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MARK SHOPNICK JEWELERS

28859 Orchard Lake Road, Farmington Hills, Michigan 48018
Market Place Plaza
553-2196
HOURS: Mon. & Thurs. 9:30-7, Tues., Wed., Fri. & Sat. 9:30-6

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LOEHMANN'S PLAZA

14 MILE AND ORCHARD LAKE ROAD, FARMINGTON HILLS, MI

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ms. THREADS

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8554464

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$550

1992

Q45

36 mo. lease
plus tax
per mo.

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Fred Lavery Infiniti

525 S. Hunter, Birmingham (313) 645.5930

•MSRP is S42,385.00. All lease prices are plus sales and FET tax. Total of monthly payments S21,564.00. Exp. 12-31-91.

24

I®

FRIDAY, DECEMBER 27, 1991.

Health Care Act

Continued from Page 1

dent. The State of Missouri
opposed such a move.
The case went to the U.S.
Supreme Court, which ruled
by a 5-4 vote that a patient
has the right to refuse
medical treatment.
But the court did not sup-
port the Cruzans' request to
remove their daughter's
feeding tubes because it was
not clear this was what Ms.
Cruzan herself would have
wanted, the judges said.
To comply with the Patient
Self-Determination Act,
local hospitals are giving pa-
tients the opportunity to fill
out "advocate forms." Ques-
tions include whether the
patient would wish con-
tinued medical treatment if
he were in an irreversible
coma, if he were terminally
ill and "life-sustaining pro-
cedures would serve only to
artificially delay my death,"
or if he were in any condition
in which "the burdens of the
treatment outweigh the ex-
pected benefits."
In addition, health care
facilities will ask incoming
patients whether they have
a living will, according to
Gloria Miller, vice president
of patient care services at
Sinai.
A living will may address
any aspect of a patient's
desired medical care. Such
documents are not binding
in the State of Michigan, but
they can serve as further
evidence of the patient's
wishes should he be unable
to communicate these
himself.
Even though the Self-
Determination Act gives pa-
tients a greater voice in
their own treatment, Sinai
physicians will continue to
play a prominent decision-
making role for their pa-
tients.
Dr. Gerald Mandell,
chairman of Sinai's bioethics
committee, said families and
physicians generally concur
on patient treatment.
Should a physician oppose
a family's decision regarding
a patient's care, he will
make his views known, Dr.
Mandell said. If the parties
involved cannot reach
agreement, the family "will
have to go to another in-
stitution."
Cases like that of Nancy
Cruzan are rare, he said, ad-
ding that he does not an-
ticipate many families will
request that food and water
be withdrawn from a pa-
tient.
In response to the Cruzan
case, a rabbinic board of the
Orthodox Agudath Israel of
America designed a
"Halachic Living Will." The
will specifies that the

health care provider contact
a rabbinic authority when
considering life-sustaining
treatment for the signatory.
David Zwiebel, the
Aguda's general counsel and
director of government af-
fairs, said "It's a basic ques-
tion: When is a person dead?
Secular law may say one
thing, Halachah another."
Orthodox, Conservative
and Reform responsa agree
that under no circumstances
would suicide be permissible
under Halachah. But the

"What the patient
may never do is to
say, 'Enough
already. Let's get
this over with.' "

Rabbi Elliot Dorff

groups diverge on other
issues like continued
medical care in life-or-death
situations.
Writing in the fall 1991
Conservative Review, Rabbi
Elliot Dorff, provost and pro-
fessor of philosophy at the
University of Judaism, and
Rabbi Avram Israel Reisner,
chairman of the Conser-
vative movement's subcom-
mittee on biomedical ethics
of the Committee on Jewish
Law and Standards, discuss
medical ethics and Judaism.
Both rabbis say it is per-
missible to refuse certain
types of treatment where
prognosis is undetermined.
Both believe mechanical
equipment may be removed
if this alone is sustaining
life. And both concur that
CPR may be refused if it's
doubtful the patient can be
restored to any kind of de-
cent life.
But they differ on a key
issue. Rabbi Dorff says
Halachah would permit the
right of a terminally ill pa-
tient to refuse medication,
food and water. Rabbi
Reisner disagrees.
"What the patient may
never do — for it runs
counter to the divine trust —
is to say, 'Enough already.
Let's get this over with.' "
Rabbi Reisner writes.
The Reform movement's
Rabbi Solomon Freehof ad-
dressed the issue in the Cen-
tral Conference of American
Rabbis' American Reform
Responsa:
"If the patient is a
hopelessly dying patient, the
physician has no duty to
keep him alive a little
longer. He is entitled to die.
"If the physician attempts
actively to hasten death,
that is against the ethics of
Jewish law."

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