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Must we always 'choose life'?

"Who shall live and who shall die; who by fire and who by water?" These frightening words at the heart of the High Holy Days remind us that our life and fate are not within our control.

But what if they were? What if it does fall within our power to switch off the machine, or travel to Switzerland to help a loved one end his or her life in peace? Anyone whose beloved pet had to be "put down" knows that added to sadness is responsibility: was I right?

It is incomparably more difficult if the one suffering at the border between life and death is our parent, spouse, or child. Perhaps most challenging is the fate of those who feel trapped in prolonged, hopeless pain in the prison of their own body. Would Jewish law have helped Tony Nicklinson to an assisted death? If not, is it pitiless?

"Choose life" is a central Jewish teaching. But are there exceptions? Western and Jewish approaches differ fundamentally, argues leading ethicist Elliot Dorff. American ideology in particular has us "think of ourselves in utilitarian terms, with our worth being a function of what we can do for ourselves and others". In Judaism, "life is sacred regardless of its quality or usefulness". We are created in God's image and may not therefore commit, or assist others in committing, suicide.

Thus "the right to die" as autonomous human beings (a "right" notably not recognised in this country's civil law,) contrasts sharply with the ancient saying of Rabbi Elazar Hakappar: "Without your consent, you are born; without your consent, you live; without your consent, you die."

Would Jewish law have helped Nicklinson?

Yet there is a remarkable similarity between Jewish attitudes to passive euthanasia - allowing a dying person's life to end naturally rather than persisting with aggressive treatment - and that of contemporary western medicine. Jewish views are based on the Shulchan Aruch's key statement that the dying must be treated like the living; anything to deliberately hasten death constitutes murder.

"But", adds talmudic scholar Moses Isserles, "if anything is preventing the departure of the soul, such as the sound of banging nearby, as from chopping trees… one can remove them, as no act is involved, only the removal of the obstacle."

On this basis, Jewish law has been widely understood to allow the dying to refuse further treatments, request no resuscitation, and, where there is no brain activity, for life support to be switched off. Dorff himself argues that, in certain circumstances, nutrition and even hydration may be stopped if these serve only to prolong the suffering of an irreversible dying process.

A British Medical Journal article highlighted the anguish when hospital staff feel nothing more can be done for a child and further treatment would impose purposeless suffering but, ostensibly for religious reasons, parents are not willing to give up. One can empathise with both; the doctors who judge they are merely bringing a patient further pain, the parent's heart-rending reluctance to part with their beloved child. Yet Judaism teaches that if we are only prolonging dying, the time comes when we have to let go, and praying for our loved one's release becomes an act of mercy.

But mercy killing? The Shulchan Aruch is clear: we may do no act intended to shorten life. Jewish law does not condone assisting suicide. Its sympathies lie with Reverend Michael Hore, a motor-neurone disease sufferer who wrote to The Times after Tony Nicklinson's death. "My fear is that if the present public debate results in the legalisation of euthanasia, the argument to seek death in order to spare my family would become more compelling." Being an emotional and practical burden, alongside the suffering itself, he worried, could lead people to feel that dying is the only decent thing to do.

Yet, though it is a criminal offence in both Jewish and civil law, only the merciless would condemn assisted suicide in every circumstance. Judgment of those moved by disinterested pity for the hopeless suffering of a dying person whom they have tended and cherished for years is best left to heaven.

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