Showing posts with label attempted suicide. Show all posts
Showing posts with label attempted suicide. Show all posts

Tuesday, September 20, 2005

Case of Yossi Boker

Case of Yossi Boker
Assistant Commander, Police Investigative Department - Jerusalem, Israel
Head of the Central Investigative Unit - Shfela Police


Arrested on charges that he sexually assaulted his secretary.   If you have a photograph or any updated information on this case, please forward it to The Awareness Center.
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Table of Contents: 


2005 
  1. Police commander interrogated on charges of sexual harassment (08/11/2005)
  2. Senior police commander accused of sexual harassment (08/12/2005)
  3. Senior cops suspected of bribery (09/14/2005)
  4. Top cops probed for taking bribes (09/14/2005)
  5. Remand extended for cop in bribery case (09/15/2005)
  6. Museri charged with accepting bribes  (09/20/2005)
  7. Clean up the police (09/18/2005)
  8. Senior police officer questioned (09/20/2005) 
  9. Senior police officer sent on forced leave pending bribery probe (09/20/2005)
  10. All's not well at the central district's Central Unit (11/04/2005)

2006

  1. Suspended CIU head treated after suicide attempt  (01/10/2006)
  2. Senior police officer attempts suicide (01/11/2006)
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Police commander interrogated on charges of sexual harassment:  
Boker released after questioning, will not return to post in the meantime
Haaretz - August 11, 2005

Justice Ministry officials on Wednesday night interrogated Police Central District commander Yossi Boker on suspicion that he had sexually harassed his personal secretary. 

Boker was called into the Ministry of Justice's department for the investigation of officers after his secretary filed complaints weeks ago that he had spoken to her coarsely and had touched her inappropriately. 

He was released past midnight after several hours of questioning, but it was decided that in the meanwhile, he would not return to his post.

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Senior police commander accused of sexual harassment
By Roni Singer-Heruti
Haaretz - August 12, 2005


Commander Yossi Boker, who heads the Police Central District's central investigations unit, was questioned under caution for several hours on Wednesday by the Justice Ministry's Police Investigations Unit, on suspicion of sexually harassing a secretary in his department. 

Following the interrogation, Boker was released, but forbidden to return to work for two weeks or to have any contact with the secretary. Boker denied the allegations against him. 

The secretary, who filed her complaint a few days ago, said that Boker had harassed her both verbally - by making crude sexual suggestions - and physically, by touching her. Boker was summoned for questioning Wednesday afternoon, and the session lasted until after midnight. 

Haaretz has learned that the police filed disciplinary charges against Boker 10 years for a similar offense. In that case, a policewoman who worked with him accused him of sexually harassment. Boker was convicted, fined and given a severe reprimand, but the conviction never hindered his upward progress through the police ranks. 

Boker was appointed to his current position less than a year ago. News of the new investigation was greeted with shock by colleagues.

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Senior cops suspected of bribery
By Yaakov Katz
Jerusalem Post - September 14, 2005  

Two senior officers from the Central District were questioned on Tuesday by the Justice Ministry's Police Investigations Department for allegedly receiving bribes from criminals. 

Asst.-Cmdr. Yossi Boker, head of the Central Investigative Unit, was taken to the hospital after he complained of not feeling well during his interrogation. 

The other officer, Meir Musseri, Boker's subordinate and head of investigations

Boker was suspended from his sensitive position and put on leave in August after an investigation was opened into allegations he had sexually harassed his secretary. Recently appointed head of the unit, Boker had previously served as chief of police in Lod, where he initiated the Green Island drug crackdown operation in which police arrested dozens of drug dealers and had dramatically lowered the level of crime in the area. 

A well-respected officer in the Central District, Musseri on Monday oversaw an undercover operation and the arrest of 19 drug dealers in Lod. Ironically, before the policemen went out to make the arrests, Insp.-Gen. Moshe Karadi and Cmdr. Beni Kaniyak, head of the Central District, praised Musseri for a job well done.

