Scholarship

Hippocratic Healthcare and Christian Absolutism: Can Halakhah Allow for Compassionate Euthanasia?

Print Friendly, PDF & Email

Leead Staller

Introduction[1]:

“In examining whether a liberty interest exists in determining the time and manner of one’s death, we begin with the compelling similarities between right-to-die cases and the abortion cases.”

Compassion in Dying v. Washington,                                                                            79 F.3d 790, 800 (9th Cir. 1996)

With the recent Supreme Court decision to overturn Roe v. Wade, much has been written about halakhic or Jewish perspectives on abortion, and how that should inform our opinions on the matter. Personally, I have little to add to that discussion, as it has already been thoroughly addressed by figures with greater personal and textual knowledge and insight than I could offer to the current discourse.

The adjacent issue of right-to-die, or compassionate euthanasia, however, has, surprisingly, received much less attention. I hope that re-visiting this discussion through the lens of a rarely examined sugya will shed new light on the question of halakhic attitudes towards compassionate death and a right-to-die. In addition, I think this discussion will, as the 9th Circuit Court writes (above), beg important questions about the Jewish attitude towards life in general, which has many far-reaching implications.

Contemporary Survey:   

The current field of both halakhic responsa and halakhic bioethical literature would seem to indicate a clear majority position that outright rejects any possibility for a halakhic right to a compassionate death as an a priori non-starter, with little room for halakhic discussion.

Writing for the Jewish Virtual Library, and published widely, Rav Yitzchok Breitowitz in his article on the topic writes:

Taking one’s life is regarded as halachically and morally improper. While we cannot personally condemn those who in the midst of unbearable pain and suffering take their own lives, we cannot encourage, condone, or participate in the commission of such an act. The preservation of life has always been regarded as a cardinal value in Judaism. The Torah was given to man so “that he may live.” The paramount necessity to save life (pikuach nefesh) supersedes virtually all the commandments of the Torah (Shabbat, Yom Kippur, Kashrut) except for idolatry, sexual offenses, and murder. Because all human beings are formed in the image of the Divine, all life is regarded as being of infinite value regardless of its duration or quality. As all mathematicians realize, infinity cannot be halved. If and when some human life is deemed to be less valuable than others, then life as a whole has gone from being infinite to being relative and the lives of us have become cheapened and debased.[2]

Notably, the article opens with abstract appeals to “the value of life,” and incorporates rhetoric about how questions like euthanasia would necessarily “cheapen and debase” halakhic life. The “halakhic” discussion that follows invokes few sources, perhaps because the matter seems so resolutely settled from this a priori perspective already set forth.

Similarly, Rabbi Jason Weiner, who has written about this topic in a number of areas, also opens his article on “Does Judaism Believe in a Right to Die?” with an assertion of Jewish belief with absolute certainty:

Judaism teaches that we do not own our bodies; our bodies belong to God, and we do not have the right to destroy them. Furthermore, our lives are not simply needed for utilitarian purposes. Each person is sacred, having been created in the image of God, and there is thus a value to life regardless of one’s relative quality or usefulness. Not only is human life itself sacred, but every moment of life is valued, and there is thus an obligation to attempt to save all life, regardless of how much time a person has left to live.[3]

For one familiar with halakhic literature, it is surprising to see a halakhic question discussed in such abstract and theological terms–instead of in terms of text or legal precedent. Nevertheless, that trend is common when it comes to questions of euthanasia in Halakhah.

Perhaps most surprising, though, is that actual responsa literature, such as Rav Eliezer Waldenberg’s Tzitz Eliezer, also starts from abstract notions and values, instead of text and halakhic precedent. Faced with the question of compassionate euthanasia, Tzitz Eliezer settles it by saying:

ִIt is forbidden to take any action that will bring someone on their deathbed closer to death, even if they are suffering greatly in their deathbed and they would prefer to die, since the world and its contents are God’s, and such is His will.[4]

R. Waldenberg makes an appeal to a theological idea- that the world is God’s- to support his decision. Later on in the same responsa, he explicitly refers to this principle as a svara, a logical assertion without any sourcing. Clearly, R. Waldenberg feels that the matter is settled without the need for a heavy textual discussion.

