The God Squad: Medical ethics issue sparks questions

Q: I have a question regarding prolonging life. My mom had a stroke and the doctor insisted she’d have pain without a feeding tube. I don’t believe this is true. In any case, do I have a moral obligation to have a feeding tube inserted when there’s no chance of improvement?

A: If your mom is dying from the stroke, you don’t need to put in a feeding tube. If she’s not dying, you do need to put in the tube or risk allowing her to starve.

You face a critical medical and spiritual moment where a line divides prolonging life through clinically-approved therapeutic medical treatments (which is always the religious imperative) vs. authorizing non-therapeutic procedures whose only purpose is to postpone imminent death, which is not only not required but not permitted according to every major religious tradition.

Talk to the doctors until you understand everything you can about your mother’s condition, then make the most loving, wise choice you can. God bless you and your mother in this difficult time.

Q: You wrote a very good column recently about medical ethics, but I do have some questions regarding your ideas.

I’m not sure I understand the difference between palliative care — pain management which clearly hastens death — and suicide. I’ve personally witnessed both of these things with two separate loved ones.

Suicide leaves loved ones with unanswered questions and a lot of guilt. Palliative care, in my opinion, is the same thing, but it’s OK because it brings the closure suicide does not. However, if God owns our bodies, as you say, then why is one OK and the other is not?

A: Palliative care aims at making a patient comfortable and free of pain. I was referring only to the use of palliation for dying patients. Such care is not therapy but it is a moral and spiritual good because it eases pain and does not delay death. Suicide, on the other hand, either kills a healthy living person or kills a sick living person who’s not about to die. The difference is enormous.

When a person is dying, he or she is beyond therapy but not beyond hope. There’s still the religious hope that death is not the end of us; it’s not the death of our souls, which live on with God. Suicide is the death of hope when it’s the choice of healthy people sunk in despair.

If God owns our bodies, then we’re not permitted to take what we don’t own. If, on the other hand, you believe that we own our bodies, then suicide is our right. I stand with hope and faith on this one because suicidal despair can pass with therapy, but suicide is an ultimate surrender. Suicide, as you wisely note, also leaves those left behind filled with confusion, grief and guilt. When you choose life and hope, you always stand with God.

Q: My wife and I love your column and thoroughly enjoy your enlightened approach to questions. If I had a rabbi like you nearby, I might just convert to Judaism! I do have some questions based on two recent columns:

1. First, relating to whether animals (dogs) have souls, your response suggested that only man was made in God’s image and therefore only humans have souls (while animals do not). But in your column dealing with ethical issues as “life nears its edge,” you pointed out that “God owns everything in the world” (therefore, suicide would constitute a sin). Would this not also suggest that, if God owns everything — including animals — killing them would also constitute a sin (thus arguing on behalf of their “souls”)?

A: God owns all the broccoli in the world and it’s not a sin to eat broccoli. I think it’s religiously and ethically preferable to eat broccoli than to eat animals, but eating animals is not like the sin of eating people (who probably taste better than broccoli).

2. Secondly, would not our decision to seek medical attention and/or attempt to prolong life with chemotherapy, insulin injections, heart transplants, etc., contravene God’s prerogative to determine if and when our lives should end? Are we not substituting our judgment for His? Or might think of God having bestowed on us the ability to think, reason, unravel the human genome puzzle, develop modern medical treatments, etc., as His way of “allowing” us to master our own destiny (with His implicit approval)?

A: Yes.

3. If that is the case, would it not also suggest that by so empowering us to control the longevity of our lives to a greater (or lesser) extent, we may also elect (with His approval) to end our lives, when not doing so would only subject us and our families to needless suffering due to terminal illness? -- P., New Bern, NC, via [email protected]

A: Refusing non-therapeutic medical procedures at the end of life is God’s will because death is an eventual, natural and intended end to life. It’s not our decision to end our lives. It’s our acceptance of God’s decision to let our lives end.

Now, how about signing up to be Jewish? Repeat after me, “Mazal Tov!”

Send questions only to [email protected].