On Disconnecting a Patient from Life Support: The Case of Alta Fixsler (Column 424)
With God’s help
Disclaimer: This post was translated from Hebrew using AI (ChatGPT 5 Thinking), so there may be inaccuracies or nuances lost. If something seems unclear, please refer to the Hebrew original or contact us for clarification.
We have almost forgotten that about a week and a half ago there was a jolting case in Britain, in which the infant Alta Fixsler was disconnected from life-support machines and deliberately left to die in the hospital against her parents’ wishes. In my impression, outside of Haredi media, this case hardly found a place in public discourse and news coverage, appearing on the margins of the news (to my surprise, I searched for a Wikipedia entry about her and found none). Beyond the minor reports, I did not hear any ethical discussion of the matter anywhere (I assume there were some, but they were not very present). Well, it is apparently not as important as what model X said to singer Y (by the way, her words were taken out of context), but still I would have expected far more serious reporting and debate regarding such a wrenching case.
Description of the Case
Alta was an infant with Israeli and British citizenship who lived with her (Haredi) parents in Britain. She was born about two and a half years ago with a rare defect that impairs brain function. The doctors at the Royal Hospital in Manchester decided she should be disconnected from life support to spare her continued futile suffering (there was no chance of saving her). The parents demanded to continue treatment and eventually petitioned the court to allow them to transfer her to Israel for further care. They expected involvement from official bodies in Israel, and hardly received any (apart from a few not-very-official appeals, such as that of former President Reuven Rivlin). The British court authorized the hospital not to transfer her to Israel and to disconnect her from the machines against her parents’ will, and the UK Supreme Court upheld the decision. On a Monday about a week and a half ago she was disconnected and passed away in the hospital.
You will surely not be surprised to learn that in Haredi discourse there were very harsh expressions against this decision (“cold-blooded murder,” and the like). Although Haredim do not really have another (more moderate) mode of expression, and therefore even if someone decided to donate to the community charity fund (for the poor orphans who, with their last breath, whisper “give us life”) only 5 shekels instead of 10, you would find screaming headlines in the Haredi press about the murder of the unfortunate, “whose heart of stone would not be moved,” “a stone from the wall cries out,” and so on and so forth.[1] But in Alta Fixsler’s case it is indeed hard not to feel that way, even if you are capable of seeing things in reasonable proportion. There is an incomprehensible stubbornness here to go against the parents’ will, against their religious faith, against the option of transferring her to a place willing to continue treating her (meaning there is no financial cost to the British treasury), and all this in order to take the active step of disconnecting life support (not just something entirely passive like not connecting). This in itself is an ethically fraught decision, and therefore all the other considerations I described certainly carry weight, if only as supporting considerations toward leniency (or stringency). In the end, a paternalistic decision was made to kill her now in a fairly active manner despite all the impediments, solely to prevent her continued suffering.
What the Discussion Is About
As stated, on its face this looks like an infuriating and blatantly immoral decision. Precisely for that reason, I thought it appropriate to devote a bit more thought to it, and to try to find logic and an ethical basis for the decision that was made—to examine whether it is indeed such an absurd decision. My conclusion is that it is not. I will preface by saying that the considerations I present here are merely arguments in favor of the court’s decision. My words should not be read as a clear ruling or as my fully formed position in such a case.
One more note. I am not here to discuss what ought or is permitted to be done in such a situation, halachically or morally. I am discussing who and how should make the decision—namely, whether the court acted properly in taking upon itself the authority to decide according to its own value scale. Whether such an act is permitted or forbidden, and whether a person may disconnect himself from life support in such a state, is a different question. I think that in cases of extreme and prolonged pain there is room to argue that yes. But, as noted, that is not my topic here.
A Preliminary Note on the Dire State of the Value of Life
In the reports I saw about this case, it was presented as an action against the religious beliefs of the infant’s parents. That was the only reference I saw to the problematic nature of this decision. Somehow it seems that the question of euthanasia and the value of life today is nothing but a “meshugas” of religious people. Clearly, there is the value of preventing suffering that stands against the value of life, as well as considerations about the worth of such a life altogether; but it seems that no one mentions those sides of the dilemma. Somehow it seems that enlightened secular people can no longer even see the complexity and the problematic nature of such a decision. All that troubles them is that the decision went against the parents’ beliefs (their “meshugas”).
My explanation for this phenomenon is that the value of life in our world is truly no longer what it once was. At most it is a person’s asset that must not be harmed, just as one must not steal. Life as an absolute value (some would say “the sanctity of life”) no longer really exists there (except for occasional pompous declarations when pacifism or the pursuit of peace are on the agenda). I pointed this out in Column 73, when I discussed abortions and the strange and bizarre—yet nonetheless very popular—argument about “a woman’s right over her body.” I think the survival of values such as tolerance, respect for autonomy, and freedom of religion is based on the fact that these are distinctly secular-democratic values. These are values that still speak to the typical secular person. The value of life, by contrast, is apparently no longer really with us.
Again, I do not intend to claim that this decision is absurd in the eyes of everyone for whom the value of life still exists. I already mentioned that there are different sides to this equation, and it is not a priori clear which of them prevails. Had this been the decision, but I had seen a discussion of the price in the currency of the value of life (and not only of the harm to the beliefs and autonomy of others), I would have remained silent. My words here about the cheapening of the value of life do not stem from the decision itself, but from the character of the discussion surrounding it (if any), and from which sides of the issue are raised and debated.
