This principle is significant for our lives even under normal circumstances, when there is no thought of suicide. Some write that a person has no halachic ownership over his own body, extrapolating that we are obligated to save a person who makes a suicide attempt. According to this opinion, it is also forbidden for a person to donate organs for a charge.[4]

Even according to those who dispute this,[5] it is certainly incumbent on each person to care for his body and he is not permitted to do as he chooses with it. Even if one owns his body, he receives it as a present from Hashem and must act accordingly.

How to relate to physical pain

The Torah also recognises the fact that sometimes physical pain is harder to endure than death. The gemara says that although Chananya, Mishael and Azarya were willing to give up their lives in order to avoid bowing to the image of Nebuchadnezzar, had they been beaten they would have bowed down. Although death is considered to be a more severe punishment than lashes, this only applies to a fixed number of lashes where the end is in sight.[6]

The rishonim go to great length in explaining this gemara. Some write that as the image of Nebuchadnezzar was not worshipped as a deity, bowing down to it would not technically transgress the prohibition of idolatry.[7] Others write that the truth is that one is obligated to bare the pain of lashes rather than serve an idol - the gemara merely questions why Chananya, Mishael and Azarya did not flee, trusting that they would manage to endure the test.[8] However, there is also a view that the Torah could not expect a person to consciously choose unlimited physical affliction, a fate worse than death. In such a situation, it would be permitted to bow to even a bona fide idol.[9]

According to this last opinion, it would appear that suicide is permitted in situations of severe, unrelenting pain. There is no indication that suicide is a transgression worse than idolatry – if even idolatry is allowed in these circumstances, suicide should be no different. However, one could counter that the leniency regarding idolatry is based on the fact that one bowing down under duress is not really worshipping the idol, as he has no belief in its purported powers.[10] As such, this form of idol 'worship' is indeed a lesser crime than suicide, which may remain forbidden.[11]

Either way, according to all views it is explicit that unlimited physical affliction is considered a harsher punishment than death. Our question is whether one suffering to this degree is nevertheless expected to continue serving Hashem, or whether the Torah did not obligate him to such an extent. Clearly, even if suicide is forbidden under all circumstances, it is impossible for us to judge one who does not live up to this.[12]

Shaul's act

One of the most prominent precedents in Jewish history to learn from here is the case of Shaul Hamelech, in the war against the Philistines. Sefer Shmuel describes how Shaul asked his henchman to kill him, so that the Philistines would not stab and abuse him. When this request was denied, Shaul fell on his sword in an attempt at suicide.[13] According to the Amalekite convert, Shaul did not die from this and asked him to complete the killing. As the convert saw that Shaul was to die anyway, he carried out Shaul's wish. However, David Hamelech scolded the convert for this act and had him put to death for it.[14]

This episode raises many questions. Firstly, who was right and who was wrong? Shaul's henchman felt that killing Shaul would be inappropriate even under the circumstances and even though Shaul requested it. Shaul decided to commit suicide. The convert felt that carrying out the request was correct considering that he would die anyway; David strongly disagreed.

Chazal tell us that the Torah's warning of vengeance for those who commit suicide, quoted above, does not apply to Shaul.[15] Shaul did not lose his portion in the World to Come due to this act. The Ba'alei HaTosfos quote two opinions as to whether Shaul's deed also had approval, but side with the view that it did not.[16]

Even if Shaul acted appropriately, we cannot necessarily conclude that the same applies to anyone who suffers from severe pain. The 'lenient' view quoted by the Tosfos only talks about a case where "one is afraid that severe afflictions will be imposed on him and that he may not be able to manage the test." The implication is that pain is not enough, unless there is also a fear that enemies will force him to transgress.

Maharshal adds further factors that justified Shaul's act:

1)      He thought that the nation would sacrifice themselves in order to save their king, causing many thousands to fall.
2)      It would not be appropriate for the King of Israel to die in the hands of the uncircumcised and for them to kill him with affliction and shame. This would be a desecration of Hashem and our religion.[17]

The martyrdom of R' Chanina ben Tradyon

Another potential source event is the story of R' Chanina ben Tradyon. Chazal tell us that the Romans killed R' Chanina in the most brutal fashion – they burned him together with a Sefer Torah, placing sponges soaked in water on his heart so that he should not die quickly, and suffer more. His students witnessed this and suggested that he should open his mouth in order to allow the fire in, to which R' Chanina responded "Better that the One who gave it (my soul) should take it, rather than me harming myself."

