click here to jump to start of article
Join Our Newsletter

Get latest articles and videos with Jewish inspiration and insights​




The Physician-Assisted Suicide of My Sister’s Friend

The Physician-Assisted Suicide of My Sister’s Friend

An elderly, paralyzed woman choosing death has shocked and saddened me.

by

What do you say when you are about to meet someone for the first – and last – time, because she is scheduled for a physician-assisted suicide in 72 hours?

I faced this disturbing dilemma a few weeks ago when I went to visit Paula (not her real name), an 82-year-old woman who had been one of my sister’s closest friends and confidants for close to 20 years. They had known each other for 47 years, since Sharon had been a young teen, and had befriended with one of Paula’s children.

Paula had become a surrogate mother to Sharon after our dear mother had passed away, regularly dispensing her witty, frank and sometimes irreverent advice about life. She encouraged my sister to return to school and offered standing invitations to family events and celebrations. For her part, Sharon had also become a surrogate daughter to Paula, whose adult children were shockingly inattentive and self-absorbed.

During recent years, Paula had endured three increasingly debilitating strokes. Paralyzed and confined to a hospital bed for five years, she could only take liquid nutrition, and a live-in caretaker attended to her most private needs. She suffered frequent pain. After the last stroke in June, Paula entered a home-based hospice program and was not expected to live more than a few weeks. Sharon visited Paula several times a week, often for several hours at a time. Paula told my sister that she was more than ready to die and end her suffering. In fact, she said, she welcomed it.

Instead of weakening further, Paula rallied, regaining some strength, mental clarity and the ability to speak again.

Yet instead of weakening further, Paula rallied, regaining some strength, mental clarity and the ability to speak again. She defied medical expectations and continued to live.

In the fall, unbeknownst to Sharon, Paula requested permission for physician-assisted suicide, which has been legal in California since the California End of Life Option Act went into effect in June 2016. Its proponents refer to it as “medical aid in dying,” and it is currently legal in six states. When Sharon discovered the request had been approved, she was distraught.

“I know she’s ready to go and I hate the thought of her suffering, but I also hate the thought of it being a suicide,” Sharon told me. “The anticipation of what she is doing has my stomach in knots. It’s incredibly painful. I don’t know what to make of it.”

I offered my sister the hope that perhaps God would take Paula peacefully before the appointment with death could take place. The realization also jolted me that I had been remiss in not going to visit Paula earlier; my sister’s close friend should have earned more attention from me. On the spur of the moment, I called my sister from the car and said I was coming over.

Before I arrived, Sharon warned me not to tell Paula that her action was wrong. “She’s heard that from enough friends already. She knows you’re Orthodox and you probably disapprove.”

Rebuking Paula would have been the last thing I could imagine doing, yet as I drove to the visit, I was surprisingly overwhelmed with emotion. I was filled with tears and sadness.

“I want to go out on my terms.”

“I want to go out on my terms,” Paula said. But as my sister discovered, the knowledge that someone plans to end her life, even when that life is painful and seemingly has no prospect of recovery, is unnerving, even alarming. I couldn’t help but think: Paula had already defied medical expectations by living months longer than expected, recovering both mental and speech faculties. Was a miracle impossible?

In her hospital bed in the living room, Paula greeted me with a warm smile, her big blue eyes alert and bright.

“It’s an honor to meet you!” she said when my sister introduced me. I instinctively took Paula’s hand and returned her greeting in kind. She was very talkative and spoke mostly about her Jewish upbringing and values. She referred to her grandfather as a Talmud chacham, a Torah scholar; recalled fond memories of working in a Judaica shop during the Hanukah shopping rush; and of happy childhood memories.

Paula did not appear to me to be someone with nothing to live for, or out of steam. When I shared this observation with my sister, she said, “Don’t be fooled. She’s very happy to have so many visitors now. Everyone’s coming to say goodbye. If she cancelled the appointment on Friday all the visitors would stop. Even her kids who live nearby barely come over.”

I left that visit deeply moved, and over the next few days often found myself looking at the clock, counting down the hours until Paula’s date with death. I began to understand why it would be a terrible thing to know the time when we will die; it forecloses hope.