Leibowitz on the Value of Life
In the last essay in his collection, Faith, History and Values, Leibowitz discusses a similar case. An American girl named Karen was terminally ill and connected to machines. At that time the value of life was still a prevalent, almost self-evident value, and it is no wonder that in the United States there was a stormy public and legal debate about whether it was legitimate, permissible, desirable, or forbidden to disconnect her from the machines. I will note here that, in my estimation, as a result of such cases and the decisions made about them in recent decades, the status of the value of life has been severely damaged (at the expense of elevating the value of autonomy), to the point that we have reached the situation I described above. Here the slippery slope appears in all its glory.
If we return to Karen, Leibowitz argued emphatically that it is absolutely forbidden to disconnect her from life support. His claim was based on an analysis of the concept of “value.” He explained there that the claim in favor of disconnection is based on viewing life as a means to pleasures and meaning. Once those possibilities no longer exist, life has no value and there is a legitimacy to end it. Leibowitz argued that this reflects a misunderstanding of the concept of “value.” He defines a value as an unconditional principle that cannot be rationalized (that is, reduced to other principles), and therefore it cannot be made contingent on particular outcomes. Life is not a means to anything—neither to pleasures nor to meaning. Life has absolute value in and of itself, regardless of what one does with it.
We can add that any justification or argument rests on assumptions. Thus, at the beginning of any justificatory chain there must stand principles that themselves cannot be grounded in other, more basic principles (otherwise we fall into an infinite regress; moreover, as a matter of fact we do not have an infinite number of principles to insert into such a chain). What are the unconditional assumptions at the basis of any ethical justification? These are what we call “values.” A value is a binding principle not grounded in other principles and therefore not a means to achieving some outcome (for if it were, it would be grounded in that goal—and then the goal would be the value). One of the central values in our ethics, if not the central one, is the value of life. Therefore, arguments that view life as a means and attempt to rationalize the value of life, in effect say in subtext that life has no value in and of itself. Life is not a value but a means. Many still use the humanist pathos from the school of Kant—talk of the human being as an end, and of his life as a supreme, unconditional value—but in today’s normative world these are usually empty words, lip service.
A Critique of Leibowitz
My humble self fully accepts Leibowitz’s definition of values. One cannot rationalize them or ground them in more fundamental principles. By definition, a value is a fundamental principle under which nothing more fundamental stands. And yet we cannot ignore the fact that there are conflict situations. There are cases where one value clashes with another, and then we must decide in favor of one side. The picture Leibowitz presents—according to which there is never a justification to infringe a fundamental value because any infringement would express its rationalization, a view of it as a means—is not necessary. It may be that I understand that the value of life is unconditional and not subject to rationalization, but it is overridden by other values that stand against it (autonomy, prevention of suffering, some quantification of the value of life, and so on).
Consider, as an example, a situation where a person (an adult, not an infant) wants to end his life due to suffering or any other reason. There is a conflict here in which the value of life stands against the value of autonomy. If I decide to permit him to do so or even assist him, does that necessarily mean that the value of life is not absolute in my eyes? Not at all. Autonomy and the prevention of suffering are also values, and thus they too are not subject to rationalization and limitation. So what do we do when there is a conflict between two values, each of which is unconditional and not subject to rationalization? One can, of course, freeze in place and die like Buridan’s donkey, but people usually decide in favor of one side (for that purpose they build a value hierarchy that determines which value overrides which). Such a decision does not necessarily express doubt about the value of life any more than the opposite decision expresses doubt about the value of autonomy. There are cases in which we have no choice but to harm one value in order to uphold the other (when both cannot be upheld). The value of life is overridden not because life is a means but because the value of autonomy prevails over the value of life.
From here we understand that even in Alta Fixsler’s case, one can say that the decision to disconnect her from life support does not necessarily express an affront to the status of life as a value; rather, it may be—and is even likely—the result of a decision in a conflict between two values: preventing suffering (and, as I will explain below, perhaps autonomy) versus the value of life. Preferring the prevention of suffering does not testify to any deficiency in the attitude toward the value of life. Therefore, this decision, in and of itself, does not say that the value of life is no longer a value. As I explained above, my claim about the decline in the status of the value of life is based on the nature of the discussion and not on the decision as such.
One can, of course, argue that the value of life should stand at the top of our value hierarchy and override autonomy or the prevention of suffering. That is a legitimate ethical claim, but it is a different claim. Moreover, if Leibowitz intended that claim, what would he say in a conflict where the value of life stands on both sides (war, harming one in order to save others, fetal reduction, separating conjoined twins, the law of the “pursuer” [rodef], and so on)? In such cases, whatever we decide will harm the value of life. He too must concede that the picture he presented is overly simplistic. One cannot claim that since life is a value, there can never be any situation in which life is harmed.
Thus, Leibowitz’s assumptions about the meaning of values and about life being a value are indeed correct and acceptable to me. But the sweeping conclusion he drew from them—that there is no legitimacy under any circumstances to harm life—is certainly not correct.
So How Do We Decide, After All?
The question now arises: in a case like that of the infant Alta Fixsler, how is the decision made? We have seen that there is a clash between the value of life and the prevention of suffering (regarding autonomy in the case of an infant, we will see below). I will note that preventing suffering is a value from the perspective of another person. From the person’s own perspective, preventing suffering is an interest, not a value. But even in a clash between an interest and a value there are times when the interest prevails, and that is legitimate. For example, if my life is threatened, I may kill the one threatening me, even though what stands against the value of his life is my interest in living. The same goes for harm to a thief who threatens to steal my property.[2] Likewise, with charity, I am not obligated to give all my property to charity, nor even half of my property, even if the remainder is enough to live with dignity. This is so despite the fact that we are dealing with a conflict of interest versus value.