From there, R. Waldenberg pivots to quote and discuss halakhic sources limiting one’s ability to harm one’s self or commit suicide, as the Teshuvah assumes that, in addition to the obvious point that you cannot harm someone else under any circumstance as they belong to God, you also may never harm yourself. In other words, the actual basis of the Teshuvah– that from a legal perspective, life is considered a gift from God that we are just entrusted to watch- is asserted as self-evidently true. The only source-based discussions worth engaging in are secondary issues that result as a natural byproduct of that axiom.

Saul’s Suicide and the Absolutist Perspective:

It’s worth noting that both R. Weiner and R. Waldenberg reference the biblical account of King Saul committing suicide as a source that indicates the prohibition of, but sympathy we feel for, those who end their lives early. Yet, both R. Weiner, in his book on medical decision making, and R. Waldenberg, in a parenthetical statement in the continuation of the above responsa, acknowledge the limitation of this proof by referencing in their respective notes that Beit Yosef (Yoreh Deah 157) quotes a position of Rabbeinu Yeruham that justifies the suicide of Saul as permitted and may even allow for auto-euthanasia in certain extreme cases. Going even further than Tzitz Eliezer’s parenthetical reference, R. Weiner even notes that Rav Hershel Schachter has quoted this source post-facto to justify Shivah and mourning for one who has already committed suicide, even if he does not invoke in preemptively.[5]

A closer look at the discussion of King Saul, however, reveals it to be only adjacently relevant to the topic of this article. This presents us with a good opportunity to define the scope of what is being explored in this article when we refer to “compassionate euthanasia.” This article is not attempting to defend a maximalist stance that would support a definitive right-to-die in all cases where someone (at least of sound mind) makes such a self-determination, and even extend as far as allowing suicide. Rather, this article will address those cases where the amount of suffering one would face relative to the brevity and low quality of life remaining is such that the compassionate course of action is euthanasia.

For some this may beg the question of the coherence of a system that forbids suicide and disallows self-harm but permits euthanasia. However, this serves to highlight the very guiding principle being argued for here, and that which distinguishes the cases of compassionate euthanasia from Saul’s suicide. An appeal to compassion may make the unthinkable act of euthanasia thinkable in certain extreme edge cases, but that does not necessarily mean it’s compassionate for a legal system to allow for suicide. The difficulty in assessing mental states of mind, in determining one’s future, and the fear of regret are just some of many reasons a system could disallow suicide and self-harm while still fundamentally respecting an individual’s right to a compassionate death in more extreme cases.

This distinction, then- between the suicide of Saul and compassionate euthanasia- highlights the very point of departure between previous approaches and the approach I will argue for in this article. While it is true that an absolutist perspective on human life would forbid any action that leads to a loss of life- whether it is suicide or euthanasia- as every second of life is precious irrespective of its quality, it is not clear that the halakhic perspective is as absolute and uncompromising.

Perhaps this point is best highlighted via distinction. An ethical system with a more absolute perspective on human life would find less room to ever allow for the loss of life. As an example of Halakhah’s heavy, but not absolute, emphasis on the value of human life, Sanhedrin 74a establishes that one should violate all but three commandments in the Torah in a matter of life or death: murder, idolatry, and sexual promiscuity. Thus, on a very simple level, we see that Halakhah values the observance of those three commandments more than it values the life that will be sacrificed. This perspective is relatively uncontroversial within Halakhah.

Nevertheless, this perspective stands in clear distinction to Christianity, with its more absolutist perspective on human life. Thus, Thomas Aquinas, in addressing the question of martyrdom, codifies the Christian doctrine:

Now it is evident that fornication and adultery are less grievous sins than taking a man’s, especially one’s own, life: since the latter is most grievous, because one injures oneself, to whom one owes the greatest love.[6]

Very clearly, Aquinas lays down the Christian perspective that no commandment- ritual or otherwise- could possibly be worth the “grievous sin” of taking a human life. He explicitly mentions sexually illicit relationships- one of the Talmud’s examples of a sin one must martyr themselves rather than violate- as not superceding the value of human life, in a clear rejection of Jewish practice.