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Top cops probed for taking bribes
By Roni Singer-Heruti
Haaretz - September 14, 2005 

Police officers at the Central District's central unit didn't know whether to laugh or cry yesterday when they found out that their commander, Yossi Boker, was being questioned for the second time in several weeks by internal affairs investigators in the Justice Ministry.
A few weeks ago Boker was suspected of sexually harassing his secretary. Now investigators suspect him of working with a Shfela district police commander, Meir Musari, and accepting bribes and favors from criminal elements in exchange for closing the cases against them. The bribery allegations relate to a period during which Boker and Musari worked together in the Lod police station. 

Early yesterday morning, the internal affairs investigators arrived at the office of Shfela district commander Yifrah Duchovny and informed him they planned to question Musari - who made the headlines this week as the officer responsible for a large, successful operation that captured a Lod crime ring suspected of dealing drugs. Musari was called into Duchovny's office, where the investigators told him he was under arrest and took him in for questioning. The interrogation lasted several hours. 

Other investigators arrived at Boker's house yesterday morning. Boker has been at home for the last few weeks because he was suspended in connection with the sexual harassment investigation. Boker too was taken in for questioning, but a short time before the interrogation began in Rishon Letzion, Boker became ill - apparently from heart pains - and was taken to Assaf Harofeh Hospital for treatment. 

Several police sources said the investigation appears to relate to events that allegedly took place several years ago, while Boker was in charge of the Lod police station and Musari was the station's intelligence chief. 

The sources said Musari collaborated with members of a Lod family with a criminal reputation and received favors from them. In one instance, the sources said, one of the family members allegedly hit someone with a car and killed him. Musari and Boker came to the scene, and when they realized who was involved, they apparently made sure the case was not pursued, the sources said. In return, Musari and Boker are suspected of having received favors - in this case, apparently a sailing trip. 

The internal affairs investigators are said to also be looking into the suspects' involvement in several other cases of alleged bribery. Police officers in the Central District expressed shock when they found out yesterday morning that the two admired senior officers were being questioned. Police issued a statement on the investigation early yesterday in the wake of the circulating rumors, and in the afternoon Duchovny convened Shfela district commanders and discussed the probe.

It was only Monday that the Central District celebrated Musari's success in breaking the crime ring in Lod. Public Security Minister Gideon Ezra and the police chief participated in a festive ceremony and praised Musari as the head of the team that broke the case.

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Remand extended for cop in bribery case
Yaakov Katz 
Jerusalem post - September 15, 2004

The Jerusalem Magistrate's Court on Wednesday extended the remand of Ch.-Supt. Meir Musseri, suspected of receiving bribes from underworld elements, by an additional five days. 

Musseri was arrested on Tuesday by the Justice Ministry's Internal Affairs Department on suspicions that, as head of the Shfela Police's Central Investigative Unit, he received various benefits from criminal elements and assisted in closing open cases against them. 

Musseri's commander, Asst.-Cmdr. Yossi Boker head of the Central District's Central Investigative Unit, was also detained for questioning on Tuesday but was evacuated to hospital after he complained of not feeling well during his interrogation. Internal Affairs reportedly intends to question dozens of cops from the Central District as part of their investigation. 

Judge Haim Liran wrote in his decision to extend Musseri's remand that, if released, the suspect might try to obstruct the investigation. Lod resident Sami Jusas, arrested on Wednesday for allegedly bribing the senior officers, was released to five days of house arrest.

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Museri charged with accepting bribes
Jerusalem Post - September 20, 2005

Police Chief Superintendent Meir Museri, commander of the Police Investigative Department, was arrested and charged Tuesday morning for allegedly accepting bribes from criminals.

The Police Investigative Department (PID) recommended that Museri be removed from the police force.

Also arrested Tuesday was Asst.-Cmdr. Yossi Boker. Boker, who was interrogated a few weeks ago on charges of sexual harassment, was taken in for questioning Tuesday morning after an additional complaint of harassment was received, Israel Radio reported.

Once Boker was in custody, investigators used the opportunity to question him on charges of bribery.

Both Boker and Moseri were suspected of closing cases for members of crime families.

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Clean up the police
Jerusalem Post - September 18, 2005 

Editorial

Police organizations the world over like to believe that that their members are incorruptible "untouchables," who cannot be tempted by criminal elements with ample resources to buy immunity from law enforcement. But absolute incorruptibility exists only in fiction. Real-life policemen are in contact with lawless elements and, in close proximity, dirt can rub off. 