Therefore, even in Alta Fixsler’s case, it is legitimate to argue that it is permitted to kill her (or to disconnect her from life support; here I set aside the question of passivity versus activity) to prevent her suffering. From my perspective, this is certainly value versus value; but even if she herself were making the decision—where it would be interest versus value—it is sometimes legitimate to override a value due to an interest.
Yet of course, the counter-claim, which prefers the value of life over preventing suffering, is legitimate as well. So how is the decision made in such a case? In other words, how do we reach the conclusion about which of the two legitimate rulings is the correct/appropriate one? This brings us to constructing a value hierarchy.
I do not have much to say about constructing a value hierarchy. This is a matter entrusted to each of our ethical intuitions, or to our religious or other beliefs. But each person constructs for himself a value hierarchy and acts accordingly. I have often pointed out the inherent difficulty in constructing such a hierarchy (the problem of incommensurability),[3] and I will not enter into that here. For our purposes, I will suffice with the assertion that we have value hierarchies by which we make this decision.
The Decision Regarding Alta
The question that now arises is: whose value hierarchy determines our conduct toward an infant like Alta Fixsler? After all, she cannot express her own hierarchy. In fact, she does not yet have one, since she has not reached the age of reason. So it is true that the hierarchy of the British court prefers preventing suffering over the value of life (at least the value of life in Alta’s state—which is perhaps a diminished value). But her parents’ hierarchy is different; in this case it is a religious hierarchy, according to which the value of life overrides preventing suffering (let us assume this for the sake of discussion; there are cases in which this is far from clear). Why does the court regard it as legitimate to impose its value hierarchy on a family that clearly believes otherwise?
It is commonly thought that in the case of an infant, who has not yet formed her own value hierarchy, the relevant hierarchy is that of her parents. Moreover, had she continued to live, her parents would have educated her according to their hierarchy, and there is a fairly high chance she would have adopted it herself. Therefore, there is a common intuition that what determines is the parents’ hierarchy. This, of course, only deepens the troubling feelings regarding the decision of the British court, which acted against the parents’ value hierarchy. It is one thing if the judges’ value hierarchy differs from the halachic-Jewish one; that is entirely legitimate. But here we are dealing with a Jewish infant raised in a family committed to halacha. How can the court impose its hierarchy on that of the family?!
I will add another point. I am not a legal scholar and did not check, but it is quite clear to me that there is no explicit law in Britain that mandates disconnecting an infant in such a state from life support (though British law is generally based on precedents—Common Law). If so, this was an ethical decision made by the court and the doctors on behalf of the infant. That only worsens the problem, since in the realm of ethics there are disagreements among individuals and groups, and as long as there is no clear law on the matter, it is hard to see the justification for imposing the ethical hierarchy of these particular judges and doctors on a person or family who think otherwise. This is precisely the claim of a lack of respect for the autonomy and beliefs of the other that was raised against this decision.
And Yet…
So what, after all, can explain the difficult decision the British made here? The analysis above assumed that the infant has no value hierarchy of her own and therefore the relevant one is that of her parents. But at this point we must invest a bit more thought.
If indeed what matters is the person’s own hierarchy, then why do the parents have any standing in this matter at all? In fact, we ought to ascertain Alta’s own value hierarchy. True, she is an infant who has not formed such a hierarchy and certainly cannot express it, but still, in such cases the logical thing to do is to assess what she would want. And in the absence of clear information, we must assess what a reasonable person would want. Of course, the term “reasonable person” is exceedingly vague, and someone once quipped that the reasonable person, in his eyes, is the person he meets every morning in the mirror. And yet we have no choice: we must assess what a reasonable person would do in such a situation. We are essentially asking: assuming Alta were an adult and able to form and express a position, what would she herself say? That is, in fact, what matters for making this decision.
The conclusion is that if the court assessed that a reasonable person in such a situation would want to be disconnected, then a situation arises in which it is appropriate to act against the parents’ position. As noted, what determines is the person’s own position, not that of the parents. And even if the assumption is correct that had they raised her she would likely have adopted their hierarchy, we must remember that this is not necessarily what would have happened. Beyond that, they have no option of raising her, and therefore this is a hypothetical discussion. Alta is a concrete person, not a hypothetical one, and as such she is not supposed to end up holding a halachic position. Hence, it is doubtful how much standing the halachic position has regarding her.
This, of course, depends on the question of what a reasonable person is. The dispute between the parents and the doctors and court may revolve around that: in the parents’ view, a reasonable person would want to continue living; in the court’s view, a reasonable person would want to be disconnected. So the same dispute rages over the very determination of who is a reasonable person. But here I will again say that the parents have no special standing. The question of who is a reasonable person is, in principle, an objective one (for now the parents’ and the court’s views are not being considered as such, but only as measures for determining who is reasonable). True, opinions about this are divided, but there is no reason to assume that the parents are more correct than the judges and doctors on this question. Note well: here the question is who is right, not whose opinion is decisive. It is a question of right and wrong, not of who has the authority and right to make the decision.