This article will argue that just like Halakhah can distinguish between martyrdom and self-murder, there is room to distinguish between suicide and euthanasia. To be clear, the goal of this discussion is not to argue for any specific practical policy in Halakhah, and certainly not in the halakhot of euthanasia, but to highlight that halakhic questions pertaining to matters of life and death are more complicated than one might suspect. This is in service of a broader goal of revisiting previously assumed beliefs about Halakhah and its perspective on the questions of today. To that end, the end of this article will revisit the above distinction between Jewish and Christian perspectives in an effort to understand how the current discourse got to where it is.

Textual Source in Halakhah:

While it’s fine and easy to be critical of others for their lack of sources and their appeals to abstract values, is there a textual source in Halakhah that would support this more humanist model of compassionate care, with all of its broader implications for Jewish values?

To that end, we turn towards the Gemara (Nedarim 22a). While few to no discussions of halakhic euthanasia quote it as a source , this passage has the potential to be an important source on the matter:

The Gemara relates: Ulla, on his ascent to Eretz Yisrael, had two residents of Ḥozai join him. Because of a brawl between them, one arose and slaughtered the other. The assailant said to Ulla: Did I act properly? He said to him: Yes, and open the place of the slaughter, i.e., cut it more so that he will die faster. When Ulla came before Rabbi Yoḥanan, Ulla said to him: Perhaps, Heaven forbid, I strengthened the hands of sinners by commending him, although I did so merely because I was afraid that he would kill me. He said to him: You saved yourself by doing so, as it is permitted for one to say words like this in order to save his own life. [7]

Interestingly, the pseudo-Rashi[8] (Nedarim 22a s.v. “amar lei in”) explains Ulla’s reaction to the initial attack against his companion as being motivated solely by self preservation.

“He said: Yes and open the place of slaughter” – And he was afraid to say he did not do the right thing, lest he kill him.

Ulla said what he said solely to save his own life. By saying he approved, and adding his own addition of “open the wound,” Ulla showed he was on the assailant’s side and protected himself.

Rosh, though, presents a slightly different nuance to Ulla’s response:

“And open the place of slaughter” – Because of fear he reinforced his actions, and also, in order to hasten the death [of the victim]

According to Rosh, Ulla had two goals in mind. One was self preservation motivated by fear. But in addition to the fear, Ulla also was motivated by the desire to hasten the victim’s death. From a simple perspective, these seem like two different motives. One is selfish, as Ulla is saving his own life, while the other is compassionate, as Ulla tries to save the victim from suffering. In other words, one can read in Rosh’s addition a perspective that sees compassionate euthanasia–at least in the case of Ulla’s story–as halakhically legitimate.[9]

Most later Aharonim reject this way of reading of Rosh’s commentary on the Gemara, and assume Rosh was actually saying that even the idea of hastening the victim’s death was merely to impress the murderer, and not out of compassion for the victim.

Rav Shlomo Kluger, though, in his commentary on Nedarim, Nidrei Zerizin, reads Rosh the way I suggested:

And one must acknowledge there is a question: While Rebbe Yohanan said [Ulla’s response was legitimate] because he saved his life, nonetheless, it would have been sufficient for Ulla to say “Yes” (i.e. you acted properly). But why did he add “open the place of slaughter?” One must conclude that Ulla intended this for the well-being of the victim so he dies faster. And one must conclude that that which Ulla said that he was strengthening the hands of a sinner was specifically when he said “Yes,” but that which he said “open the place of slaughter,” was not [potentially] sinful.

Strong evidence for Rav Kluger’s read in the Rosh may be found in the earlier Tosafist work, Tosafot Yeshanim. Adopting the view that one of Ulla’s goals was to hasten the victim’s death, the Rosh’s Tosafist predecessors spell out very explicitly that it was only the first statement- that Ulla approved of the murderer’s actions- that was said for self-preservation, and that Ulla felt guilty about later on in the story. However, Ulla never even asks R. Yohanan if his encouragement to hasten the victim’s death was problematic.[10]

Yet while R. Kluger definitively reads Ulla as making two separate statements according to Rosh, with the former potentially sinful and the latter for the sake of the victim, he ultimately concludes that while it might be the right read of Rosh, its halakhic implications–that compassionate killing may be permitted–are too difficult to swallow due his broader halakhic understanding of the value of human life.[11]