On occasion in years past isolated cases of cops-on- the-take have surfaced in our bailiwick as well, but they seemed few and far between. Lately, however, two big cases have burst on our scene almost simultaneously. 


The first involves the Perinian brothers of Moshav Hodaya, described by the prosecution as running a veritable organized crime empire. Their case includes all the hallmarks of a cinematic thriller. They allegedly hired a policeman to carry out contract hits for them and then tried to assassinate him. The prosecution, for reasons which themselves warrant investigation, failed to strike a deal for the "bad apple" to turn state's evidence. After various convolutions of the plot, the officer-terminator fled abroad, but was murdered in Mexico. 


The brothers reportedly continued their operations while hobnobbing with prominent police higher-ups. Though social contacts with known criminals are strictly taboo for policemen, the police's own Internal Investigations Section seems to have let those senior officers off the hook. 


In the second case, Ch.-Supt. Meir Musseri and Asst.- Cmdr. Yossi Boker, commanders respectively of the central units of the Coastal Plain and Central Districts, are both under investigation for taking bribes to halt pursuit of underworld kingpins. 


The very fact that policemen can turn off the heat immediately makes greasing their palms an attractive option for those attempting to escape justice. This has spawned recommendations to take away file-closing authority from the local precinct level. But that's not good enough. Attempts to buy police "cooperation" can also be made at the point in which files are opened. 


Corruption is a constant potential companion to police work. It has little to do with how much policemen earn, as some here currently suggest. Lawbreakers will always earn more than lawmen. At one time in New York, officers were categorized as herbivores or carnivores. The former enjoyed forbidden perks from shopkeepers, the latter were accomplices to serious crime. 


Despite all this, it must be stressed that Israel's police - as compared to its counterparts abroad - is relatively clean. Yet this fact cannot suffice for comfort. The recent incidents are warning signals that must not be ignored. Moreover, the confluence of cases and their attendant bad publicity trigger dynamics of their own, undermining public trust in the police. 


The tarnishing of the police's image hampers its ability to function adequately, which in turn further boosts crime. This escalating spiral can lead to far- ranging and unanticipated social consequences. The challenge is first and foremost one for the internal security minister and the police inspector-general. It is in their power to nip in the bud this dangerous phenomenon, which hitherto has been largely swept under the rug and belittled, if not altogether denied. 


A systematic internal supervisory structure can be created to address this problem and prevent the development of improper police norms. 


In addition, the methods whereby officers are appointed to top jobs are ripe for reform. Today promotions are in the hands of small departmental cliques, hardly free from outside influence. A more transparent process, possibly involving open tenders within the force, along with requirements for proven ethical standards and spotless past records might keep shadier personnel away from key positions. 


The establishment of an outside control framework like New York's famed Police Foundation, to keep tabs on the actual effectiveness of police work as well as on its ethics, would go far towards inculcating in officers the realization that fighting corruption is more than a slogan. It is a basic value without which the police cannot function. 

Last but not least, there must be no leniency towards cops who have sinned just a little. There should be zero tolerance for minor transgressions, indeed for any infraction, even if these may not generate actual indictments. When all our officers understand that they cannot zigzag on the shady edges of the law with impunity, we will all sleep better at night. 

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Senior police officer questioned 
By Yaakov Katz
Jerusalem Post - September 20, 2005

Asst.-Cmdr. Yossi Boker was questioned Monday by the Police Investigative Department in the Justice Ministry on suspicion of taking bribes from criminal elements in Lod. 


Boker, head of the Central District's Central Investigative Unit, was released after five hours of questioning, Israel Radio reported. He was summoned for continued questioning, possibly as soon as Tuesday. 


The recently appointed head of the CIU had previously served as chief of police in Lod, where he initiated the Green Island drug crackdown operation in which police arrested dozens of local drug lords and dramatically lowered the level of crime in the area.

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Senior police officer sent on forced leave pending probe
By Roni Singer-Heruti and Jonathan Lis
Haaretz - September 20, 2005

Superintendent Meir Museri, intelligence officer for the Shfela Police District, was sent on a forced vacation from the yesterday because of an investigation concerning him being conducted by the Justice Ministry's Police Investigations Department (PID). Museri was released on bail yesterday after being held following questioning by the investigations unit. 

