Ask the Rabbi with Rabbi Chaim Mintz
In the nursing home where I work, I noticed that many patients have a DNR (“do not resuscitate” order). This means that if the patient’s heart stops, the doctors will not make an effort to restart it and bring the person back to life. What is the Jewish view on this? Can one sign such an order for himself or a relative? If the patient will suffer or just be a vegetable, is there any point in keeping him or her alive?
Rabbi Chaim Mintz responds:
It Ain’t Over till It’s Over!
Generally speaking, a Jew does not sign such an order. Every moment we are here in this world is cherished. This is certainly true when one is still capable of performing mitzvos (Good Deeds). We can never overemphasize the greatness of even one “simple” mitzvah. As our rabbis (Pirkei Avos 4:17) tell us, even one moment of mitzvah performance in this world is greater than the eternal bliss of the Next World, because it is only in this world that one can perform mitzvos and rise to greater heights.
Even if a patient is out of commission — in a coma, or the like — the assumption that “it’s all over” is incorrect. One can never give up hope because, even if it seems like the end is near, there can always be a turnaround. In the words of our sages (Berachos 10a): “Even if a sword is against one’s neck, do not cease to beseech Hashem (God) for mercy.” There are many cases where the medical profession gave up, yet the patient went on to live many healthy and productive years.
Alive for a Purpose
But this goes even further. Even if a patient remains in an unconscious state, we still believe that God has a special reason for keeping him alive. Every person has a specific task to accomplish in this world. A person lying in a hospital bed in a coma still has a soul within him, and Hashem obviously has decided that this soul still has a purpose to fulfill in this world. Otherwise, He would immediately take back the soul.
Although we can never be sure what that purpose is, we can mention a few possibilities. It could be to allow family members the merit of caring for him, to inspire people to change their ways when they realize that life is limited, or to atone for the sick person’s soul. There can also be many other reasons that only God Himself understands and are not comprehensible to our feeble human minds.
A Haunting Dream
Let me relate an incident that demonstrates this point. There was a patient in a coma, suffering immensely. A doctor felt bad for the suffering patient, and “pulled the plug,” allowing the patient to die in peace. A short while later the deceased patient came to the doctor in a dream, and reprimanded him, “Do you know what you did to me by shortening my life? The suffering I was enduring was very beneficial for my soul, and you took that away from me!”
At first, the doctor ignored the dream, but after it repeated itself numerous times, he went to a rabbi to discuss it with him. The rabbi told him that since he took away from the patient this great opportunity to go to the Next World with a pure soul, he must make up for it. If the doctor would start keeping Torah and mitzvos, this would be a merit for the soul of the deceased, who was the cause of all this, and would have the power to purify his soul. The doctor agreed to do so, and indeed the dreams stopped.
The Magnitude of the Decision
Every second of life in this world is extremely precious, even if it seems to lack what society considers “quality of life,” because it’s a fulfillment of God’s Master Plan. The pleasure-seeking world we live in today focuses solely on the physical aspect of living. According to this limited viewpoint, one who can no longer enjoy what the material world has to offer has no purpose in living. That is one reason doctors nowadays are so quick to suggest that we allow the patient to die in peace. They see no reason to prolong the suffering, having a patient undergo further treatments that are painful or unpleasant.
At times we are not obligated to reconnect life-support equipment, but we are certainly not allowed to remove it from a patient. In certain circumstances, a DNR is permitted. These are all extremely complex questions — literally, a matter of life-and-death — and we do not dare to make such decisions on our own. If we appreciate the magnitude and the greatness of every moment of life, we would never take responsibility for shortening a person’s life, without the proper rabbinic guidance.
In short: In general, a Jew does not sign a DNR order. Every second of life in this world is extremely precious — an opportunity to do more mitzvos and a fulfillment of God’s Master Plan — even though we do not understand why Hashem has chosen to keep this person alive. And even if it seems like it is all over, there can be a real turnaround.
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