Israeli court OKs pulling plug on sick man

By Aaron Klein

In an unprecedented ruling for Israel, the Tel Aviv District Court yesterday declared that an unconscious man’s wife can disconnect his life support even though the man did not provide written consent for her to do so, setting off a flurry of debate regarding Jewish law and euthanasia.

Immediately following the groundbreaking decision, the prosecution asked the woman to wait until Thursday before pulling the plug on her husband’s breathing machine so the state would have time to file a possible objection.

It was the first time euthanasia has been approved in Israel without the patient’s express consent.

Judge Uri Goren, president of the District Court, wrote in his decision that even though there was no written consent, he was convinced that the 71-year-old man, whose name is being withheld and who has been hospitalized in a vegetative state for seven months since suffering cardiac arrest, would have wanted to be disconnected from the life-support system.

“Even though the petitioner can no longer feel any pain in his present condition, I find that his desire not to live on artificial life support, should be respected,” Goren wrote in his decision, immediately clarifying that his ruling was based on the specific circumstances of this case and that it shouldn’t serve as a precedent for other euthanasia cases in Israel.

“The court was required to rule in a difficult and painful issue which contains characteristics that are not purely legal,” Goren wrote. “This case touches on human suffering, which raises the difficult and tense conflict between the sanctity of life and the advancement in medical technology and the personal autonomy of the patient who asks not to continue extending his life through artificial means.”

The family claims the man told his wife on several occasions that he didn’t want to be sustained by life support, but the family didn’t document his decision because they weren’t aware of the law that requires written consent for so-called mercy killings.

But the ruling angered some in the Israeli and American Jewish populations.

Traditional Jewish law recognizes various forms of euthanasia and expressly forbids active euthanasia – the direct killing of a terminally ill patient. The issue of passive euthanasia, withholding treatment that can keep a patient alive, as in the Israeli court case, is more complicated.

The Talmud forbids all acts that might hasten death, and its ruling is upheld by medieval Jewish law. But Rabbi Moshe Isserles, whose opinions many Orthodox Jews follow, writes in his commentary to the authoritative 16th-century Code of Jewish Law that “if there is anything which causes a hindrance to the departure of the soul … it is permissible to remove [it] from there because there is no act involved, only the removal of the impediment.”

Contemporary rabbinic authorities express a range of opinions. Orthodox Rabbi Eliezer Waldenberg, for example, does not allow the withdrawing of any sort of therapy, but he agrees with administration of pain medication, even if that medication could potentially have adverse affects.

Conservative Rabbi Avraham Reisner permits the withholding of medication and artificial respiration, but not the withdrawal of artificial hydration and nutrition, such as intravenous and tubal feeding.