Doctors and their Limitations

It was reported last week that St George Hospital, after a successful application to the Supreme Court, had turned off the life-support of a man who they believed to be in an irreversible coma. The application by the hospital and doctors had been strongly opposed by the patient's family who believed that he should be given every possible chance of recovery. After the machines were disconnected, the patient survived for sixteen minutes before passing away.

Were the doctors right or wrong?

Before embarking on a discussion of this matter, it is important to have an understanding of the authority of doctors. After all, as the Talmud asks, isn't it G-d who makes a person sick? Or as the Zohar says - a sick person is in G-d's prison. This being the case, perhaps the doctor should not interfere.

The Talmud responds to this question by quoting a verse of the Torah: v'rapoh yerapeh - "he shall most certainly heal" - upon which the Talmud comments, "From this verse is derived the doctor's authority to heal".

What is clear from the above is that it is not a given that the doctor can heal. He must be given specific authority. And that authority is to heal - and to heal alone. Nowhere is the doctor given authority to prescribe death!

Democracy is without question the fairest form of government known to mankind. It's not only about the power to elect officials. It is about accountability - about all people being equal before the law. The judge, as we have seen this week, can be judged.

But democracy, in spite of its fairness, does have its drawbacks. It often gives rise to the patently false assumption that anyone can express a sensible opinion about anything - even things which are well beyond their field of expertise or knowledge.

Only recently we heard that Stephen Hawking - a truly great physicist - called the invasion of Iraq a war crime. Now, while I deeply respect Stephen Hawking, and am an avid reader of his books on science, I didn't know that he was a member of the judiciary with special expertise on war crimes. He may have an opinion on war crimes, but it is no more than that, and should be treated with no more interest than anyone else's. And then there was Madonna, who demanded that the troops be brought home. I mean, why would you argue with a famous pop star who has dabbled in "kabbalah"...?

It really is high time that we recognized the boundaries of our expertise and were humble enough not to step too far outside them.

Returning to our discussion: Matters of healing are within the purvey of medical science. Matters of life and death are outside that boundary - they exist in the realm of ethics and religion.

The mode of treatment is one for the expert doctor to decide. Whether to continue treatment is for the expert rabbi to decide.

So what is the religious position here?

While every case is different, and should be addressed individually, the following should give us some broad insight.

The Talmud says that there is no difference between a child of a day old, and an old man of 100. Killing either one of them is an act of murder. Or as former Chief Rabbi Jakobowitz once explained: Life is infinity touching the finite - something which is totally beyond our comprehension - and hence every moment of life is of infinite importance.

In one of his responsa, Rabbi Moshe Feinstein writes that if a person is on life-support and the doctors are not sure whether he is still alive or merely responding to the machine, they may not disconnect him from that machine as this would be akin to killing him. However, should the oxygen run out, they may wait for about a quarter of an hour to see if there is a spontaneous response before reconnecting him.

The important consideration however is not whether in this particular case the doctors did or didn't do the right thing. What's really important is a clear understanding of the boundaries of medical knowledge, and indeed of all knowledge.

As the true Kabbalists have explained: The Gateway to Knowledge is Humility.