removing respirator from terminal patient – Halachick considerations

Shalom Ubrucha,

I had an interesting shailo recently and I was wondering what your view would be on this issue.

Situation:

Eighty year old Jewish male patient (non observant) was admitted to the hospital with severe lung issues, after being treated for a couple of weeks, pt. developed labored breathing and was placed on a ventilator. The doctors who were treating the pt. felt that there was a big chance that pt.will recover from this stage in the illness and would be able to breath on his own.

Patient's family was adamantly against putting the patient on a respirator, claiming that there is a chance that he will not recover and the machine will prolong his agony. However since the patient has never appointed an Health-Care proxy to have the right to make a decision the Drs. were obligated by law to intubate the patient.

After this episode the patient was moved to the Intensive Care Unit for a couple of days, patient deteriorated and was now neurologically in a vegetative state. Patient's family was very distressed and claimed that the patient would have not wanted to live on a respirator. A hospital administrator put together a Bio-Ethics Committee meeting, whose decision was to allow to remove the respirator.

Family was very well aware that removing a respirator from the patient would not be allowed according to Halacha, but decided to go forward. The family has than requested the hospital Chaplain/ Rabbi be present before and during the extubation to say Jewish Prayers which are said for dying people.

Question:

Should the Rabbi respond to such a request or shall he not honor request, due to the fact that this could be interpreted by patients and families, and Jewish and non-jewish hopsital staff that extubation are allowed according to Halacha.

On the other hand one may argue that if the family has decided to do the extubation anyway, the Rabbi should at least tdo a chessed shel emess and recite the Shma and Vidui with the patient. The Rabbi might also have an obligation to stay with the patient, as written in Shulchan Aruch that "a dying patient must not be left alone to die and that it is a Mitzvah to stand by him".

Thank You,