Sunday, March 3, 2013

Nursing home refuses to do CPR on sick residents


  1. I recently spoke to someone whose mother was chronically sick and halachically died - that is - she was no longer breathing. Hatzalah personnel asked the person is he wanted resuscitation and the rov paskened this should be done. My question is why?

    1. Why not?

      How about, in an 87-year-old woman, the certainty of broken ribs, broken rib cage, broken sternum, and then spending the rest of her days intubated in the ICU, in agony?

      WADR to the Rav, no way that halacha requires it in such a case.

  2. it is a violent, painful and eventually invasive [ they always intubate afterwards and hook up iv's] procedure
    that in the circumstances described here, not halachically mandated.
    i don't know why this is even a story.

  3. I asked this shaalo to the Gadol Reb Moshe Feinstein zt'l and he said that if the person indicated that he would prefer not living to a life of pain there is no obligation to do procedures or surgery that will prolong the life. We are not talking about starving people to death, but we are talking about not doing procedures to keep them alive when they are dying. I presented this to a senior Hassidic rabbi and he seemed to demur. I know of another rabbi who said we should do the procedure. The Tsits Eliezar, one of the great poskim, disagreed with Reb Moshe and said we have to fight to keep the person alive with all of the pain. I found a gemora in two places that says that if someone is beaten by a poisonous insect and will surely die we keep him alive until he can arrange his affairs and say goodby to his family and then let him die. We see that if there is not a special reason that he would want to remain with the pain until he departs from his family we let him die. I showed this gemora to the Gadol Reb Shmuel HaLevin of Bnei Braq and he accepted it saying, "Poshut azoi" meaning, "Reb Moshe does not need my haskomo. But this is a proof." I then showed this gemora to the Tsits Eliezar and he had no answer, but told me to write it up and send it to him. I have a story about this with the Tsits Eliezar to show his great midose but perhaps another time. What a world when there were such Gedolim in Torah and midose!
    It is important to keep in mind that this is not a question for a Rov. It is a question for those who know what the person wants. And in such a case, the closet people to that person must understand what the person really wants. It is a mitsvah to talk to people of old age or those with illness to find out exactly what they want. There is a story said in the name of Reb Moshe that he told someone, "If you want to escape the pain you may. But how many good deeds could you do that will enter heaven with you?" So, we must know exactly what the person wants, and this is not a simple thing, as the person himself may not know what he wants and may change his mind here or there. So, this is quite a challenge.

    1. "What a world when there were such Gedolim in Torah and midose!"
      quite true!

    2. 1) The elderly woman was already dead, so it is not comparable to what one need do for those who are still alive.

      2)The added factor is where the treatment itself is extremely painful. Chest compression is extremely violent; in the elderly and frail, it cracks ribs already with the first compression.

      3)It is not only the treatment that is painful, but its aftermath, as the ribs will likely not heal and the patient will be in agony with each breath, for the rest of their life.

      4)There is a difference between treatment that effects a cure and one which does not. In the case at hand, the woman died before and will die again, probably of pneumonia, after a stretch of having a tube down her throat for the remainder of what will be left of her life.

      One need not know the patient's wishes, as the majority of normal people would not want this.


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