MONTREAL — A couple is trying to have a baby, but can’t. A patient is on his or her deathbed and in intractable pain. Another patient is waiting for a heart-lung transplant.
What does Jewish law have to say about these situations?
Those are the types of issues that arise regularly at the Jewish General Hospital (JGH), says Rabbi Raphael Afilalo, which is why he hopes an all-day symposium on Jewish medical ethics, to be held Sept. 1 from 9 a.m. to 5 p.m. at the Gelber Conference Centre, will serve as a practical guide for health care professionals, social workers, clergy, as well as the public.
“This is historic in the sense that this is the first time, I’ve been told, that this has happened in Quebec,” said Rabbi Afilalo, the hospital’s director of pastoral services, who conceived of the event. “I was just at a similar seminar in Lake Placid [N.Y.]. People really have an interest in this.”
Rabbi Afilalo stressed that the symposium aims to make participants aware of the choices, systems and procedures in place at the JGH to help patients, doctors, clergy and families arrive at a consensus regarding care.
“The hospital wants people to know what we do here,” Rabbi Afilalo said.
Most commonly, he added, when conflicts do arise, they involve “end of life” issues – patients and/or their families sometimes want doctors to “do everything” to keep someone alive, or there are misperceptions about what is halachically acceptable and what isn’t.
“Regular” medical ethics, and “Jewish” medical ethics aren’t always the same, Rabbi Afilalo said.
Under Jewish law, for example, the concept of “quality of life” doesn’t exist, he said, since all life has intrinsic “quality,” and “whether you’re 40 or 90, the importance of the life of the person is the same.”
Similarly, from a halachic point of view, he said, it’s never permissible to withdraw a feeding tube from a patient in a chronic vegetative state, even after many years.
On the other hand, he continued, it is considered halachically acceptable to administer morphine to a deathbed patient to ease the person’s suffering, even if it might shorten a patient’s life.
“Under certain conditions in Jewish law, you are not supposed to do everything,” Rabbi Afilalo said.
Issues of medical ethics, he noted, including from a Jewish perspective, have been made more complicated due to huge advances in technology and science.
The practice at the JGH, he said, is to bring in rabbis from the family’s own “community,” if requested, to consult on end-of-life issues.
The issue of organ transplantation is also one that has challenged Jewish law, Rabbi Afilalo said, since it concerns the question of when death occurs.
Organs such as hearts and lungs need to have blood continually flowing through them to keep them viable for transplant, but some Orthodox Jews consider such potential donors to be “alive” even if they’re “brain dead.”
“They say brain death is not complete death, so their organs can’t be harvested,” Rabbi Afilalo said. “The symposium will give the different opinions on this.”
Participants at the symposium will also learn about a program at the Montreal General Hospital that allows infertile couples to undergo halachically supervised fertility treatments.
That program’s Dr. Hananel Holzer will be among the speakers at the JGH symposium. Others will include Rabbi Afilalo, Rabbi Yonasan Binyomin Weiss, chief rabbi of the Vaad Ha’ir’s Beth Din, and Dr. Michael Bouhadana, a supportive care consultant at the JGH.
The event will also address other issues from a Jewish medical ethics perspective, among them “living wills,” the general concept of “sanctity of life,” and the question of “Shabbat and the physician.”
The cost to take part in the symposium is $75, which includes breakfast and lunch.
The day concludes with an hour-long roundtable and debate, and the event has also been approved for up to seven continuing medical education study credits for physicians who participate.
More details are available by calling Rabbi Afilalo at 514-340-8222, ext. 5677, e-mailing him at [email protected], or visiting, www.jewishmedicalethics.info.