Knowing that a loved one may be close to death often creates an urgency for final expressions of life lessons previously learned but never acknowledged, for final expressions of love and appreciation. Sharon and Paula shared such confidences in those final days, with each discovering how deeply each one had comforted and supported the other. Paula bluntly told Sharon that without her visits, she would have died long before.

Rabbi Benjamin Blech has written eloquently about Judaism’s opposition to any form of suicide. In his article Brittany Maynard’s Tragic Death, Rabbi Blech directly addressed the pressing question of how we can square our compassion for those facing a terminal, painful illness and who, as Paula stated repeatedly, want to leave this world “on their terms,” with the dictates of morality and an awareness of the unseen spiritual dimensions of our actions. Our society trumpets the virtue of the self through self-actualization, self-empowerment, and “following your passion.” Society has reframed physician-assisted suicide as “death with dignity,” which can have a compelling and romantic appeal.

But as Rabbi Blech wrote:

“Suicide in the simplest sense is disagreeing with a Divine verdict for life. To the question of why? – Why should I continue to live when I am in so much pain? Why should I go on when I am only a burden to others? Why should I stay the course when the end I desire is in any event inevitable? – we can only find comfort in God’s response to Moses when asked to ‘show me your glory – let me understand your ways’: ‘Man cannot see Me and live… I will pass before you and you will see my back, but my face you shall not see’ (Exodus 33:18 – 23). As mortals we can never fully grasp the why of God’s management of the universe. Yet there is one truth that often serves to give us a glimpse of His wisdom. We can never see His face; as life unfolds in its mysterious ways we are often perplexed by its seeming cruelties, bewildered by its inexplicable hardships. Yet oft times we can see ‘his back’; in retrospect, events take on meaning, difficulties recognizable as having had purpose.”

I believe my sister’s close friendship with Paula, particularly in her last years, illustrates powerfully why the Hebrew word for love, ahava, has the word for giving, hav, as its root. Those who gave to Paula most, loved her most, and filled her life with the meaning and joy that was possible. Paula’s love enriched and added purpose to my sister’s life, and my sister’s love enriched and extended Paula’s life.

May Paula’s soul rest in peace.

January 6, 2018

Give Tzedakah! Help Aish.com create inspiring
articles, videos and blogs featuring timeless Jewish wisdom.
The opinions expressed in the comment section are the personal views of the commenters. Comments are moderated, so please keep it civil.

Visitor Comments: 15

(10) IrisB, January 11, 2018 4:07 AM

Death can be a blessing

Only the person who is experiencing the pain can decide if life is worth living, it would be better if they died.

My mother had Parkinson's disease for over 30 years, her condition every deteriorating. For years she wanted to die and said so. My father would cry and beg her not to die, that he needed her. The day after my father died, my mother picked the actual date of her death, 6 months in the future. I visited her in the nursing home twice a week and every time she reminded me of her date of death.

A week before her chosen date, my mom developed pneumonia and slipped into a semi-coma. Her doctor informed me she would only last about 4 or 5 more days. On the day after her determined date of death, she woke from her coma and asked what has been happening around her. I told her that she had pneumonia and almost died. She asked me the date. I told her and she was greatly disappointed that she was still alive and that it ruined her plans. We talked for about 3 hours and then she slipped back into the coma, never to wake again. She died a week after her selected date.

Her death was a personal loss for me, but is was NOT A TRAGEDY. My mother was ready to die, she wanted to die. My father and brother would not give her permission to die, so she named me her healthcare proxy, because she knew I would let her have what she desperately wanted - for it to be over. Had she asked for me to arrange for assisted suicide, I would have not hesitated to honor her wish. Her death was a blessing for her. No one should prevent her from achieving her wish.

(9) Burtb, January 11, 2018 12:37 AM

death with dignity is often a lie

as has been pointed out
http://www.nationalreview.com/corner/455264/oregons-permissive-assisted-suicide-regime

Assisted suicide laws are abused with little oversight.

Oregon sold the euthanasia laws as governed by strict guidelines to prevent abuse.

