In life-or-death legal dispute, modern medical ethics, Jewish law and civil law clash

As David Stern, 61, an observant Orthodox Jew suffering from a rare neurodegenerative disease, lies conscious and hooked up to a respirator at the Providence Tarzana Medical Center in the San Fernando Valley, the hospital and lawyers for two of Stern’s children are battling to determine whether the hospital should remove Stern from life support

[additional-authors]

Jared Sichel

August 17, 2015

***This story has been updated (Sept. 11, 12 p.m.)

As David Stern, a 61-year-old Orthodox Jew suffering from a rare neurodegenerative disease, lies conscious and hooked up to a respirator at Providence Tarzana Medical Center, the hospital and lawyers for two of Stern’s children are battling to determine whether the hospital should remove Stern from life support — as administrators say they are obligated to do — or perform a life-saving tracheostomy, as Stern’s family demands.

The dispute highlights a conflict at the intersection of modern medical ethics, Jewish medical ethics and civil law as it pertains to the validity of a living will and the extent to which “quality of life” measures should impact whether a life-saving procedure is appropriate.

In 2011, two years after he was diagnosed with cortical basal ganglionic degeneration (or CBGD, an incurable and ultimately fatal disease), Stern signed an advance medical directive. The directive names Shirit Gold, one of his two daughters, as his agent in medical emergencies where Stern is unable to make his own health decisions, such as this one. But it also stipulated that “life-sustaining procedures” that would only “artificially prolong” his life when he’s suffering from an “incurable and irreversible condition” should not be pursued.

Gold and her brother, Rayi Stern, argue that their father, who became Orthodox in 2003, never would have knowingly signed an end-of-life document that would violate Jewish law. The directive he signed allows for an autopsy, which is forbidden under Jewish law in most cases, and for organ donation, also forbidden in most cases (the directive did not account for the few instances in which an autopsy or organ donation would be permitted under Jewish law).

The family asserts he could not have understood the contents of what he was signing, and both Rayi Stern and Gold said their father was already two years into his neurodegenerative diagnosis, which has resulted in dementia and extreme loss of motor function, when he signed the directive. “I am 100 percent certain” he didn’t know, Rayi said. “He lived his life as a Jew. He wouldn’t want to end it in any other way.”