Does halacha strongly encourage the use of aggressive medical interventions?

Question

It seems from what I've read in books: Jewish law encourages the uptake of aggressive medical interventions. Some examples include CPR, ventilators, chemotherapy, and intensive care unit (ICU) care.

Such interventions are not always required by Jewish law, but they often might be.

Yet they're not necessarily as good or as successful as you might think.

• CPR can crack ribs and do other major damage. Yes, the person might survive, but they may have a long and painful recovery ahead of them. Or they might end up dying.
• A ventilator can save a person's life. They may make a full recovery; or they may not. In some grim cases, they may never be able to walk, talk, or feed themselves again. Did they recover? Technically yes. Will they have the life they wanted? Perhaps not.
• Some chemotherapies for cancer can have very severe side effects. Certain chemotherapies might have an excellent chance of effecting a full cure. However, others might extend life by just a month or two.
• The intensive care unit (ICU) is pushed as a universal good. It can save lives, and some ICU patients might make a full recovery. But, other times, it might just prolong the suffering of a patient who would end up dying either way. Some patients in dire condition might want to try it for a few days, to see if it helps. Other such patients might not want it at all.

Some patients might not want all these fancy medical interventions. They might just want more basic care, such as painkillers, anti-nausea pills, prayer, Psalms, and (maybe) antibiotics.

Does halacha strongly encourage the use of aggressive medical interventions? If so, why?

Related reading

If you have health insurance, you're at risk of possibly getting unnecessary medical care. Unnecessary pills, tests, and screenings can make you sicker and poorer. Such interventions can also take up valuable time which could otherwise be used for prayer, Torah learning, and acts of kindness. I strongly recommend that everyone with health insurance read (or at least skim) the following book: Less Medicine, More Health: 7 Assumptions That Drive Too Much Medical Care, by H. Gilbert Welch, MD. I think I may have read it a few times now.

ICU care is extraordinarily expensive. Perhaps part of the reason why so many people end up getting ICU care is because of health insurance. People may be more likely to consume expensive medical care, which may be of limited benefit, if someone else is paying. See various online articles and columns by David Goldhill (e.g. Forbes, Washington Post, The Atlantic). He also wrote a book, which was published under two different titles.

Possibly related questions

• When one is diagnosed with a terminal disease, is refusing treatment a form of suicide or acceptable considering the circumstances?
• Does the existence of insurance affect end-of-life Halacha?

Answer 1

I think you're jumping to a conclusion that halacha demands the maximum possible every time. That's a bit of a straw man.

There is a range of opinions here, put mildly, even among contemporary Orthodox authorities. We certainly don't believe in prolonging death. Additionally, there are cases where it's reasonably a patient's call. And, yes, financial considerations do play a role. Rabbi Asher Weiss has a heartbreaking responsum about one. (The parents can't pay for someone to constantly monitor their daughter to make sure she doesn't pull out the tube.)

Try reading some of the material at ematai.org.

Answer 2

This article Jewish Perspectives on End-of-Life Care https://www.myjewishlearning.com/article/jewish-perspectives-on-end-of-life-care/ presents a useful general overview. To quote from the article it

“. . . is a general overview of a number of issues that commonly arise at life’s end — and how Jewish authorities have weighed in on them. Jewish thinkers often emphasize that specific cases vary substantially and must be considered individually. And while weight is always given to a patient’s wishes, those who are concerned about complying with Jewish law are always urged to consult with trusted advisers.”