Saturday, January 25, 2020

Life. What is it? This is perhaps the central question around the debate over physician-assisted suicide. For if one doesn’t first define life, how can one discuss the topic of physician-assisted suicide, now legal in the State of New Jersey in addition to eight other U.S. states. Proponents of ending one’s life for the terminally ill often pose the question of whether one has autonomy over one’s own life, particularly at the end. Others turn the discussion into a question about suffering at the end of life. Both of these valid questions only scratch the surface of the topic, but the core deeper question is “What is life?” And when one finally defines life, one also must ask: does life have intrinsic meaning? And if so, do the last six months, or six seconds, for that matter, lack so much meaning that one may end them with a pill?

First, one must address pain. Despite barbs back and forth, both sides in this debate must agree that no side wants any patient at any stage to suffer. When the debate starts there, a healthy discussion can ensue. No person, healthcare professional or layperson, wants anyone to suffer in pain, not even for a moment. Proponents of physician-assisted suicide may say that those against this practice want patients to needlessly suffer at the end of life. This could be no further from the truth. Demonizing those who hold each second of natural life as intrinsically meaningful is unproductive and false. One must assume the best intentions for the alleviation of pain on both sides. But there are two types of pain at issue: physical pain and existential pain. Physical pain is surely a challenge to treat at times, especially when there is nerve damage or metastatic disease, for example. Effectively treating physical pain requires accurate reporting, an attentive patient advocate and a responsive health care professional, but it can be done.

Oftentimes, however, in this emotionally charged discussion about suicide for the terminally ill, one is often referring to existential pain—the general pain of being alive. Every human possesses some degree or another of existential pain, by virtue of being a weightless spark of soul, forcibly injected into a heavy body. This pain is much more complex to address, but is often the main issue to address, particularly toward the end of life. The electromagnetic force that animates the body is weighed down by carbon, calcium, oxygen, magnesium and nitrogen, amongst other earthly heavyweights. Our bodies are not easy to carry, even when we’re not in any physical pain. The soul is light and the body is gravity-bound. Even if one does not believe in a soul, one would still acknowledge that the animating force, when gone, only leaves dead, heavy weight. Those who deal with corpses on a regular basis know that without the animating force, whatever one calls that force, the body literally reverts to a heavy clod of earth.

Secondly, it is important to remember that this debate is not about a “minority religious view” imposing itself onto larger society; rather, it is a battle for the preservation of universal values. Most rational people acknowledge the need for a universal morality, whether in the form of society possessing a secular court system of justice or prevention of cruelty toward animals, for example. Additionally, several laws built into society that espouse universal values are often taken for granted, but add to the fabric of the peaceful interconnectedness of humanity. In that vein, most people might agree that the U.S. taboo against adultery, whether criminal or misdemeanor, should not be voted out. The majority might also agree that the prohibition against stealing office supplies should not be voted out. Some may make the distinction: end of life suicide “doesn’t hurt anyone else,” whereas adultery may hurt the feelings of the spouse, and stealing office supplies may hurt an employer’s bottom line. Yet, the opposite is true: suicide only briefly affects the self actor both emotionally and financially; the deceased has no detectable emotions, nor financial means. Yet suicide will affect those closest to him or her for years to come, both financially and emotionally. All people who oppose “biblical injunctions” onto secular law may indeed also oppose the biblical injunctions of consensual adult sibling incest, but this is highly doubtful. Those biblical injunctions that have been quietly built into the fabric of American society without a peep will often stay in place since they represent universal values. Those who treat universal morality as a fast food menu will often suffer indigestion. End-of-life suicide is no exception. Suicide is indeed self-murder.

Additionally, if one is to advocate truly separating religion and state (a nearly impossible feat), one might also be vehemently opposed to any form of Christian religious decorations in December that are funded by the local municipality, including the White House X-mas tree. These symbols certainly impose a particular religion onto America, whether consciously or not. Mistletoe and mall santas are surely not Jewish, Hindu nor Muslim decor. The token menorah doesn’t take away from the overwhelming nature of most public municipality imposing state religion on the masses. Additionally, a true anti-coercion advocate might do well to avoid dollars that clearly state “In God We Trust.”

