Since I've been speaking about death so much lately, here's my contribution to Purim Torah 5775: The Torah's 616th mitzvah, Assisted Suicide:
Vayikra 19:16 warns, “You shall not stand by as the blood of your friend is shed.” From this verse, the Supreme Court of Canada shli”t derives the Torah’s 616th mitzvah: To assist your friend in dying. This active commandment is an aseh haba michlal lav, a command derived from a prohibition: You must not stand by, but rather, you must act.
Writing in Carter v. Canada (Attorney General), 2015 SCC 5, the Supreme Court explained further that prohibitions against helping others to die are misguided, as they cause early death. They wrote, “[T]he prohibition deprives some individuals of life, as it has the effect of forcing some individuals to take their own lives prematurely, for fear that they would be incapable of doing so when they reached the point where suffering was intolerable.” Therefore, the Court concluded, it is better to pledge to assist someone to end his life, so that he will live long enough for you to end it, and not kill himself earlier. [Note: This was not a Purim paragraph; this is part of their actual decision. You can look it up.]
The decision did not come without controversy. Rabbi Moshe L’chaim shli”t argued that the talmudic principle, “We do not sin in order to provide merit for another (Shabbat 4a)” should apply, since the killer here sins (murder) in order to prevent his victim from sinning (suicide). However, an amicus brief filed by the KFMI (Kosher Frozen Meals Industry) contended that assisting others in dying is a time-honoured religious practice, and it should be protected regardless of talmudic logic.
Scholars disagree regarding whether it is appropriate to recite a blessing when assisting at the time of death. Igeret She’ol suggests that m’chayeh hameitim (“He who gives life to the dead”) should be recited, since the assister has lengthened the life of his victim by killing him. In response, Bila haMavet argues that no blessing should be recited; the mitzvah of extending the victim’s life has concluded, and therefore the blessing would not be recited over la’asiyato (preceding the mitzvah), as is required.
There is also considerable disagreement regarding the appropriate punishment for a physician who refuses to assist in ending a life. The Royal College of Physicians and Surgeons of Canada favours lashes, but Gesher haMavet disagrees, because failure to assist is a lav she’ein bo maaseh (a prohibition violated via inaction), and therefore there is no corporal punishment.
Another question arises regarding the proper means of assisting. Per Maavir Yabok, it would be best to minimize one’s assistance by using a shinui (an abnormal action), as well as grama (an action which does not directly cause the result). An example would be to place an obstruction in a breathing tube, then use the back of one’s thumb to push a button which would cause carbon dioxide to vent into the tube (shinui), and then to remove the obstruction from the breathing tube (grama). However, Artscroll’s Laws of Assisting Death contends that use of grama could invalidate the mitzvah.The Artscroll guide prefers direct administration of a poison pill, but it acknowledges some debate regarding the blessing the patient should recite upon the pill.