However, several years ago, a House of Lords commission uncovered that Oregon death bureaucrats destroy all records used to compile their annual reports–meaning that there can be no effective independent inquiry or investigations.

Recently, a Swedish citizen-investigator named Fabian Stahle sent the Oregon Health Authority questions about how it interprets the law. For example, the Authority very liberally construes the law in its regulatory approach.
"The law is best seen as a permissive law, and states only that patients must have a terminal illness with six months or less to live. It does not compel patients to have exhausted all treatment options first, or to continue current treatment."

Stahle asked whether someone would live longer than six months could qualify for assisted suicide if they refuse the medical treatments that kept them from dying:
Turns out, all the patient needs to do is assert that they will refuse treatment to qualify.
Even someone suffering from depression, with a chronic illness, such as diabetes, would qualify.

Stahle asked whether a patient could qualify for assisted suicide even if a cure was available, or the treatment was unaffordable.
Answer; yes.
So...A person could be put in the situation where the insurance company would pay for suicide, but not pain medication!!!

IrisB, January 13, 2018 12:46 PM

Why should they be forced to undergo treatment?

Just because there is a treatment that could possibly extend the days of their lives, why should someone be forced to undergo that treatment? I have seen friends undergo repeated rounds of radiation and chemo with the hope of a cure or perhaps a few more months of time. Sometimes the treatments themselves are so debilitating that there is no joy or quality of life during those extra months. One friend underwent surgeries and chemo, several times because his wife begged for more time with him. His life during that time was living hell, pure hell. He finally told her he had enough, no more treatment. He could not enjoy a day while undergoing treatment. Once he decided to stop treatment he physically felt better and enjoyed the few weeks he had left. His wife has since realized she was selfish and her selfishness subject her husband to sickness and pain and removed joy from his life.

One should not be forced to undergo treatment s if there is no guarantee of a cure and good quality of life along* the way. If the patient has determined they had enough, no one should stand in their way of an assisted suicide.

(8) Peter Krones, January 8, 2018 3:48 AM

Misinformed.

Death With Dignity is not the reframing of suicide, but rather it's the other way around. Notwithstanding someone who has willingly lived in severe pain for 30 years, because she feels it is God's will, to assume that an individual has no say so ad to how they leave this planet, when their illness is certified as irreversible and imminent, and when the pain and suffering is intolerable, and when the family itself is comfortable with the patient leaving peacefully, holding their hands - what could possibly be wrong with that.? The analogy of someone blowing their brains out to having a single pill prescribed for an individual who has had to go through extensive assessments psychologically before being approved, is a ridiculous analogy. This culture, in which the business of dying is a secret subject to be feared and ignored, has a lot to do with why people become so upset with death with dignity. I understand the Orthodox View that God's will is beyond our knowing is a powerful statement of how helpless we are in this world, and yet who is to say that it is not his will 2 permit someone to intelligently, lovingly leave this planet? I recommend that anyone who may be on the fence about this subject look at the work of Compassion and Choices, the group that has had much to do with getting these laws passed. They have a presence on Facebook, and post solid information, and some very moving stories, supporting the other side of the story.

(7) Anonymous, January 8, 2018 1:22 AM

I'm Torn Abiut This

I am so torn about this. Eighteen months ago I watched my 94 grandfather spend 6 months dying of sweat gland cancer. Given his age and declining health, nothing could be done. My siblings and I grew-up next door to him and adored him. I watched this active man who walked 3 miles per day suffer as the cancer spread and made his right arm double in size. I watched his body burn as he took radiation treatments in an attempt to make him more comfortable. In the 8 weeks, I heard him tell me every week when I visited and asked how he was feeling, "I'm just waiting to die..." There was no honor for this WWII vet and adored family patriarch. The only positive experiences were A). I was able to take the time and (in tears) tell him how much I loved him; B). I was able to tell him goodbye; and C). He finally received his only wish-- To die on our family's 200 year-old farm..... I think about all 4 of my precious grandparents often and am tearing-up even now from the holes they have left in my heart.

See All Comments

Submit Your Comment:

  • Display my name?

  • Your email address is kept private. Our editor needs it in case we have a question about your comment.


  • * required field 2000
Submit Comment
stub