But while R. Kluger finds it difficult to accept the idea of compassionate euthanasia in the broader halakhic system, he also admits that the alternative understanding of the Gemara in Nedarim 22a is just as difficult. Even if Ulla was solely concerned with protecting his own life, how could it be that Ulla was allowed to hasten the death of one person to save himself? Sanhedrin 74a famously says, “who says your blood is any redder,” establishing the principle that one cannot sacrifice the life of one person to save another! Ultimately, Rav Kluger concludes without an answer, conceding on the matter that “tzarich iyun,” it requires further examination.[12]

Halakhah, however, isn’t decided based on one commentary’s novel approach to one Gemara. It’s decided based on textual interpretation and legal precedent. We’ve demonstrated a strong read of the Gemara, that could serve as a textual basis, but is there any legal precedent within the world of contemporary Piskei Halakhah that would preserve this Gemara as a source for compassion-driven ethical principles, even within the contemporay halakhic scene that largely wholesale rejects euthanasia?

Halakhic Precedent:

In a tragic and fascinating piece in the Hashukei Hemed, Rav Zilberstein discusses the halakhic status of those Jews who, trapped in the Twin Towers during 9/11, decided to jump from the towers rather than await a more painful death inside. While it’s worth noting that this type of Halakhic literature- ex post facto justification of actions- doesn’t carry the same weight as a typical Beit Din case in terms of setting precedent, it is nonetheless a fascinating example of a contemporary usage of Nedarim 22a as a source for a Jewish sense of a right-to-die.

Was it permissible to jump from the Twin Towers [on 9/11] out of fear of the flames?

Question: Many people jumped out of the Twin Towers in America [when the wicked ones killed and destroyed and murdered thousands], despite knowing they would certainly die from the jump. Was it permissible for them to do this, since by jumping they are hastening their deaths, whereas by waiting for the flames they would live longer?

Answer: A priori the matter appears forbidden… however, it is possible that there is room to permit it based on the words of the Tiferet Yisrael who writes about the story of Ulla… And based on this, perhaps when there is a concern of suffering by burning, which is awful… it is permitted to forego momentary life in order to avoid that kind of suffering and to jump from a high place, in order to escape the fire. For that is an action of salvation, and not an act of suicide.

Citing Nedarim 22a, albeit from Tiferet Yisrael’s perspective,[13] R. Zilberstein suggests that perhaps those who jumped from the towers were halakhically permitted to do so, as they were saving themselves a painful death in the towers, just as Ulla was sparing the victim a painful end by suggesting his throat be slit. Fascinatingly, R. Zilberstein feels that while this Gemara may provide an ethos or a spirit to the law, there is still a need for a more technical explanation for how such an action could be permitted. He explains that those who jumped were not committing a “Ma’aseh Retzihah,” an act of murder (or in this case suicide) when they jumped to their certain deaths. Rather, they were engaged in a “Ma’aseh Hatzalah,” an act of salvation as they jumped out of the building away from the fire.

Clearly this additional mechanical explanation of R. Zilberstein expresses a general discomfort with a generalized possibility of allowing a right-to-die for compassionate purposes. It was specifically because there was fire and an imminent painful threat in the building that one could justify their act of jumping as an act of “salvation from fire” and not “jumping to one’s death.” Perhaps it is because of this discomfort that R. Zilberstein elsewhere grabs at a different, albeit even more radical, halakhic explanation to explain how exactly Nedarim 22a allows us to “kill” someone who is suffering. R. Zilberstein suggests a radical idea: Hayei Sha’ah, someone who is certain that they have merely moments left to live, is not considered Hayim (life), and therefore, cannot be murdered.

We find that fleeting life is not considered life. And if the Mishnah writes anything that pertains to “living” people it means long-term life, for they are considered “living.” But less than that isn’t considered “living,” rather, fleeting life is temporary living and not considered living.

Given this shocking perspective, R. Zilberstein must go on to explain how this idea interacts with pre-existing areas of Halakhah such as Goseis and Tereifah, which create civil and criminal laws and regulations around killing and harming someone who is terminally ill or on their deathbed. However, all of that work- and the very need to wade into the thick of those details- is only necessary if one thinks that there is fundamentally a halakhic comparison between injuring or killing a terminally ill person and assisting a suffering person in their chosen end. That comparison only really makes sense if one adopts an absolutist perspective on human life, that is indifferent to the circumstances and context in which a life may be threatened or terminated. From the perspective of compassionate care, though, one can conceptually differentiate between actions taken for the sake of the suffering person, and those taken for selfish or ulterior motives.