Museri and Commander Yossi Boker, commander of the Police Central District, were questioned regarding allegations they accepted bribes in exchange for "taking care" of certain investigations, and in some cases closing them. 

The PID is investigating 25 alleged offenses by the two men, including suspicions that the two acted to close the investigation of Sami Ja'asus, a Lod resident who was suspected of manslaughter. Ja'asus was suspected of running over and killing a woman while driving his car. The PID is checking whether the two officers received bribes or other benefits from Ja'asus in exchange for closing the case. 

Since Museri's arrest, there have been numerous rumors among the police about the two officers' alleged misconduct, including the possibility that they may have tried to tamper with evidence or even have move the dead woman's body. 

Police Major General Gabi Gal, the head of service's Human Resources Department, yesterday ordered the forced leave for Museri and his brother, Assaf Museri, who was questioned by the police yesterday on suspicion of having prevented the raid of a gambling establishment after discovering that his mother was present at the scene.

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All's not well at the central district's Central Unit  
By Roni Singer - Heruti
 Haaretz - November 4, 2005 

Members of the Central Unit's Investigation Department in the central district have been on a staff trip in the south for the past two days. Such trips are common for the police, since they offer an opportunity to raise morale and strengthen the bond between the unit's commanders and its members. However, the unit's morale is said to be low, and it has not had a commander for the past several months. 

Since an August probe of the unit's head, Commander Yossi Boker, on suspicions of sexual harassment, and a subsequent bribery probe of Boker in September, the unit has been run by his deputy, Chief Superintendent Danny Balorian. 

The possible move of the commander of the central district, Major General Benny Kaniak, to the post of deputy police commissioner has also contributed to the sense of uncertainty in the Central Unit. As long as a new district commander has not been appointed, sources in the unit say, it would not be appropriate to make decisions about other positions. 


Highlighting woebegone state
As in other districts, the central district's Central Unit deals with the worst crimes and organized crime in its area. The unit achieved several highly publicized successes under its former commander, Brigadier General Menashe Arbiv, now commander of the Sharon region, including the capture of the man who killed police officer Aviv Karado in Lod in an operation that involved field work in Jordan, and the arrest of several "soldiers" of reputed underworld leader Itzhak Abergil. 

But past successes only highlight the unit's present woebegone state. Police headquarters decided to transfer the Abergil case from the unit six months ago, and then it also moved a case involving the reputed crime Abutbul family in Netanya to the International Relations Unit. 

Sources in the latter unit say that contrary to Central Unit statements that the Abutbul case was "close to being cracked," the material was insignificant and certainly not enough to issue arrests. 


Mutual recriminations
Relations between the central district's Central Unit and its Tel Aviv counterpart have never been particularly warm. However, last year's arrest of the alleged crime kingpins the Ohana brothers and the success of the central district's Central Unit to obtain a key witness, Yaron Sanker, which Tel Aviv's Central Unit had failed to accomplish, led to a series of ongoing mutual recriminations between the two. 

The central district's Central Unit sources say investigations are going nowhere, and they come to the office to "pass another day." The central district's Central Unit spokesman, Chief Superintendent Yigal Hadad, however, says it is working on a number of big cases that he cannot currently discuss. He adds that as long as the investigation against Boker is proceeding, a decision as to whether to appoint his replacement will not be made. 

However, unit sources say that work is proceeding on Jowarish crime family case as well as a few bogged-down investigations, such as the murder of three-year-old Leah Katayev and her cousin, who were apparently accidentally shot while riding in a car in Ramle. Regardless, no arrests in this case are imminent. 

The unit's gloom is further deepened by a lawsuit filed by Sanker against the unit for illegally extracting testimony from him. During the trial, the judges harshly criticized the unit's investigators. 


Proud of the collar
The unit is reportedly proud of it success in nabbing an alleged central figure in the Hariri-Ayiat crime organization, businessman Daniel Molkanadov, who is suspected of having sought to take out a contract on the life of journalist Moshe Danon. 

