Religious Views on End-Of-Life Care



The  Catholic church considers it morally unacceptable to withhold hydration  and nutrition, and this should be provided by any means necessary  unless death is imminent. While the Church firmly believes in the  sanctity of life, when it comes to the terminally ill, Catechism 2278  allows for discontinuing medical procedures that are burdensome,  dangerous, extraordinary, or disproportionate to the expected outcome. 



 The  Quran states that “it is not possible to die except with the leave of  Allah, and at the appointed time”. Likewise “Allah takes the souls at  the time of their death, and those that do not die during their sleep”.  As a general rule, Muslims should advance the best effort to maintain  life, but may not introduce unbearable pain or suffering. Nutrition,  hydration, and pain relief are to be provided, but when scientifically  evaluated treatment is obviously futile and holds no promise, it ceases  to be mandatory. 



 “God  sends us and we take birth, God calls us back and we die.” A Sikh’s  duty to someone who is dying is to care for them until God decides they  die, not to hasten death. However, sickness is the will of God, and  while one has to make an effort to get well, maintaining a terminal  patient on artificial life support for a prolonged period in a  vegetative state is not encouraged. 



 The  Hindi faith’s tenet of reincarnation gives comfort to the dying, yet at  the same time suggests that suffering leads to spiritual growth. While  there is a lot of room for debate, the general guideline is that death  should neither be sought nor prolonged. The terminally ill should be  allowed to die a natural death, without experimental attempts at  prolonging life or artificial means of shortening it, even if it would  reduce the person’s pain and suffering. However, there is also the  concept of Prayopavesa,  or fasting to death, which is an acceptable way for a Hindu to end  their life when the body has served its purpose and become a burden.  When it comes to those in a vegetative state, it is unnecessary, and  possibly inappropriate, to use artificial means to provide hydration and  nutrition. 



 Pikuach  Nefesh, or “saving a life” is paramount, and the preservation of human  life overrides virtually any other religious consideration. When it  comes to saving a life, a Jew may do almost anything, save for murder  and Chillul Hashem. Jews may not do anything that would shorten life,  and must take any action to prolong life. However, that only applies to a  somewhat healthy person. If someone is expected to die imminently, they  are Goses, and according to the Sefer Hasidim, nothing should be done  to prolong their life or hasten their death. Contrast this with someone  who is Terefah, meaning the person has an irreversible, terminal  disease; Maimonides states that one who murders a terefah is exempt from  human judgment, i.e. euthanasia is permissible. When it comes to those  in a persistent vegetative state, the departure of the soul is becomes  the moment of death. If a person cannot, and will never again be able to  perform mitzvot, that person is no longer alive, and there is no  obligation to support the body. 



 Buddhists  regard death as a transition, the deceased person will be reborn to a  new life. But a central tenet of Buddhism is non-harm, avoiding end of  life. By implication, hastening the end of life is forbidden, but this  prohibits deliberate attempts to destroy life, it does not require  extreme lengths to preserve life at all costs. Medication and the proper  use of pain killing drugs should enable a Buddhist to attain a state  where they are not in mental pain. But at the same time, clarity of mind  is important, and it is acceptable to refuse treatment that would cloud  the mind. While there is a difference in interpretation between  different streams of Buddhism, with Theravada taking a stricter approach  to preserving life, and the Mahayana and Tibetan traditions placing  more of an emphasis on compassion, there is a respect for the dying  process, and efforts to maintain life beyond what is possible are not  encouraged.