Thus, R. Zilberstein, clearly still working within a model that would a priori reject a right to a compassionate death due to its religious commitments to the absolute value of human life, is nonetheless comfortable invoking our Gemara in Nedarim 22a as a source for such a notion as a post-facto justification in dire situations.

Where R. Zilberstein felt uncomfortable, though, Rav Menashe Klein trailblazed. In his Mishneh Halakhot, R. Klein presents a halakhic perspective on compassionate euthanasia that definitively accepts it as a practical concept in Halakhah- rejecting much of the more absolutist approach we’ve seen until now. R. Klein invokes our interpretation of Nedarim 22a in direct response to a question of what can be done for someone who is suffering a torturous death. He concludes from the story of Ulla that it must be permissible to hasten death[14] to avoid suffering.

…and there is a third proof from the story of Ulla… And it seems obvious that there were two motivations here, and the motivation of hastening the victim’s death was its own statement. And that which the murderer asked “do you approve of what I did,” Ulla could have just answered “yes.” So why did he add “open the place of slaughter?” The Rosh answers, in order to hasten his death. And it’s puzzling, how was it permitted to hasten someone’s death? It must be [it was permitted] because of suffering. And if that’s the case, it’s explicit it is permitted to hasten death to avoid suffering.[15]

However, even R. Klein is not unmoved by abstract theological appeals, and he puts a somewhat puzzling limitation on his own principle.

But all of this is only in a case of someone who is dying from an external cause, like in the cases of Hanina ben Teradyon[16], Ulla, and those sentenced to death by Beit Din. In all those cases it is permitted to hasten the death so they will not suffer. However, someone who is dying from natural illness, and is suffering from it, God forbid you hasten his death. This is what the Talmud says, “suffering empties [one from sin]. On the contrary, the Heavens understands all the reasons why one suffers, whether to empty their sins or give them more reward…[17]

Basing himself on the Talmudic example of UIla’s story as well as others, R. Klein concludes that one is only allowed to intervene and hasten death in the case where someone has been injured due to human intervention in the first place. However, if someone is suffering from natural illness, then it is a divine punishment from God, and man has no right to intervene and cut the suffering short.

Even if we accept R. Klein’s assumption about the role of theology in determining Halakhah, I’m not sure many would agree with his theological beliefs. Is it so obvious that illness is divine punishment from God, but man-inflicted suffering isn’t? What about the man-inflicted suffering of the Egyptian slavery, or the Babylonian exile? This clearly theological question is beyond the scope of this article, but, at the very least, it gives one good reason to question the practical limitations of R. Klein’s principle of halakhic euthanasia, even if one fundamentally agrees about its existence conceptually.

The Role of Christian Influence:

Thus, I have shown the majority approach, which assumes that there is no halakhic basis to even discuss compassionate euthanasia, and therefore addresses the question purely from the perspectives of theology and the value of life instead of textual sources. But having fleshed out our sources and their relevance as potential textual sources on the topic, why did hundreds of years of rabbinic authorities flat out reject the idea as a non-starter?

While I acknowledge it is speculative, I am left wondering if the answer lies in the majority-Christian culture many post-Talmudic Jews found themselves in, from Medieval times until today. It is no secret that many sects of Christianity ascribe to a theology that views life as a temporary gift entrusted to humans from God to protect at all costs, and we have already seen practical distinctions between Jewish and Christian law on this basis in the comparison between Halakhah’s and Aquinas’ laws of martyrdom, above. Indeed, the Parable of the Talent in Matthew and Luke serves as a foundational theological tale about the unrelenting responsibility life places upon the living to be willing to serve their creator, despite any circumstances.[18] Thus, the very same section of Aquinas referenced above, in which he rules that one should commit adultery rather than kill one’s self, justifies this ruling by saying life is “God’s gift to man and subject to God’s power,” comparing one who commits suicide to one who kills someone else’s slave.[19]

Indeed, Dr. Michael Manning’s 1998 work Euthanasia and Physician Assisted Suicide lays out what seems to be a relatively uncontested belief that:

