Wednesday, November 10, 2010

Review of Lesson Three

Thank you for joining us for Lesson Three of Medicine and Morals: Rolling the Dice. The following is a brief summary of what we learned:

There are two distinct states in life, and they generate very different views. When one is healthy, life feels like it stretches on indefinitely. We term this state chayei olam, literally, eternal life. But when debilitating illness strikes, life can suddenly begin to feel very tenuous. We term this state chayei sha’ah, literally, life of a moment. When one is in the state of chayei sha’ah, one is sometimes willing to take chances that would normally be considered outrageous for the opportunity to achieve a possible recovery to full health. Is one allowed to undergo such risk, jeopardizing the limited time one has left?

We learned the passage in the Talmud which rules that a terminally ill patient may risk their chayei sha’ah in the hopes of achieving a normal life. This is based on the incident related in the Bible where a group of famished lepers surrendered to an occupying force in the hope of receiving food, despite the possibility of being put to death as a result. This is the precedent which allows one to undergo a risky procedure if terminally ill. As long as death is imminent and inevitable without intervention, and a complete reprieve from death is possible, one may undertake the risk.

We looked at some important qualifications on the permissibility of pursuing risky treatments. According to many opinions, chayei sha’ah is defined as a state in which one has no more than twelve months to live, given the severity of the condition. There are different opinions as to how much risk one may undergo. The most stringent opinion is that it is only permitted to take risks if the chances of cure are even or better; the most lenient opinion allows even treatments with a remote chance of success so long as doctors believe that a cure is possible. To be considered cured, one must not be restored to full health, but simply no longer be at risk of imminent death from the dangerous condition.

We also considered the permissibility of experimental procedures when it is unknown whether they can be of any help to the patient and in which there is a lack of data that can allow us to assess the degree of risk or the effectiveness of the treatment. While some authorities only endorse treatments that have some track record of success, others permit experimental medicine even for a remote chance that it will save the patient’s life, seeing this as not significantly different from the case of risky treatments. Furthermore, so long as the procedure is halachically sanctioned, a parent or guardian may authorize the procedure for a patient incapable of doing so.

One is never obligated to undergo risky or experimental treatments. This is a decision that people must make for themselves, based on their own willingness to live with uncertainty.

Finally, we noted the importance of making sure that every moment of life is properly valued. We pointed out the important Jewish ethic of visiting the sick and offering comfort to the dying, making every moment of their life as meaningful as possible.

We look forward to seeing you next week for Lesson Four of Medicine and Morals, in which we examine the Jewish ethical perspective on infertility treatments.

See you then!

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