Refusing Medical Treatment: An SPH Panel Discussion

Over the last two years, I have really enjoyed developing and chairing the SPH Jewish Student Association.  It has been an honor to be able to meet wonderful and enthusiastic people who are excited to be involved in the Jewish community at school. I hope that the group continues to grow and strengthen over the next few years and continues to serve the Jewish student population at the University of Michigan School of Public Health.

Students in La Briut enjoying a homemade Shabbat dinner.

Students in La Briut enjoying a homemade Shabbat dinner.

Earlier this semester, the Jewish Student Association held a panelist event at U-M SPH.  Professor Ed Goldman, Professor Peter Jacobson, Rabbi Seth Winberg, and Rabbi Kim Blumenthal were panelists.  The evening took a lot of coordination, but it was well worth it. Below is an article I wrote about the event for the Detroit Jewish News. Thank you to the Detroit Jewish News for allowing me to share this on the SPH Student Life Blog.

When I started my master’s of public health degree at the University of Michigan, I noticed that the Jewish students were well represented in the School of Public Health, but did not find a venue within the school to bring us together.

So I decided to form a student organization called La Briut (Hebrew for “to your health”), which has about 30 members. La Briut fosters community among Jewish students of all backgrounds in the school and creates a space to explore health-related issues that affect the Jewish population at large. Since its inception last year, we have organized a number of social, religious, and educational activities together. We recently sponsored a panel about refusing medical treatment.

Ed Goldman, professor of health management and policy at the School of Public Health, opened the discussion with anecdotes about cases involving the refusal of treatment on religious grounds. For instance, what steps should be taken when a Jehovah’s Witness’ child needs a blood transfusion and his parents will not consent to the procedure? He described receiving calls from doctors at 2 or 3 in the morning asking for his advice on these matters.

Professor Peter Jacobson, also from the department of health management and policy, addressed the conscience legislation recently proposed in Michigan. The legislation, which didn’t pass, would have given healthcare providers freedom to refuse to treat a patient if it violated the provider’s moral and religious principles.  Conscience clauses usually relate to issues such as abortion, contraception, and stem cell-based treatments.  In Jacobson’s view, health providers have a duty to fulfill a patient’s legal medical needs, irrespective of their personal position on the issue.

Two rabbis added the Jewish perspective on refusal of treatment. Rabbi Seth Winberg of U-M Hillel explained that today the standard view is that the Jewish tradition of saving life above all limits patient autonomy, and “consequently, a patient would be required to accept medical treatment.”

But he then cited several precedents that challenge such a view, suggesting that there may be reasons for a patient to refuse medical treatment—if, for example, the treatment is experimental or too risky.

Rabbi Kim Blumenthal from Beth Israel Congregation of Ann Arbor shared some of her experiences of counseling congregants.  Her take on the matter was simple: If someone comes to her seeking advice about a difficult decision, she sees her main role as comforting the individual and then guiding him or her through the process of making a decision.

Each viewpoint was unique, nuanced, and interesting.  I do a lot of thinking in my public health courses, but this panel pushed me to think in a different way.  It was provocative and stimulating, and I got the sense that the speakers were enjoying the experience as much as the students. I left the event understanding that we had only begun to delve into this topic and to wrestle with its many intricacies and uncertainties.

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