1st World Conference on Jewish Services for the Elderly, Jerusalem, Israel, 1999. Abstract Book, p. 27.

Suffering and the Sanctity of Life in End-Stage Dementia

B.Z. Aminoff, MD, PhD

Geriatric Department and Memory Clinic, The Chaim Sheba Medical Center, Tel Hashomer, Israel

Reference is made to patients who are unable to communicate verbally with the outside world, lie in a fetal position with a feeding tube and urinary catheter, and suffer from extreme malnutrition and decubitus ulcers.
It is common practice for many extremely religious Jews to demand special examinations and active treatment for end-stage dementia patients in order to prolong life, as perhaps, in their final moments, they will gain entry into the afterlife. Indeed, all dementia patients require very active treatment in order to prevent, or diminish terrible prolonged suffering, e.g. restlessness, screaming, pain, severe nutritional disorders, decubitus ulcers, unnecessary invasive actions and unstable medical conditions.
The treatment of suffering in this instance is not by means of euthanasia, or the shortening of life, but by means of a suitable regimen during the natural stages of dementia, so that stress and suffering can be considerably reduced until the patients’ natural death.
This approach is in accordance with medical ethics relating to the patients and does not oppose Jewish religious belief and the concept of the sanctity of life.
The Mini-Suffering Stage Examination (MSSE) facilitates objective evaluation and diagnosis of the level of suffering in end-stage dementia patients.
Inadequate or unsuccessful medical treatment and nursing care, or negligence may cause suffering of the patient.