But perhaps the debate does have some focus around the green God-backs. It only costs $1.50 to commit suicide, but thousands of dollars for chemotherapy, dialysis and hospital beds at home, not to mention missed work time by a concerned family. That is not to say that people want their “terminal” family member to die early for financial reasons, but finances do exert considerable pressure on people both consciously and subconsciously. Physician-assisted suicide is a big money-saver over life-preserving therapies and can bring unspoken pressure.

Yet an end-stage patient who doesn’t want to die may be easily convinced by loving folks around him or her of the reality of becoming a financial and emotional burden, even without explicitly saying so. Most people naturally don’t want to be a burden to anyone. Imagine the pro assisted-suicide doctor holding his pen at the next visit with his 90-year-old metastatic cancer patient, who wants to go on living, while she sits next to her two loving children, who don’t want Mom to die, per se, but face daily stress over the challenge of visiting daily, driving her to chemotherapy. They may even innocently say at that doctor’s visit, “Mom, there is another new option in New Jersey; of course, it is your choice.”

So what is life? It is that animating force, stemming from the infinite unseen unifying energy that one may call God, or not? Doesn’t matter in this debate. The unseen energy that provides the animating force is obviously retrieving that force upon human death, and the animating human energy enjoins the universal oneness. Call it God, or not. The source is the same. Life came from the source and reruns to the source—call it conservation of energy, or call it the afterlife. It doesn’t matter. The energy that was forced on that clod of carbon, nitrogen saline bag of earth we call the human is life. One had no choice for it to enter, but the argument exists that one had a choice for its exit time.

The life debate comes down to the question of ownership. Surely the heavy saline protein earth bag that becomes the animated and meaningful living human isn’t permanently “ours.” Our heavy body is surely borrowed, both from a religious and a secular perspective. The earthly elements of the body always return to the earth. So, do we have the right then to return that sacred borrowed property early and release the animating force? Surely, from a Torah perspective, turning in the holy physical body early to free the suffering soul early is not our decision to make. Our souls were placed into the physical body to perform the will of the Creator, and has a particular role to play up until the very last natural breath. Every moment is infinitely meaningful, having been granted by the giver of infinite meaning. The giver of infinite meaning doesn’t pick and choose which moments have meaning and which do not. While we often do not see the deeper meanings in our lives or of every moment, that does not take away from their intrinsic meaning. The Torah is clear. Suicide is murder. Period. Suicide assumes that only parts of life have infinite meaning—not its entirety. And surely it denies the idea of universal intrinsic meaning.

So how does one convince someone, even someone who may believe in a soul or even a higher power, to not commit suicide, without a Torah perspective? It goes back to the question of “what is life?” If one acknowledges that the animating force that one possesses currently is part of an infinite animating source, and is indeed one and the same, then making the choice of dropping one’s physical nature assumes the role of that universal omniscient force. That is to say that the unified oneness of infinity is usurped by the minuscule spark, though while significant in some ways is essentially insignificant compared to that infinity. The minuscule spark that we call a soul, or animating force, cannot have dominion over the unified infinity, nor can be so bold as to exert its power over it whatever one calls it—whether it is God, Hashem, or the unified field theory. And while we do have the choice of using our bodies in a multitude of positive ways while we are on the earth, we have no choice when that exertion starts, nor when it finishes.

Those are two sacred moments both in secular and religious thought—and their sanctity cannot be manipulated. The minute one manipulates those forces, one plays the role of infinite and exerts his or her will on one’s source. Suicide does not only affect the self, rather its effects ripple across humanity and disrupts the balance of infinite unity.

By Rabbi Dr. Yosef Glassman, MD

Rabbi Dr. Yosef P. Glassman, MD, is an IDF Reserve Lieutenant, mohel and Harvard-trained geriatrician. He recently brought a suit that temporarily halted the implementation of the NJ Physician Assisted Suicide Act.