It may also depend on whether “reasonable person” means the person who thinks correctly (ethically) or the commonly accepted person (the statistically average type). The first definition seems circular, since there is a dispute about what the correct thinking is in this issue. That returns us to the dispute between the parents and the court, and we have already seen that the parents do not necessarily have standing in that dispute. Moreover, in my view, this is not a question that a court has the authority to decide. By contrast, according to the second definition, we are dealing with a claim that can be examined empirically or by assessing reality—conducting a broad survey and seeing what people answer about their preferences in such a situation. Here this is no longer a value dispute but a factual one. It seems to me that most people do not think as halacha does in such a case, but this certainly deserves examination.
Breaking the Question into Its Components: Instincts and Values
Beyond all this, the question of what a person would want—whether Alta herself or the reasonable person—is itself divided into two parts: (1) What does he in fact want? (2) What does he think is right to do in such a situation? These are not at all the same question. I can well imagine people who would say that ethically (according to their value hierarchy) they prefer the value of life and it is forbidden to disconnect them even in such a situation, but in practice they cannot stand it, or do not want to suffer, and therefore in practice they would want to be disconnected. Which of these decisions should we take into account when deciding about disconnecting an infant from life support?
Note that the answer to this question is also composed of three elements: What does the (reasonable, or any) person basically want? Does he have a value system that directs him to do something else? And finally, do such a person’s values prevail in practice over his simple instincts and desires, or not?
We can now argue that any reasonable person would want in practice to be disconnected. A reasonable person, of course, does not want to suffer. The question then arises: from the standpoint of his value hierarchy, does he perhaps think that the value of life should nonetheless be preferred, and thus he ought to act against his instinct? And finally, we may ask whether in practice his values prevail over his instinct and natural desire. According to this analysis, we can suggest another rationalization for the court’s decision: first of all, a reasonable person would want to be disconnected. Now there is a dispute as to whether this is ethically proper or not; and even if it is proper, it is not certain that the person would in fact uphold it (though it is not clear that this consideration is relevant for us when the person himself is not standing at the decision point). One can say that doubt does not remove certainty. First of all, he wants to be disconnected, and that is clear. Now whoever claims that it is not proper to do so and that we must take account of the value of life and prevent him from getting his wish (and perhaps that is what he himself would want), the burden of proof is upon him. He must prove that Alta—or the reasonable person—thinks that the value of life prevails, and he must also prove that a reasonable person would act that way in practice. As long as there is no such proof (and of course there is not), the basic (certain) consideration remains—that a reasonable person would want to be disconnected—and doubt does not remove it.
A Final Note: Perhaps We Don’t Need to Seek Alta’s Own Value Scale at All?
In closing, I will raise another possibility. If we begin from the premise that Alta herself has no position of her own (and she will also not reach the stage where she will have one), it may be that, regardless of all the considerations I have raised so far, in such a case we, as a society—and not the parents—will make the decision for her, according to our value hierarchy. If there is no relevant value hierarchy of the person herself, then the hierarchy of those making the decision is the one that determines. This consideration is different from everything I have described above. Until now I assumed we are searching for a relevant value hierarchy—Alta’s own, or that of the reasonable person, or that of the parents. The search was for which value hierarchy is relevant to Alta, in the absence of a known hierarchy that she herself formed and expressed. Here I suggest that there is no need to search for such a hierarchy. In a situation where a person has no clear hierarchy of his own, the determining hierarchy is that of the court and the doctors. They are the ones acting in practice and entrusted with this decision, and therefore they must act according to their own conscience.
Thus far my thoughts. As noted, there is no fully formed position here, but rather considerations I have raised to judge the court and the doctors favorably. I tend to think this is the right decision, but I am not certain. I would be happy to hear what you think, and from me and from you the matter will be clarified.
[1] I have previously mentioned the wonderful opening of Amnon Levi’s book The Haredim. In the first chapter of the book (called “The Bold Course of Life”), he notes that in their world nothing is minor. Everything is either a Holocaust or a redemption. The genre of prose is not really familiar to them.
[2] In my view it is also permitted to kill such a thief. See my article in Techumin on killing a thief for the sake of defending property.
[3] See on this in the series of lectures on halacha and ethics, as well as at the beginning of the third book of the trilogy.
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Mikhi,
In your opinion, was the killing of Eichmann immoral?
(It was revenge, not prevention of future harm.)
And I respect and honor him for his high value,
King of the Thousands of Israel,
Shmuel Razavsky
I didn't understand the question, much less its connection to the column. I am completely in favor of killing Eichmann.
What is the moral justification for this? It was not to prevent murder but as revenge.
First, what's wrong with revenge? Where it's required, I have no problem. “And you will put away evil from among you”. Beyond that, it has consequences (deterrence of future evildoers).
And you still haven't explained to me what this question is doing here.
How come you don't accept the postulate that it is forbidden to take human life? Deterrence? If you believe that humans are instruments through which you transmit messages (objects), you will be healthy.
Humans are not instruments for conveying messages. These people deserve punishment, but there are those who would not kill them unless there was a future benefit in killing them. Therefore, there is a conjunction here: the need to kill them is for deterrence. The justification for why it is permissible to kill them in order to convey a message is what deserves punishment. Similarly, we find in the halakha regarding the law of persecutorship, that there is a difference between the purpose of killing (saving the persecuted) and the justification for it (the wickedness of the persecutor).
Why do you say that we need to discuss her own values?
Also regarding sending her to school, do you think we need to discuss the child's scale of values where to send him?
There is complete agreement that in matters of values for a minor, his guardian decides on him. Even without regard to whether he would have accepted the values of where he grew up. But simply because they decide on him.