Subsequently, the king's executor asked R' Chanina if he would enter the World to Come if he would remove the sponges, to which R' Chanina responded in the affirmative and swore to that effect. The executor immediately strengthened the fire and removed the sponges, causing R' Chanina's soul to depart speedily. The executor then himself jumped into the fire, upon which a Heavenly voice proclaimed "R' Chanina and the executor are invited to life in the World to Come."[18]

At first glance, we have here an internal contradiction within the words of R' Chanina. He was not willing to haste his own death, but promised the executor reward for doing the same thing. The Heavenly voice confirmed the truth of his second statement,[19] but the clear implication is that his own refusal to act was also correct.

R' Yehoshua Boaz writes that although causing someone to die quicker is forbidden, if something such as a knocking sound or salt on the tongue is preventing death, it is permitted to remove it. He explains that this is not considered killing, but merely 'removal of prevention.'[20]

However, it is not always easy to distinguish between a direct act of murder and ‘removal of prevention.’[21] Some poskim allow disconnecting one whose hope of living has been lost from the life support machine;[22] some add that the doctors are even obligated to do so.[23] Others write that a life support machine is not merely a 'prevention’ of death, as it provides the basic requirements for life. The corollary is that disconnecting it is considered murder.[24] There is also a view that 'removal of prevention’ is only permitted in a case where the ’prevention’ should never have been placed, as in the case of R’ Chanina ben Tradyon.[25]

Conclusion

To conclude, it should be obvious that the practical application of all of this requires much thought and analysis of each particular situation. Decisions of this level should be left to those who have a deep knowledge both of halacha and the world around them – it will usually also be necessary for several rabbis to convene before coming to a final ruling.


[1] See for example this article.
[2] Bereishis 9:6
[3] Bava Kama 91b
[4] L'or Hahalacha (Rav Zevin), "Mishpat Shylock according to halacha"
[5] Minchas Chinuch, Mitzva 237:1; Chavos Binyamin (Rav Shaul Yisraeli) 3:109
[6] Kesuvos 33b
[7] Tosfos ibid. in the name of Rabeinu Tam
[8] See Ramban ibid.
[9] Shita Mekuetzes ibid. citing the Kuntresim
[10] In Sanhedrin 61b, the amoraim dispute the law of one who serves idols out of fear. The halacha is in accordance with the view of Rava, that he is exempt from punishment.
[11] One could also suggest another reason to differentiate between one being forced to bow down to an idol and one who suffers from pain 'from Heaven' – as in the latter case no-one is trying to make the person transgress, his act is one of choice and not one of coercion.
[12] As according to the last explanation above, it is possible that even Chananya, Mishael and Azarya would not have managed. See also Shu"t Chasam Sofer, Even Ha'ezer 1:69; Sho'el U'meishiv, volume 1 3:217; Maharsham 6, Yoreh Deah 49.
[13] Shmuel 1, 31:5
[14] Shmuel 2, 1:1-16. Although the Mechilta (Masechta d'Amalek, parsha 2) implies that David would not have had him killed were it not for the fact that he was an Amalekite, from a simple reading of the pesukim it is clear that this was not the only reason. It was at least in part because he killed 'the anointed of Hashem.'
[15] Bereishis Rabbah, parsha 34.
[16] Da'as Zekeinim miBa'alei HaTosfos, Bereishis 9:5. See also Radak, Shmuel 1 ibid., who writes that Shaul did not sin.
[17] Yam Shel Shlomo, Bava Kama 8:59. See also Radak ibid., who writes that it was better for him to kill himself rather than the uncircumcised abusing him.
[18] Avoda Zara 18a
[19] It is unclear what justification there was for the executor to needlessly commit suicide. Perhaps this was not in fact correct, but he was nevertheless rewarded for his good action.
[20] Shiltei HaGiborim, Rif Mo'ed Katan 16b (according to Sefer Chasidim. See there further, that some are more lenient). This is also the ruling of the Rama in Yoreh Deah 339:1. It would appear that although murder and suicide are forbidden even in the event of great pain, these prohibitions only cover direct taking of life. When there is already something killing a person, 'removing prevention' is not murder. Usually even under these circumstances, one is obligated to do all that he can to save a person in danger, as the Torah commands us not to 'stand by over the blood of your friend' (Vayikra 19:16). However, this command is subjective, and severe pain is also a form of 'blood' that the sufferer should be saved from. In such situations, one must carefully weigh up which 'blood' is the more severe and save the ill person from it. Obviously, for one not experiencing the pain this decision is far from straightforward.
[21] See Taz, Yoreh Deah ibid. 2
[22] Rav Chaim David Halevi, Techumin volume 2; Tzitz Eliezer 13:89; Mishne Halachos 7:287.
[23] Rav Chaim David Halevi ibid.
[24] Rav Goren, Toras Harefuah page 54. See also Rav Zalman Nechemia Goldberg (sheyichye), Emek Halacha, Asya 1.
[25] Rav Eliya Katz, Techumin 3.

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