However, the central district's State Prosecutor's Office recently informed Molkanadov that the case against him has been closed. 

The questioning of unit members by the Justice Ministry's Police Investigations Department (PID) has created a split between members of the unit, with those who served in the unit before he took command opposed to him. 

Next week's expected return of the unit's secretary who had filed the harassment charges against Boker, is apparently causing some tension, although some unit sources say that while it may not be "paradise," things are "not so bad." 

"True, there are things that do not contribute to morale," a source says. "But the unit's spirit is stronger than anything else."
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Suspended CIU head treated after suicide attempt
By YAAKOV KATZ
Jerusalem Post - Jan. 10, 2006


Asst.-Cmdr. Yossi Boker, suspended head of the central district's Central Investigative Unit (CIU) was evacuated to Assaf Harofe hospital following an attempted suicide on Tuesday.

He was released from the hospital after being treated for swallowing a large amount of pills.

He was forced to take a leave of absence from his top post recently after the Police Investigations Unit launched a probe against him in September for allegedly taking bribes and for sexual harassment.
 


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Senior police officer attempts suicide
By Yaakov Katz 

Asst.-Cmdr. Yossi Boker, the suspended head of the Central District's Central Investigative Unit, was taken to Assaf Harofeh Hospital in Tzrifin Tuesday morning after he apparently tried to commit suicide. 

Boker was found by his wife at home after he reportedly swallowed a large number of pills. He was treated at the hospital and was later released. 

Boker was forced to take a leave of absence from his post in August after he came under investigation by the Justice Ministry's Police Investigations Department on suspicions he sexually assaulted his secretary.
 
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Friday, June 08, 2001

Stopping a Suicide

Stopping a Suicide
by Sid Bernstein, Esq.
Aish HaTorah - June 8, 2001


Is stopping a suicide merely a question of public interest - or is it also a spiritual matter involving God?

Consider a man beset with multiple problems.

He is suffering from incurable cancer, has lost his job, is deep in debt, his wife wants a divorce, and he is estranged from his children. He decides to end his life and climbs over the rail of the Golden Gate Bridge.

As he is preparing to plunge into San Francisco Bay, he is spotted by police.

The police dispatch a highly trained psychologist, who talks to the man in an attempt to dissuade him from taking his life. In the meantime the police identify the man and confirm that all his problems are indeed true. He is not crazy, just distraught.

Should the police intervene? Whose life is it anyway?


THE FACTORS IN QUESTION
Is taking the man off the bridge is a legitimate use of police power?
Is it for or against the public interest to let people jump off bridges?

Is this a deeper issue concerning the preservation of life, or just a simple matter of public inconvenience?

Should society demand that he live - overriding his desire to end his own life?

Is there ever a time when suicide is justified, especially when a person is legally competent?

If a person has no choice about coming into the world, should they likewise have no choice when to go out?


Jewish Perspective
Judaism regards suicide as a criminal act. Someone who commits suicide is considered a murderer. It matters not whether he kills someone else or himself. His soul is not his to extinguish.

Judaism's opposition to suicide is found in the story of Noah's Ark. After the flood, God says to Noah:
Your blood which belongs to your souls I will demand; from the hand of every beast will I demand it. From the hand of every man; from the hand of every man who is his brother will I demand the life of man. (Genesis 9:5) 
The Talmud (Baba Kama 90b) learns from the first part of the verse, "And surely the blood of your lives I will demand," that one may not wound his own body. All the more so, he may not take his own life.

METAPHYSICAL LAWS
There is a deep spiritual consequence to suicide.

When a person commits suicide, the soul has nowhere to go. It cannot return to the body, because the body is destroyed. And it is not let in to any of the soul worlds, because its time has not come. This state of limbo is very painful. A person may commit suicide because he wants to escape, but in reality he is getting a far worse situation.

In this world, if we try hard enough sometimes we can solve the problem. But after death there are no solutions, only consequences.

When a Jew commits suicide, he is not permitted a full Jewish burial, and there is even a debate whether shiva (the seven-day mourning period) is observed or whether the kaddish prayer is said.

(In practice today, however, suicide is usually treated as a normal death, since it is assumed that the person was not of a normal state of mind.)


