Euthanasia: an overview and the jewish perspective.
BACKGROUND
End-of-life care poses fundamental ethical problems to clinicians. Defining euthanasia is a difficult and complex task, which causes confusion in its practical clinical application. Over the course of history, abuse of the term has led to medical atrocities. Familiarity with the relevant bioethical issues and the development of practical guidelines might improve clinical performance.


OBJECTIVE
To define philosophical concepts, to present historical events, to discuss the relevant attitudes in modern bioethics and law that may be helpful in elaborating practical guidelines for clinicians regarding euthanasia and end-of-life care. Concepts found in the classic sources of Jewish tradition might shed additional light on the issue and help clinicians in their decision-making process.


METHODS
An historical overview defines the concepts of active versus passive euthanasia, physician-assisted suicide and related terms. Positions found in classical Jewish literature are presented and analyzed with their later interpretations. The relevance and application in modern clinical medicine of both the general and Jewish approaches are discussed.


RESULTS
The overview of current bioethical concepts demonstrates the variety of approaches in western culture and legal systems. Philosophically and conceptually, there is a crucial distinction between active and passive euthanasia. The legitimacy of active euthanasia has been the subject of major controversy in recent times in various countries and religious traditions.


CONCLUSIONS
The historical overview and the literature review demonstrate the need to provide clearer definitions of the concepts relating to euthanasia, for in the past the term has led to major confusion and uncontrolled abuse. Bioethical topics should, therefore, be included in medical training and continuing education. There are major debates and controversies regarding the current clinical and legal approaches. We trust that classical Jewish sources might contribute to the establishment of clinical definitions, meaningful approaches and practical guidelines for clinicians.
Gesundheit
Benjamin
B
Unit of Bone Marrow Transplantation, Cancer Immunotherapy and Immunobiology Research Center, Hadassah Hebrew University Medical Center, Jerusalem. gesund@hadassah.org.il
Steinberg
Avraham
A
Glick
Shimon
S
Or
Reuven
R
Jotkovitz
Alan
A
D001294:Attitude to Health / Q000208:ethnology*; D004992:Ethics, Medical; D005065:Euthanasia / Q000266:history* / Q000639:trends; D049671:History, 18th Century; D049673:History, 20th Century; D049674:History, 21st Century; D049690:History, Ancient; D049691:History, Medieval; D006801:Humans; D007585:Jews / Q000266:history*; D007599:Judaism; D012068:Religion and Medicine; D013727:Terminal Care; D026712:Value of Life