Jewish tradition affirms the sanctity of life, as well as the precept that ever means must be undertaken to preserve life. It also affirms that when there is no hope for a patient and death is certain, impediments to death must not be created, and the patient must be allowed to die in dignity and in peace.
Recent medical developments now make it possible to prolong artificially the process of dying in those whose deaths would otherwise be imminent. These developments have kept many patients alive after they have become incompetent and are close to death or in a persistent vegetative state, with no chance of recovery. Often these patients, before becoming incompetent, have not expressed their views in an enforceable way or have not had the opportunity to record their views on issues of death and dying.
The prolongation of their lives through such procedures takes an enormous toll upon the spiritual, emotional and economic resources of the patients and their families and friends, and at times can result in protracted litigation. Clergy, physicians and other health care providers are often confronted with a variety of irreconcilable or unresolvable moral and ethical conflicts when patients have not expressed whether they want such procedures used to prolong their lives.
In 1990, in the landmark decision in Cruzan v. Director, Missouri Department of Health, the United States Supreme Court affirmed that 1) a competent person has a right to refuse unwanted medical treatment, 2) that right survives incompetency, and 3) that right should be protected when a decision to refuse treatment is clearly expressed with specificity by a patient, when competent. The Cruzan decision makes clear the importance of expressing and recording one's wishes before illness strikes, to insure that those wishes will be honored, to give guidance to physicians, other health care providers, family, friends, and clergy, and to avoid the trauma which ensues when a patient's wishes are either unknown or not clearly recorded.
THEREFORE, the Union of American Hebrew Congregations resolves to:
- Reaffirm that in accordance with Jewish tradition each individual has the ethical, moral and legal right to make his own or her own health care decisions, and that such right survives incompetency.
- Develop and promote educational programs to inform each member of the existence of issues relating to death and dying which often require difficult decisions and to urge members to discuss such issues with their families, friends, physicians, rabbis and cantors.
- To encourage members of our congregations to use advance health care directives and/or other legally acceptable and binding writings, such as living wills and durable health care powers of attorney, as well as the words "living will" placed on all state driver's licenses, for the purpose of memorializing their respective decisions with respect to the administration of life-sustaining medical treatment and procedures in the event of their incompetency accompanied by a terminal illness or a persistent vegetative state, with no chance of recovery.
- To promote and support the enactment of national, state, and provincial legislation, preferably of a uniform nature, designed to facilitate the decision making process set forth above.
- Call upon all member congregations to support and join in these efforts.