Indeed. A distinction must be made between a form of education and a decision whether to kill or live. In the form of education, the child is entrusted to the parents (and even then not always. Only when they are competent according to society's assessment). But not regarding his life. They are not allowed to decide whether to kill or live him.
This can be explained by the fact that these are decisions that are in principle reversible (the child will grow up and can decide whether he likes his parents' values or not). In the case of Didan, the child will not grow up and will not be able to decide to change his parents' decision.
But it seems more likely to be explained by the fact that decisions regarding the fate and lifestyle of the minor are made by his parents. But the decision to kill him is not a decision regarding the minor, after all, after they kill him, he will not be in the world. It is like the discussion about wrongful birth (see column 270 and more).
I read the above column
where you talk about an extreme situation that theoretically everyone agrees is an injustice. But as we know, people's scale of values today is very different from one another and a lot of people think that having more than two children is an injustice to your child for all sorts of reasons.
And also in a socioeconomic situation that does not include a pool at home and vacations abroad, etc.
How do we actually see that this is being addressed? Ultimately, the parents always make the moral decision.
Only in extreme cases, such as a father who is a murderer, is intervention appropriate because these are more absolute values.
But ultimately, even in life and death, it is the parents who determine the scale of values.
Chinese.
I wrote that parents have no right in murder, and in other things they do. What does that have to do with whether the situation is extreme or not? Who talked about it? Where do you see that parents make decisions about death? I'm not sure you read what I wrote to you here.
I read. I was talking about the link you made to wrongful birth
Then you likened bringing life into the world to taking it out of the world
Then I moved on to talking about bringing life into the world and said that the values of each parent also matter.
I didn't understand. The link I made is that there too, a comparison is made between two options, and if one of them is an option in which the person does not exist, then there is no room for comparison. I did not make a comparison regarding who should make the decision. That is a different question. I do indeed oppose abortion, and I have already written about that (and linked to it here in the column).
You did not address the scientific question of what is considered a living person..
Is a person whose heart beats using devices but whose brain has no electrical activity (brain waves) considered alive?
I intentionally did not address this. This is not the subject of discussion here.
See my correspondence with Dr. Vladimir Weinstein on this matter here on the website: https://mikyab.net/%D7%A9%D7%95%D7%AA/%D7%A1%D7%95%D7%92%D7%99%D7%99%D7%AA-%D7%94%D7%92%D7%93%D7%A8%D7%AA-%D7%B4%D7%90%D7%93%D7%9D%D7%B4-%D7%95%D7%B4%D7%9E%D7%95%D7%95%D7%AA%D7%B4-%D7%91%D7%99%D7%94%D7%93%D7%95%D7%AA
Is there really an absolute value of life? We are accustomed to citing the argument of May Hazit Dada Dedich Somek Tefi, but the Sanhedrin raised its hand to: He brought a different explanation.
It must be interpreted that the commandments to postpone were not given by the Pikuach Nefesh except so that he might live and keep many commandments, as they say (Yoma 5:52) He violated one Sabbath for him so that he might keep many Sabbaths, but here is a case of murder. May Hazit Dada Dedich Somek Tefi, and it is appropriate to extend the days beyond your reach so that you may say that they should postpone his life, which is few and not (sufficient) [sufficient] to keep many commandments in it, because his life, which is many and deserves to keep many commandments in it, is not Dada Dedich Somek Tefi.
According to him, there is no absolute value in life, and the value of life is placed above another value.
Indeed, it is true, and I disagree. I explained the Gemara in Yoma here (columns 420-421), and showed that he is not right. Rabbi Ben Menasya does not claim that life is a means to fulfilling a mitzvot.
According to your (excellent!) books, one can distinguish between:
Postmoderns - who lack a scale of values at all.
Moderns - people who believe that a scale of values exists.
However, according to you, it is not really possible to decide between different values. (In the same way, in my understanding, it is also impossible to prove that any value exists at all, beyond the imagination or feelings of the believer in the value).
Ultimately, I do not see a big difference between the two perspectives.
The aforementioned modern is a postmodern in disguise.
There is no way to clarify value issues, even between two such moderns, and each goes according to his gut feeling.
On the other hand, there is a principled view of modernists who see the fact that we strive to minimize suffering and increase happiness as a basic fact, which can be proven empirically. Once this value is recognized, meaningful discussions can be held and informed decisions can be made in various human dilemmas.
Your argument itself reflects postmodernism. I argue that it is possible to discuss and argue about both premises and values (=ethical premises), and to convince or be convinced from time to time. The way to do this is rhetoric, not logic. I have explained this in several places, and mainly in a truly and unshakably way.
There is no value that can be demonstrated empirically. That we strive is indeed a fact. Is it worth striving for? This is a question of values.
Your response is postmodern.
You insist on talking about values that ”exist” in the world of imagination, but your rhetoric is far from convincing educated and intelligent people.
There is no value that can be expected, I agree.
But check yourself, is there any action you do whose purpose is not related to reducing suffering and/or increasing happiness?
From scratching your head, to caring for children, everything is aimed at this rule.
In fact, this is what underlies the Golden Rule, it is the only moral intuition that is universal.
All the rest is confusion that only vain people convince the convinced.
It is hard to argue with strong statements (even if they are clearly wrong). I do a lot of things that are not designed to increase happiness and prevent suffering, and I think you do too. I made this point in columns 120-122.
So it is time to part ways as friends. I will leave the question of who is postmodern for another time.