“The ancients focused not on the act of hastening death itself, but rather on the manner of one’s dying. The important thing was for the dying person to meet death with peace of mind and minimal pain… To ensure such a death, it was permissible to arrange the circumstances surrounding one’s death, including measures that would shorten one’s life. Many ancient Greeks and Romans preferred ‘voluntary death’ over endless agony. This form of euthanasia was an everyday reality… and many physicians actually gave their patients the poison for which they were asked… A minority of physicians challenged this widespread acceptance of euthanasia. These were the adherents of the Hippocratic school who pledged ‘never to give a deadly drug to anybody if asked for it, nor… make a suggestion to this effect.’… It appears, however, that given the socially accepted notion of a ‘good death,’ it was relatively common for a physician to end the life of one of his patients, as long as he had the patient’s consent…

The ascendancy of Christianity with its view that human life is a trust from God reinforced the views of the Hippocratic school. By the twelth through fifteenth centuries, it culminated in the near unanimity of medical opinion in opposing euthanasia” (pp. 7-9).

In other words, while compassionate euthanasia was an open question and widely practiced up until Medieval times- with the Hippocratic practitioners being the exception who forbade it in the now famous Hippocratic Oath- after the rise of Christian Europe, anti-euthanasia attitudes began to spread based on Christian doctrine’s conception of life as a gift from God that human’s are mere stewards of.

All of this is to say that, while in general it feels problematic to conclude halakhic principles from abstract appeals to values, here in particular it feels particularly dangerous. The very principle that is being appealed to without strong sourcing- the absolute value of human life- runs parallel to certain strains of Christian thinking and perhaps counter with some elements of Jewish thought. While pure speculation, this may, in part, explain why the Talmud and some earlier commentaries adopt an approach that is either silent or approving of compassionate euthanasia in Nedarim 22a, while later authorities universally reject it as obviously unthinkable.[20]

Conclusion:

Locally, it seems that there is, at the very least, the basis to discuss an ethic of compassionate death in Judaism. From a theoretical perspective, the story of Ulla on Nedarim 22a as well as the early rishonic interpretation of it present a possible model of halakhic euthanasia, and the practical decisions of R. Zilberstein and R. Klein show ways in which that theoretical principle has manifest itself in our current halakhic system, despite being a relatively minor and unknown position for centuries. While clearly this perspective remains on the fringes of practice and halakhic precedent, at the very least it can serve as the basis for a new examination and discourse as to the halakhic perspective on this sensitive matter.

More broadly, though, this halakhic discussion serves as a case study for probing at a coherent theory of the halakhic ethic of life and death- or, put another way, the Jewish value of human life. While it may seem intuitive to many that the greatest good is one which prioritizes the divine image and the divine perspective in all issues, our case study provides us with an answer for those edge cases where such intuition fails. Rather than demanding a compassionless and cruel praxis, or sacrificing our commitment to the divine image in man, a halakhic ethic of life and death that prioritizes compassion would emphasize the humanist element of man’s Divine Image, empowering us to center our experience of suffering in a manner which surely God, our father, would be sympathetic to.


[1]I’d like to thank my many friends and mentors- too many to name- who read and edited drafts of this article for me. In particular, though, I want to thank Isaac Shulman, my lifelong Havruta, for first learning this Gemara with me in Rav Schachter’s Kollel, helping me develop this piece, and always being a partner in Torah.

[2]Yitzchok Breitowitz, “The Right to Die – A Halachic Approach,” https://www.jewishvirtuallibrary.org/the-right-to-die-a-halachic-approach, accessed June 2022.

[3]Jason Weiner, “Does Judaism Believe in the Right to Die,” https://www.myjewishlearning.com/article/does-judaism-believe-in-the-right-to-die/, accessed June 2022.

[4]Shu”t Tzitz Eliezer, Ramat Rahel ed., 5:29. All translations are my own, unless otherwise noted.

[5]Jason Weiner, Jewish Guide to Practical Medical Decision-Making (Jerusalem: 2017), updated e-book shared by author, Chapter 4, fn. 13.

[6]Summa Theologica, II. II. Q 64 Art. 5, Reply to Objection 3, translated by the Fathers of the English Dominican Province (1920), accessed online, https://www.ccel.org/a/aquinas/summa/SS/SS064.html#SSQ64OUTP1,

[7]Translation from Sefaria. 