THE SUICIDE OF KING SAUL
In the Bible we see an incident in which suicide seems to be permitted.

The Philistines were battling against Israel, and the men of Israel fled from before the Philistines and fell slain on Mount Gilboa. The Philistines overtook Saul and his sons, and they slew ... the sons of Saul. The battle then focused against Saul. The archers found him, and Saul was terrified of them. Saul said to his armor-bearer, "Draw your sword and stab me with it, lest these men come to stab and torture me." But his armor-bearer did not consent, for he was very afraid. So Saul took his sword and fell upon it. When the armor-bearer saw that Saul was dying, he also fell upon his sword and died with him. (Samuel II, 1:5-10)

The Sages offer a number of reasons why Saul's suicide was unique:
  • Saul feared that his enemies would use torture to try to force him to worship other gods. (Ritva - 14th century)
  • Suicide is permitted in the face of an attempt at forced conversion. (Rabbeinu Tam - 12th century)
  • Suicide is permitted only if the lives of others would be in danger as a result of torture. (Rabbi Shlomo Luria - 16th century)
  • Saul acted out of respect for the Israelite kingship, as he feared the Philistines would mockingly parade him through their cities. In other words, he committed suicide to sanctify God's name. (Y'dai Moshe - 20th century)

In summary, suicide is absolutely prohibited, unless there are unusual and extenuating circumstances - e.g. forced conversion, endangering the lives of others, or sanctifying the Name of God.

DISCLAIMER: This module discusses sources for the purpose of education. Any real-life situation must be discussed with a rabbi, well-versed in Jewish law.

Tuesday, July 06, 1999

Pain Relief and the Risk of Suicide: A Jewish Perspective

Pain Relief and the Risk of Suicide:  A Jewish Perspective
Rabbi Aaron L. Mackler, Ph.D.
July 6, 1999

Jewish ethics values healing and the preservation of life as important goods and as activities mandated by God. The case presented, involving a 29 year old male with AIDS who requests large doses of analgesics and sedatives, may involve some degree of tension between these values: actions taken to relieve pain, supported by a mandate to heal, might contribute to a patient's death by suicide, ending life and violating a traditional Jewish norm.

Upon closer examination, it appears that thoughtful provision of pain relief and supportive care has the potential both to relieve the patient's suffering and to lessen the likelihood that he would feel compelled to end his life.

As I understand the Jewish tradition, life is appreciated as a blessing and a gift from God. Each human being is esteemed as created in God's image. Whatever the level of one's physical and mental abilities, and whatever the extent of dependence on others, each person has intrinsic dignity and value in God's eyes.

Judaism respects our bodies and lives as God's creation, which have graciously been entrusted to our care. We have the responsibility to care for ourselves and seek beneficial medical treatment--we owe that to ourselves, to our loved ones, and to God. In accordance with the tradition's respect for the life given by God, it rejects homicide, suicide, and assisted suicide.

Medical treatment that contributes to a patient's recovery is clearly supported by Jewish ethics. So is treatment intended to improve the patient's functioning or relieve pain. Humans are to act as God's partners in improving the world and helping persons in need. Scriptural support for these positions is seen in passages specifically discussing healing and in the general admonition to "love your neighbor as yourself" (Leviticus 19).

In appropriate cases, interventions such as surgery or medications to relieve pain may be mandated despite risks entailed.1,2,3 In the words of Rabbi Immanuel Jakobovits: "Analgesics may be administered, even at the risk of possibly shortening the patient's life, so long as they are given solely for the purpose of rendering him insensitive to acute pain."4 The judicious provision of medications intended to benefit the patient, even with the risk of side effects, is part of the enterprise of health care.

I understand the case presented as involving the provision of beneficial medication that poses the risk of hastening the patient's death by contributing to a suicide. The risk seems relatively modest in the case as described, and should not prevent the provision of needed pain relief. Since my intention as physician would be to relieve pain, I would seek to take reasonable precautions to lessen the risk of precipitating death.

For example, if one sedative (such as a benzodiazepine) would be as effective as another (such as a barbiturate) but would be less likely to be used in a completed suicide, I would prescribe the less risky medication. In an unusual case, I might limit the prescription to only a few days' or a week's supply, if this limitation would effectively reduce the risk of suicide, and if it would not prevent the patient from obtaining needed medication.