Are you and Hab in the end?
I will just add that since the ethical/philosophical argument here was based on the specific case of the late Aleta, it is worth noting that there was a great debate about whether she was suffering at all. No suffering could be seen on her face (this is of course not proof that she was not suffering, just the lack of proof on the other side) and there were also renowned experts brought forward on behalf of the parents who claimed that she was not suffering at all.
All of this, of course, does not make the principled discussion redundant.
This is a really interesting question. It's not clear to me whether experts can even determine whether she is suffering (even if they themselves think she is suffering and that they can know it). It depends on whether physiological indicators necessarily reflect suffering, or whether they can appear without suffering or not appear with suffering, when the baby is in this kind of situation. I don't know, but it requires in-depth examination (asking the experts themselves won't help, because many of them are wrong with such questions).
“For example, if my life is under threat, I am allowed to kill the one who threatens, even though what stands against the value of his life is my interest in living”
Why is my life not a value but only an interest?
Because in terms of value, my life is not more important than the life of the one who threatens (who would dare to say that he is a fool). What's more, killing him is active murder and leaving him to die is a lie (for me). What is decisive here is my interest in living.
Leibowitz once said, “On values that are not disputed. On values that are fought over” in connection with the principle of rationalization mentioned above.
But implicit in your argument is that the person in authority should take into account the scale of values of the individual person – the patient (and in the absence of her scale of values in the above case, the question arose as to which scale of values to follow? The parents or the court).
But assuming that the person in authority’s scale of values is the correct one in his eyes – what reason does he have to consider values that are outside his scale of values?
After all, morality is universal (a statement I have heard from the rabbi several times). Therefore, what obligates me should obligate every person. Isn’t that so?
To fish, the halakha prohibits a person from harming his own body. Although he may really want it (interest/value), the Torah forbids him and imposes its scale of values on the individual.
Indeed, the question arises: who is the legislator by whom we will decide the fate of future patients (the court? the state? Maybe the parents themselves?) But even in a reality where the patient is mature and lucid, why would the authority factor consider his choice?
He said this many times, and was wrong of course. See my article on Leibovitz's mistake: https://mikyab.net/%D7%9B%D7%AA%D7%91%D7%99%D7%9D/%D7%9E%D7%90%D7%9E%D7%A8%D7%99%D7%9D/%D7%A9%D7%A8%D7%99%D7%A8%D7%95%D7%AA%D7%99%D7%95%D7%AA-%D7%94% D7%A8%D7%A6%D7%95%D7%9F-%D7%91%D7%9E%D7%A9%D7%A0%D7%AA%D7%95-%D7%A9%D7%9C-%D7%9C%D7%99%D7%91%D7%95%D7%91%D7%99%D7%A5-%D7%A4%D7%95%D7%96
The autonomy of man is itself a moral principle. Therefore, even if he is wrong, he should be allowed to act according to his understanding. Coercion is a moral evil in itself, even if one forces something good and right. See my article on autonomy in halakhic rulings and whether halakhic law is pluralistic.
A. Maybe a reasonable person wouldn't do it so as not to cause suffering to his religious parents.
B. Maybe the court and the doctors should also take this into account.
And the interesting thing about the whole story is that those people who fought for the toddler's life underestimated all the risks of the coronavirus.
I don't know if these are the same people. But to be precise, Haredim generally don't talk about the value of life, but about the prohibition of murder or suicide.
Leaving the child is such a serious moral crime - almost the most serious there is - that this whole discussion is incomprehensible to me. It is recommended that the crazy parents be killed too (from the nerves).
Finally someone writes the obvious. It's possible to rant about theoretical writing without even a minimum of familiarity with the prevailing reality, delving into the details of the current case, reading the court rulings on the matter, etc.
I think there is a complete error in the use of the term "value" in this article. Value is not a decision or agreement that exists among the "reasonable person," i.e., most people, or any other way of deciding what a "reasonable decision" is. Value must be absolute. The issue of extending life - preventing suffering, since it is subject to debate among people, and some want them to continue to extend their days, is not a "value." And using "preventing suffering" as a general value and including this case in it is an error, because there are people who want this suffering as long as they live. Value is only an absolute, universal, intuitive thing that is found in every healthy person by nature. Therefore, the "sanctity of life" This is a value, while “prevention of suffering” is a very inclusive term, and does not include our case. Therefore, without going into the question of the authority of the parents, which I think is certainly weighty since they are the natural guardians in all areas, with the exception of non-normative people of course, here a court must take a do-or-die approach and not because of the point that there is no guiding value here to disconnect devices and in any case the value of the sanctity of life does not allow this, certainly not when there is no clear expression of opinion from the patient.
What's the point of your response to mine? If you have something to add based on familiarity with reality and in-depth details, etc., please feel free to add.
The question should be whether it is even permissible to intervene in nature in such a drastic way and connect a baby with a serious, incurable disease to resuscitation machines.
“Therefore, the doctor was given permission to treat” has somehow become, among cowards, ”Therefore, everything must be done to prevent death”.
An attitude that stems from a blatant cowardice that has taken over the moral system of the cowardly thinker.
Perhaps in the future, following those cowards, we will reach a situation where healthy people will be forced to amputate limbs from their bodies so that seriously ill people can continue to live. When the supreme principle is to prevent death, then this is a necessary consequence. The cowards are simply afraid of amputating limbs, so they do not think about the obvious conclusion.
What about the halakhic aspect of the matter?