[8]The commentary traditionally printed on the side of the page for Nedarim is mis-attributed to Rashi, and is actually a later commentator of uncertain identity. 

[9]Some authorities note that Ulla merely encouraged the victims death with words, but didn’t take any actions himself. But even if it is the case that the lesson from this Gemara is limited to cases of indirect action, such as speech, the overall lesson about the halakhic room for euthanasia, and its implications for the halakhic philosophy of the value of life, would still stand.                                                                                          Fascinatingly, an alternative manuscript of the Gemara in Nedarim 22a (Vatican 110-111) reads “א”ל אין אזל וֹפרע בית השׁחיטה” “Ulla said ‘yes.’ He went and he tore the place of slaughter.” According to this text, it is possible that Ulla is actually opening the wound with his own hands (although, admittedly, it is ambiguous if that action is being taken by the initial assailant). My thanks to my friend and colleague Eliav Grossman for reading over a draft of this piece and pointing out this manuscript. Grossman speculates that even a grammatically attune understanding of our text may indicate that ופרע is a description of an action, and not a statement, by Ulla.                                                                      For more ֹon the practical halakhic discussion of whether this is limited to speech, see the Tiferet Yisrael below (footnote 12) for a discussion of whether Ulla’s actions would have been any different had he taken physical action himself.

[10]See Tosafot Yeshanim in Shitat Kamai Nedarim 22a.

[11]As an example, Rav Kluger in the continuation questions how euthanasia could be possible if everyone agrees there is a halakhic responsibility to break Shabbat to save the life of someone on their deathbed. While the discussion of lifesaving measures on Shabbat is beyond the scope of this article, it is again noteworthy which comparisons various halakhists feel are apt when discussing euthanasia.

[12]While Rav Kluger doesn’t offer an answer, we see that other authorities have no qualms offering answers, leading to ethical outcomes just as complicated as those posed by compassionate euthanasia. As an example, Tiferet Yisrael reads the Gemara like Rav Kluger, as indicating that Ulla encouraged the death of someone to save his own life, but concludes there is no ethical problem with that. Rather, Tiferet Yisrael learns from Ulla’s actions a principle just as surprising as the premise of compassionate euthanasia. Tiferet Yisrael (Boaz, Yoma 8:3) writes:

However it is difficult to me [in the story of Ulla]… the Ran [and the Rosh] says it was to hasten the victims death. And that is difficult, since we are generally concerned with saving even moments of someone’s life, which would render this like murder. And even if Ulla was afraid that if he didn’t say that, he would be murdered, we say… “what did you see that your blood is redder? Maybe your friend’s blood is redder?”… And it appears to me that one can say that even though we are concerned even for a fleeting life, that is only when it doesn’t come at the expense of someone else’s long term life. But if it comes at the expense of someone living a long life, obviously that blood is redder than the blood of a temporary life, which is not as red. And even if it is only an uncertainty that the other person will live a long life, it takes priority, and one can save themself with it. And perhaps even if Ulla had to do an action himself it would have been permitted, and all the more so via speech, which is just indirect damage.

Yet, while Tiferet Yisrael is willing to essentially overturn an explicit axiom in Halakhah- that no one’s blood is redder than anyone else’s- his approach is practically adopted by many today. HODS, the Halachic Organ Donor Society, cites this Tiferet Yisrael as a practical source in an article about the halakhic legitimacy of taking heart donations in cases of brain death. For more, see https://hods.org/pdf/Brain%20Death%20and%20Heart%20Transplants1.pdf.

[13]See footnote 12.

[14]While authorities, including some of those mentioned in this article, debate if there is a substantive practical difference between hastening someone’s death and actively euthanizing them, from the perspective of this article, that distinction is not critical. Either way, Halakhah would be acknowledging the value of ending a life early for the sake of compassion. The question of direct or indirect euthanasia is merely a practical one of how the value of compassionate euthanasia can be achieved within Halakhah, while this article is concerned with the more basic goal of arguing that such a value exists.

[15]Shu”t Mishneh Halakhot 7:282.

