Forced Surgery

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When a person refuses treatment, do we have the right to administer it by force and save the life?

Reported in the Jerusalem Post:

A 50-year-old woman, who was unconscious and near death, was brought to the emergency room at Laniado Hospital in Netanya, Israel. After examination and x-rays, the doctors determined that she was suffering from encroachment on her blood vessels due to a 33-pound tumor located in her uterus. A staff doctor commented that the tumor was "so large that it will probably make the Guinness Book of World Records."

 

Over the preceding 18 months, the woman had been hospitalized periodically for shock. Hospital doctors advised her that the tumor must be removed or she would die. She steadfastly refused, insisting that she was "scared."

The hospital applied for and obtained a court order allowing the operation in spite of her refusal. A team of 12 surgeons working 4-1/2 hours performed the operation successfully.

 

The Factors In Question

Is it relevant that the woman was diagnosed as "critically ill," without hope of recovery unless an operation was performed?

Does the fact that she is unconscious and dying change the picture?

Should a doctor be guilty of "assault and battery" if he performs an operation without the patient's consent?

On the other hand, should a doctor be guilty of negligence if he fails to perform such an operation?

Is it possible for someone to have the legal status of "mentally competent," but be mentally incompetent regarding a particular decision?

Posted Comments

Judith wrote:

I am the daughter of a woman who took her own life. No person in this world has the right to take their own life or that of another. It is the single most selfish act that anyone can commit. It happened to our family over 20 years ago, and it feels like it was just yesterday. It's something I will never get over. There is no situation that cannot be worked out with love and support. Just get someone to talk to.

Jane wrote:

God is the maker of all life, and He is the only One Who can take life. His purpose for our life is much higher than we can comprehend. God sees a much bigger picture.

Rachel wrote:

My husband's law partner was just involved in litigation. A hospital patient attempted suicide, but the hospital staff saved his life. He is now a vegetable.

The heirs have sued the hospital because they don't want their father's money to have to pay for his nursing care (the insurance is exhausted). The hospital just made a large settlement with the man's children. The hospital is being punished for saving this man's life.

Jewish Perspective

The decision of the Israeli court ordering the removal of the 33-pound tumor is consistent with Jewish law, which maintains that a person does not have absolute ownership over their body.

We are given life for a fixed time. We are obligated to guard it for safe-keeping and to make rational decisions about its care. To do otherwise is a violation of the Torah commandment to guard one's health. (Ushmartem et nafshotaichem - Deut. 4:15)

We are also taught:

Whoever destroys one life, it is as if he has destroyed an entire world. Whoever saves one life, it is as if he has saved an entire world. (Talmud - Sanhedrin 37a)

Rabbi Moshe Feinstein, one of the 20th century's leading authorities in Jewish law, was asked: Can a patient be coerced to accept treatment or medicine against his will? His response (Iggeros Moshe, Choshen Mishpat 2:73,74):

If a person refuses treatment because he wishes to avoid the expected discomfort, but the medical consensus holds that the treatment would benefit him and may lead to a cure, then it is required to administer treatment ― even against the patient's will.

 

If a patient does not want to take medication... force him, for it is the action of a child... However, coercion should not be used if actual physical force is necessary, since that may frighten and perhaps seriously depress the patient, thereby injuring him in the process of trying to help him.

If the doctors do not know of any medication to heal or lighten the patient's physical pain, but [the medication] will only marginally lengthen his life of physical suffering, do not administer such medication... If the doctor can administer medication so that the patient will live until another [more expert] doctor arrives, he should do so ― even if the patient does not want it.

If the treatment is risky, such as a surgical procedure that involves some possibility of mortal danger, or a drug with serious potential adverse reactions ― even if the drug has been approved because the risk/benefit ratio is in favor of using it ― coercion should not be applied to administer the drug if the patient refuses treatment.

DISCLAIMER: This module discusses sources for the purpose of education. Any real-life situation must be discussed with a rabbi, well-versed in Jewish law.

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