Is there no fundamental prohibition against euthanasia?
And if there is, there is essentially religious coercion on the parents.
I didn't get into the question of whether it's allowed or not. The discussion in the column wasn't about that. But the doctors did it, not the parents.
I recently came across a case concerning the violation of the autonomy of a fetus – attached link:
https://docs.google.com/document/d/1lEFPc_pfcUXbi9daEUKZILOhk2U9v0Ma/edit?usp=sharing&ouid=103054435058019085063&rtpof=true&sd=true
In short, this is a case of a woman whose doctors recommended that she have an abortion on the grounds that her fetus had Syndrome X, when in fact she had a syndrome similar to X but not X. The doctors deliberately hid this from her so that the woman would have a higher chance of miscarrying. In the end, the mother chose to have an abortion, but it was unsuccessful and it turned out that a girl was born with defects that were caused, among other things, by the failed abortion attempt. The mother could no longer sue because the statute of limitations had expired, but as far as the girl was concerned, the statute of limitations had not yet expired. The judges ruled by a majority that the fetus does not have its own autonomy, and therefore its autonomy cannot be violated. From what I understood from the ruling, the fetus's autonomy automatically passes to its parents as its natural guardians. Therefore, ostensibly, in Pixler's case, her parents were the ones who should have made the decision whether to keep her alive or not. Only in extreme cases where society views the parents' decisions as clearly unreasonable (such as criminal neglect) is there justification for violating the parents' autonomy for the child's benefit. The question is whether in this case the British viewed the parents' choice as a clearly unreasonable choice that justifies violating their autonomy. What's more, I'm not sure that the girl is capable of feeling pain or suffering in her condition. Especially nowadays, with anesthetics and sedation, so it's not clear why the British insisted so much.
This is a legal question, and is a matter for lawyers. I will just point out that there is a difference between a fetus and a child. A fetus is the result of its mother's actions, and therefore if there is already a guardian (and as you know, I, like you, do not think this is the case), it is likely to be the mother/parents. But after the child is born, he is an independent person and the considerations I described in the column could lead to a conclusion by the British court.
I didn't understand how this case was different from any case where parents are given autonomy over their young children - in the type of education, in choosing medical treatment for them, etc.
The ruling stems from a law on children's rights in the European Union, under which the authorities can intervene and even impose their opinion on the child. This is also the problem with the study of abominations, which the government wants to impose on religious institutions in the country under this law.
They are not allowed where their decision is particularly unusual. In the understanding of British law, the decision there was particularly unusual (or very much contrary to the child's wishes in the ways defined in the column). Beyond that, I explained that a decision about life is different from a decision about education (such as a wrongful birth).
Oh my, how do you always end up with the Haredim?
I'm starting to think that your hatred for the Haredim definitely rivals Hitler's hatred for the Jews.
What the hell. There's no comparison. I'm much worse.
It is worth adding that according to the common opinion today, if we exclude halachic considerations (which are also expressed in Israel in law), the life of a person who will not be able to live on his own in the future and who does not function in any way now is not considered life, and there is no point in constantly resuscitating him, but rather letting him die. According to this, there is no “value of the sanctity of life” here, because there is not that much life here. Therefore, there is no need to come into conflict with another value (suffering in this case, which is questionable) in order to disconnect it from the devices.
I commented on this (adding in parentheses about the value of life in such a situation).
In the column you deal with the – moral– problem of causing the cessation of life. But if a hurricane comes and cuts it off, will you “be satisfied” without a doubt? This point was not clear to me from the column (which Donovan has every right to demand that it be compiled four months before the holiday). Similarly, in the problem of throwing a trolley off a bridge, let's say a wind comes and knocks it down, will you “be satisfied” (perhaps the trolley won't and the child will, because some lives are of diminished value). This is not a normative question, but it does reveal something.
Psychologically I would certainly be satisfied. Morally – I don't know. But as my heart desires, I might be able to respond. We'll wait another four months.
You discuss morals and criticize the secular sociological group. It sounds like you are making a claim for a shift from a secular perspective towards a moral lapse. If so, what could explain such a shift? [It is less likely that the one who helps religious people to recognize the value of life morally is the halakha, because it seems that even religious Christians share in the appreciation of life.]
Possibly. I'm not sure about that. Simply put, it seems to be the very belief that man was created by God and that he has a role and value. Christianity may have been influenced in this by Judaism, from which it came. In a world without God (especially if we are talking about materialism), it is unlikely that an attitude of "holiness" will arise towards anything, including life. The secular pathos when talking about the sanctity of life is nothing more than a religious remnant that has undergone scholasticization.
I think this is very significant. It's not just a diminished value, I think the prevailing opinion is that there is no difference between this situation and a state of brain death. And another thing, do you think there is a place for a “secular” view of the difference between passivity and activity in this matter? If we take the halakha out of this, is there a fundamental difference between disconnecting a person from a device and if you knew he would reach this state, you would not have connected him to the devices from the start?
The question is not defined because in my opinion, in a secular framework there is no place for values at all. The distinction between passive and active is based on interpretation and not on verse, and therefore I do not see a need for it to appear specifically in a religious framework.
So I will try to define:
The moral framework in which I understand most ”secular” people live is: belief in universal human values (life, equality, etc.) that God created in creation (even if they are not aware of it), but lack of belief in a religious framework of laws that is added on top of the above. The definition of these values and the decision between them is according to the intuition of what is more “moral” (good?) which is a kind of “supreme value” to which everyone is subject (this is what I understand you also wrote somewhere).
