Healing not an option for Terri Schiavo: To deny the reality of death is religiously perverse

There are several issues involved in the Terri Schiavo case.

One is the status of artificial nutrition and hydration. That is a matter of dispute among many ethicists, and it is one point that divides Rabbi Avram Reisner and me, the two rabbis who wrote rabbinic rulings about end-of-life issues, both of which were approved by the Conservative Movement's Committee on Jewish Law and Standards. Reisner thinks that we may remove medications and machines from people who are not benefiting from them, but he thinks that artificial nutrition and hydration constitute food and liquids because they function in that capacity, and therefore he thinks that we must insert tubes into a person who cannot eat or drink on his or her own to provide artificial nutrition and hydration and that we may not take tubes out of a person until that person is dead.

I, on the other hand, think that artificial nutrition and hydration are medicine because they do not have important characteristics of food — specifically, they do not have taste, temperature or texture, and they enter the body through tubes rather than through the mouth which then chews and swallows. Therefore, I think that we should insert tubes according to whether it is in the best interests of the patient.

That leads to the second issue. As a front-page article in the March 22 Los Angeles Times explains very well, people in a persistent vegetative state usually become that way either through a stroke or heart attack that deprives the brain of oxygen or through head trauma, typically in a car accident. If the former, the chances of recovery are really poor and doctors typically wait at most three months before telling the family that there is really no hope for recovery. If the latter, there is still a poor but somewhat better prognosis for recovery, and so doctors generally keep such patients on life support for up to a year.

In Terry Schiavo's case, her brain lacked oxygen because of a potassium deficiency, and so she falls into the former category. I, then, think that the artificial nutrition and hydration should have been removed three months after she entered a persistent vegetative state — that is, more than 14½ years ago.

This does not expose her to pain, as it would a person whose upper brain (cortex) were functioning. Furthermore, it would be of definite benefit to her — she would be allowed to die painlessly rather than being kept on machines in a state from which she can never recover consciousness — as well as to the family and community. 

As Jews, we have a strong mandate to heal, but when we cannot, we must recognize and accept the fact that we are mortal (this goes back to the Adam and Eve story). As Kohelet, King David's son, says, "There is a time to be born, and a time to die." To deny the reality of death is both psychologically unhealthy and religiously perverse.

Two other aspects of this case are very troubling. The Republicans supposedly stand for less government, but now they have intruded the federal government — Congress and the president, no less — into the private health-care decisions of a family. Second, the artificial nutrition and hydration Terry Schiavo is being given is being paid for by Medicare, but President Bush wants to reduce the funding of Medicare while still claiming that it should pay for what is effectively a futile procedure. We need to spend our health care dollars much more productively than this.

I hope that this helps people think about this from a Jewish perspective.




Rabbi Elliot Dorff is a Los Angeles-based leading scholar of medical ethics in the Conservative movement.







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