Jewish medical ethicist focuses on bedside issues

That's why Zoloth-Dorfman's contribution to a recent lecture on the subject dealt not with esoteric bioethical matters, such as genetic engineering or the ethos of cloning, but rather with a matter she calls "close" — decision-making at the bedside.

In her March 2 talk, which was part of the "Medicine, Ethics, and Judaism" lecture series, Zoloth-Dorfman began with a story that was indeed close — a situation her own family faced.

Just weeks before, Zoloth-Dorfman had received an anguished telephone call from a relative by marriage. The relative sought Zoloth-Dorfman's advice because his mother had suffered a stroke that rendered her paralyzed and unable even to swallow.

"She wanted [Dr. Jack] Kevorkian to come and kill her," the professor told the crowd of about 30 assembled in Los Altos Hills at Congregation Beth Am, the series sponsor.

The ill woman's kin were faced with deciding whether to prolong their mother's life against her will or grant their mother's wish to die by withholding nourishment via a feeding tube.

"It's issues like this that really haunt us at the bedside," said Zoloth-Dorfman.

In recent months, the right-to-die question has been thrust into the national spotlight with famed child psychologist Dr. Benjamin Spock's fight to die and with news of Kevorkian's youngest-ever "patient," a young man of 21. In addition, Hallmark has introduced of a line of "suicide cards."

"The questions that must be asked at the bedside are: What is the right act and what makes it so?" said Zoloth-Dorfman.

Rather than focus her lecture on the specific considerations Jewish law brings to the right-to-die debate, the professor focused on how Judaism's approach to end-of-life issues might offer a valuable new perspective on the topic for the non-Jewish medical community.

Zoloth-Dorfman said one of the most interesting lessons that Judaism can teach mainstream medical ethicists is its ideal of open discussion. Unlike other faiths, Judaism, she said, is willing to admit that on issues like this, "sometimes nobody knows the answer."

This understanding that resolutions aren't always attainable — called tayku in Jewish texts — helps Jewish scholars, ethicists and community members maintain a continuing dialogue on the issue.

"Jewish ethics is not about finding an answer. It's about finding many answers and then having the argument," Zoloth-Dorfman said.

Jewish medical ethics, free of dogmas, looks at both outcomes and religious duty in considering how to face death-related decisions. Greek bioethics, on the other hand, is more inclined to ignore outcomes and concentrate on adherence to principals.

"Judaism promotes a multivocal discourse on this issue," she said. "The past rabbis and the modern reader occupy the same moment in time in the text to consider the text."

In Zoloth-Dorfman's family, the bedside decisions ended up being left to a higher power. The ailing mother contracted pneumonia within days of her expressed wish to die, and passed away naturally. Nonetheless, Zoloth-Dorfman said the question of how one can die dutifully and with dignity remains a contentious one.

In the end, Zoloth-Dorfman said, end-of-life issues require constant revisiting, whatever one's faith is.

"Bedside ethics will always be a thousand decisions," she said. "We're not going to find a Newtonian answer."

The Jewish community, she added, "needs to think and talk more about a death that is meaningful as part of a Jewish journey."