Within this framework there are 2 ways to look at Alethe's life:
1. They have value, therefore we should continue to revive her even if she suffers, which is then less good.
2. They have no value, because the value of life is only if life has a purpose, if something can be derived from it and not just a beating heart.
If we believe that such a life has no value at all, there is no point in continuing to revive it. And in such a situation, there would also be no difference between cutting it off and not reviving it in the first place. Although the main difference between the two is in this reasoning, an argument whose main purpose is to analyze the halakhic commandment of “Thou shalt not murder”, it is not sufficient to decide the moral decision of “Thou shalt not murder” because it is not an external commandment that prohibits the action itself, but a moral commandment to reach the desired result, and in the test of the result there is no difference whether I reached the result actively or passively.
The issue of what the secular person thinks is less significant to me. As a religious person - if the halakhic problem is solved for one reason or another - I think it is moral to disconnect from the devices and there is no moral problem here. (I think the alleged Haredi mistake stems from thinking that if there is a halakhic prohibition, then there is also a moral problem with disconnection - and therefore it is possible to project this even to a situation where she suffers)
I think I'm the father of the approach that separates law from morality, so I assume you're not arguing with me here.
You wrote, “I will point out that preventing suffering is a value from the perspective of another person. From the perspective of the person himself, preventing suffering is an interest and not a value.” What do you mean? If a person decides to cause himself suffering, then apparently in his hierarchy of desires, suffering satisfies his desire more than anything else. Therefore, there is no moral problem with this. But when a person weighs the moral obligation against his own suffering, then it is clear that avoiding involuntary suffering for himself is an important and valuable moral issue. And why wouldn’t it be? And that Dema Didia is always pale and pale. And if so, here, when the girl is unaware and does not decide and those who discuss from the outside discuss what prevails according to her own values, then surely her suffering has enormous value weight. In other words, even when deciding from her own perspective, there is value versus value here.
Even in the hierarchy of the other's desires, my suffering is justified because it satisfies his desire. In my opinion, you will not be able to escape the difference between me and another.
Therefore, in my opinion, even when I discuss her, the discussion is one of interest versus value. I step into her shoes and act on her behalf. This is of course on this particular side that I raised, beyond all other sides.
A. If a person decides to climb a tree to pick a fig even though he knows that he will scratch the branches and get tired – clearly there is no moral problem here. And why, because overall, in his opinion, the expectancy of satisfying his desire is positive and therefore he does it. In such cases, suffering is justified because, on balance, it satisfies the sufferer's desire. The problem with suffering is that the person does not want it.
B. But when we are not dealing with a person's will but with his commitment, then why does his suffering not enter the value calculation like any other suffering. For example, when a person sees that the cost of obeying a moral value, for example, being grateful to his parents, will cost him great suffering. I understand that you see here a conflict of interest versus value, meaning that morality on its part demands every effort and suffering from the person in order to fulfill being grateful to his parents, but that interest comes in its own way and somehow also prevails in terms of values, and not value versus value. But when a person discusses, for example, gratitude to one's parents when suffering is at stake (for example, while investing in showing kindness to one's parents can benefit someone who is in trouble and captivity sevenfold), then it is indeed a conflict of value versus value. Is that really what you are saying? If so, then I do not understand at the most basic level why to think that way.
[Therefore, even when the girl herself considers her ethical commitment, she sees here the value of her life and, in contrast, the value of reducing suffering (hers, or that of any other person). However, if she herself considers and decided that she wants, on her own behalf, not on the moral side, to continue living, then indeed there will be no moral problem here of causing suffering to herself, because overall her will was fulfilled more. But when she considers from a moral perspective, then how in the world is it possible that her suffering is not considered or measured. Therefore, when others consider for her, they only consider the values and do not descend to the end of her self-interested will, and therefore her suffering is a distinctly ethical matter].
Throughout the entire column, I was struck by the same question you posed in the last section.
Regarding what she wants, and what she thinks is appropriate to do. Another point should be added.
You have a person whose instinct wants to stop suffering, but whose belief in the reward awaiting him (as opposed to the punishment awaiting him if he gives up his life) overrides the instinct. More precisely, changing his perspective causes the instinct – which wants the best – to change its conclusion. This is not necessarily a value decision in the face of instinctive action, but rather a faith-based situation, which causes a different decision.
From my perspective, a religious worldview is part of his values. This is not a different discussion.
The halachic and human assumption regarding a minor, that we judge according to the law of his parents.
This assumption is also true in the case of a person who lacks intelligence, whether in his adulthood or in his youth.
This is why Shabbat is profaned by a foolish and small Israelite – which means that his life is valuable, and not the life of a foolish and small Gentile who has not committed any offense that the son of Noah is obligated to commit, and even on a weekday his life is not saved. (This is according to the Dagmaara, and does not currently enter the Meiri and Micah method that today “natures have changed” and Gentiles are moral and are saved whether on Shabbat or on a weekday).
This is also why a circumcision is performed on an eight-day-old infant and he is grieved (and even though it is not possible to say that he is fulfilling a mitzvah in this) – because this is the value of his parents, and therefore also his own.
This also exists in a baby who will likely never reach adulthood and will not recognize the value of circumcision. We see the value as existing in the baby already now, even if he will never acknowledge it.
Therefore, the parents' values are also relevant in this case, and the court cannot kill the girl in violation of her parents' values - which we see as the girl's values.