Perhaps more importantly, I would try to clarify for the patient my intention in providing the medication: to relieve pain, and not to assist in the ending of life. The prescription should not be taken as a judgment that the patient's life is not worth living, or that I am tired of caring for this patient who will not get better, or that I am giving my approval or "permission" for actively ending life. Rather, it should be seen in the context of the therapeutic relationship, as a manifestation of my commitment to care for, and never to abandon, the patient.

My commitment to care for the patient has other implications as well. As the physician in this case, I would be troubled that the patient is "in constant pain." It would be important for me to increase my knowledge of palliative care for AIDS patients, and perhaps to arrange for a consult by those with greater expertise in pain relief and/or HIV disease.

Review articles and handbooks suggest that much can be done to alleviate pain and other symptoms of patients with AIDS.5,6,7 I am mindful of studies suggesting that only 20 to 60 percent of cancer pain is treated adequately, even though adequate treatment is possible in at least 90 percent of cases, and even patients whose palliation is not "adequate" generally do not experience the constant pain described.6

Both the patient's report of constant pain, and any suggestions that the patient might commit suicide, dramatically signal the need for careful attention to the patient's suffering and possible responses. Clinical depression is relatively common among patients who are terminally ill or in pain, and correlates highly with suicide.

Contrary to popular misconception, major clinical depression is distinct from the sadness that typical accompanies terminal illness, and generally responds to psychiatric treatment, even in the absence of improvement of the underlying disease.6 Other issues may include inadequate social support, spiritual despair, or a fear of abandonment. Together with family members, other health care professionals, and other individuals who may be of help, I would explore and seek to alleviate the patient's suffering.

I would investigate in particular the possibilities for hospice care. I understand the patient's wish not to "spend his last days in a hospice" to refer to a free-standing hospice or other health care facility. Provision of hospice services to outpatients and those cared for at home is often available, however, and in fact is the primary way in which such services are provided in the United States. For information on resources, I might turn to local colleagues, or to organizations such as the National Hospice Association (800-658-8898).

The same principles would guide a decision to prescribe medicine that the patient says may well be used for a deliberate overdose within the next few days. Here the details of the case and my conversation with the patient would be crucial. Especially if the patient volunteers this information, what is superficially a request for palliation may be in fact a thinly veiled request for assisted suicide, or at least an invitation to discuss the issue.

In this case, I would not supply the prescription, but would address the patient's suffering and perceived need to end his life. If the medication was in fact needed to relieve the patient's severe pain, and this seemed to be the patient's primary motivation in requesting the prescription, I might well prescribe the medication. I would take especially extensive precautions to minimize the risk of suicide; for example, in my choice of drug and amount prescribed. I would take special care as well to ensure that my actions were not seen as a signal of approval for suicide.

Most importantly, if told that a desired prescription might well be used for suicide, I would redouble my efforts to explore and respond to the patient's suffering. Health care professionals with the greatest experience in caring for terminally ill patients report that when patients' suffering is taken seriously and efforts are made to alleviate it, the need to end life is no longer seen as compelling.

By providing the medication that is needed to alleviate pain in the context of a treatment plan of supportive care, I would likely alleviate the patient's suffering and lessen the risk of hastening death, by suicide or other means. Such a course of action would be supported by Judaism, as it would be by other approaches to health care ethics. Based on the reports of experts in palliative care, it appears that this course of alleviating suffering without contributing to the active causing of death is possible in virtually all cases. It certainly appears to be possible in the case at hand.


References
  1. Bleich JD: Judaism and Healing. New York: Ktav, 1981.
  2. Dorff EN: A Jewish Approach to End-Stage Medical Care. Conservative Judaism 1991; 43: 3-51.
  3. 0 Reisner AI: A Halakhic Ethic of Care for the Terminally Ill. Conservative Judaism 1991; 43:52-89.
  4. O'Neill WM, Sherrard JS: Pain in Human Immunodeficiency Virus Disease: A Review. Pain 1993; 54: 3-14.
  5. New York State Task Force on Life and the Law: When Death is Sought: Assisted Suicide and Euthanasia in the Medical Context. New York: New York State Task Force on Life and the Law, 1994, pp 40-43.
  6. Washington State Medical Association: Pain Management and Care of the Terminal Patient. Seattle: Washington State Medical Association, 1992.