[16]While this article does not explore the case of R. Hanina ben Teradyon for brevity, it is worth noting his story as it relates to the broader theme discussed in this article. Avodah Zarah 18a tells the story of Hanina ben Teradyon, one of the ten martyrs, who was burned to death by the Romans wrapped in a Torah scroll. The Gemara relates that, while initially R. Hanina ben Teradyon refused to take action to hasten his own death, eventually he requested that the Roman executioner hasten his end.                                  Interestingly, this case is generally invoked in the context of end of life decisions, but never euthanasia. Rav Moshe Feinstein (Igrot Moshe Yoreh Deah 2:174) cites this Gemara about R. Hanina ben Teradyon as a potential source to allow one to remove factors that would prolong a painful end of life, but elsewhere (Hoshen Mishpat 2:73) seems to reject this source as a useful model for practical Halakhah, as R. Hanina ben Teradyon was a martyr and the circumstances were extenuating.                                                Similarly, Nishmat Adam (1:8) entertains the possibility that one can personally request that life-extending care be removed in the case of suffering based on the story of R. Hanina ben Teradyon, but does not conclude as much practically.

While these issues of end of life care are only adjacent to that of euthanasia, Maharshal, in his Yam Shel Shlomo (Bava Kamma 8:59) raises an even closer case, as he effectively learns from R. Hanina ben Teradyon that one can set their house on fire and allow themself and their family to be burnt to death rather than be captured and tortured or converted by the Christians. While certainly that case may be more situational from the more universal question of compassionate euthanasia, as it deals with a particular historical circumstance of potential mass death and destruction for the Jewish people, we nonetheless see another example where human suffering and compassion is taken into consideration in halakhic matters of life and death.

[17]Shu”t Mishneh Halakchot 7:282.

[18]Matthew 25:14-30, and Luke 19:11-27. Although slightly different, the basic parable across sources is that a wealthy master/nobleman entrusts his sons/servants with money to watch for him. While some of them invest it and make more money, one person is too fearful and holds on to the money until he returns. When the master/nobleman returns, he is pleased by the investors, but outraged at the one who held it, that he could squander his gift out of a lack of faith. God is the master, humanity the servants, and life the money entrusted to us. One takeaway, of many, is that we are stewards of that life on God’s behalf, and thus, do not have full autonomy in how to spend it.

[19]Summa Theologica, II. II. Q 64 Art. 5. While some point to Adam’s command to guard and work the Garden of Eden as an undeniable example of stewardship within the Jewish textual tradition, that stewardship is very different from the personal stewardship over the human body of Christian theology. For more on the Jewish concept of stewardship see Aharon Lichtensten, By His Light: Characters and Values in the Service of God (New Jersey, 2003), 1-27.

[20]For a model of separating the Christian influence on the ethic of Halakhah without sacrificing the continuity of Jewish tradition and practice, see Aharon Lichtenstein, “Of Marriage: Relationships and Relations” in Tradition 39:2 (Summer 2005): 7-31.

There, dealing with the influence Christianity had on laws of family purity, R. Lichtenstein writes:“To be sure, post Hazal gedolim, rishonim, or aharonim may be affected by the impact of contact with a general culture to which their predecessors had not been exposed and to whose content and direction they respond. Upon critical evaluation of what they have encountered, they may incorporate what they find consonant with tradition and reject what is not. In the process, they may legitimately enlarge the bounds of their hashkafa and introduce hitherto unperceived insights and interpretations… In our case, however, we are seemingly dealing with apparent contravention rather than nuanced accretion; hence, while we may assign some weight to the historical factor, this will hardly suffice, and we must entertain other factors as well, seeking resolution in other directions” (p. 25).

Leead Staller just began a new position at NYU as the new OU-JLIC Director. Leead had been rabbi-ing in downtown New York City for a couple years prior to starting at NYU, moving from pulpit to campus work. He received his Rabbinic Ordination from RIETS and is finishing up a Masters in Jewish History from Revel. Originally from Highland Park, New Jersey, he attended the University of Pennsylvania as an undergrad, where he studied history and philosophy and received an award for best thesis in Jewish History. As a Wexner fellow and a fellow of Hillel’s Office of Innovation, Leead has been fortunate enough to learn from Jewish leaders and colleagues across the Jewish spectrum. Currently, he is working to apply those lessons and pursue his passion for Jewish community by fostering a warm and welcoming community in downtown NYC.