Rabbi Aaron L. Mackler, Ph.D., is Associate Professor of Theology at Duquesne University in Pittsburgh. He serves as Vice President of the Society of Jewish Ethics. Rabbi Mackler is a member of the Rabbinical Assembly’s Committee on Jewish Law and Standards, for which he serves as Chair of the Subcommittee on Bioethics, and of hospital ethics committees in the Pittsburgh area.

Dr. Mackler served as ethicist for the New York State Task Force on Life and the Law, and taught as Visiting Assistant Professor at the Jewish Theological Seminary of America. He received a B.A. from Yale University, an M.A. and rabbinic ordination from the Jewish Theological Seminary of America, and a Ph.D. from Georgetown University. He has spoken on health care ethics and theology for numerous professional societies and other audiences.

Dr. Mackler's publications include Introduction to Jewish and Catholic Bioethics: A Comparative Analysis (Georgetown University Press, 2003), and an edited volume, Life and Death Responsibilities in Jewish Biomedical Ethics (New York: Finkelstein Institute, Jewish Theological Seminary of America, 2000). He also has written numerous articles in the fields of Jewish theology and bioethics.


Friday, January 01, 1999

Is there a Jewish Right to Commit Suicide?

Is there a Jewish Right to Commit Suicide?
Temple Sinai of Sharon, Inc. and Rabbi Clifford E. Librach
(Originally published in the January 1999 Temple Sinai Bulletin)


The Talmud tells the story of a rabbinic sage who returns to his old community after a long and lonely absence, exclaiming "either friendship or death!"

Every one of us is vulnerable the psychological dangers of loneliness. Each one of us is a person necessarily imbedded in a range of multiple relationships-we are all children, most of us have siblings and many of us have spouses and children in addition to friends and acquaintances.

Therefore, no one is really independent in anything but a relative sense-no one is truly and radically autonomous. Autonomy, in the Jewish view, can only be the property of a Force who is capable of creation out of nothing (creatio ex nihilo). Only God has this capacity; it is a capacity no creature should attempt to achieve, let alone assume that it already possesses.

To view any individual as being independent of all relationships is like viewing a point outside of a line.

So privacy and autonomy are relative terms in the classical Jewish view.

We have a right to privacy from the government in certain aspects of our lives-our family life, our political persuasion, our friendships, our religion. The state is entitled to intervene, however, when our family life becomes a shield for the abuse of children, when our friendships become a shield for criminal conspiracy, or when our religion becomes a shield for conduct which society deems immoral.

Why do we need the authority of government? For two reasons-polar opposites, in many ways. We need a state because so many human beings are selfish individuals inclined to (a) distrust each other and (b) to pursue their own self-interest without restraint. But in addition, we need a state so that we can properly order the mutual satisfaction of our personal needs and those of each other. It is not good for us to be alone (Genesis 2:18), which is why we are ultimately and intimately attached to each other (Genesis 2:23) in family, tribe, society and nation.

In either case, the state has as one of its prime responsibilities the intervention against behavior when there is a strong possibility that death might otherwise occur. Society-and its principal agent, state power-is charged to defend all innocent human life from destruction. Accordingly, there is really no difference between homicide and suicide. The killing of innocents is to be contained irrespective of who is killing and who is being killed.

The problem with seeing a "right" to suicide is not only that it suggests that we are responsible to no one (family, friends or God) but ourselves. In addition, we can (and, no doubt, will) be pressured to exercise that "right" when it would seem to us to be in the best interest of those in our immediate circle.

It was no accident that the suicide rate of German Jews, beginning in 1933, dramatically increased years before the actual "Final Solution" of the death camps was implemented. When the German society, of which most of them believed themselves to be integrated members, sent them so clear a message that their presence was to be removed at any cost, death became the last privacy to which they were consigned.
Suicide is an exaggerated scream of loneliness.

For Judaism, the proper medicine for loneliness is love, not death. We have no more "right" to murder ourselves than we do to murder each other.