Hospice and Palliative Care

(1) One in a dying condition is considered a living being in all respects.³He is considered a living being with respect to granting a divorce (provided he is able to speak, according to one opinion in E.H. § 121, 7) ; to giving gifts, and as to a Kohen entering the house of a person in a dying condition, some permit and others forbid. infra § 370. We may not tie up his jaws,⁴So that he does not open his mouth. nor may we annoint him with oil, nor wash him,⁵In order to remove filth. nor stop off his organs of the extremities,⁶This was done in order that the corpse should not swell on account of the air which enters through his open organs. nor may we remove the pillow from under him, nor may we place him on sand, clay-ground or earth, nor may we place on his stomach a dish, a shovel, a flask of water or a globule of salt,⁷These were ancient practices. nor may we summon the towns on his behalf, nor may we hire pipers and lamenting women, nor may we close his eyes⁸For all these hasten his death — TaZ. On closing the eyes, cf. Gen. XLVI, 4, ‘And Joseph shall put his hand upon thine eyes.’ before his soul departs.⁹Tur citing T.H. who derives this from Sem. Cur. edd., however, do not contain all the items enumerated. W.G. a.l. and Sem(H). p. 233; also supra § 337, n. 2. Cf. further Shab. 151a-b, Mishna. And whosoever closes [the dying person's] eyes before death¹⁰Lit. ‘with the departure of the soul.’ is regarded as one who sheds blood.¹¹One must make sure that he is dead, for it is quite possible that the patient has only fainted — Maim. The Talmud (ibid.) and Sem. (l.c.) compare this to a lamp that is going out. If one places his finger upon it, it is immediately extinguished — ShaK. One may not rend garments, nor bare the shoulder in mourning, nor make a lamentation for him, nor bring a coffin into the house in his presence before he dies,¹²A healthy person is, however, permitted to prepare shrouds for himself — T.H. according to Men. 41a. nor may we begin the recital of Ẓidduk Haddin¹ Glos. before his soul departs.¹³T.H. Cf. W.G. a.l. Gloss: Some say that we may not dig out a grave for him. although it is not [done] in his presence, [i.e.,] in the house, — before he dies.¹⁴RIBaSh, Resp. 114. But if this is not done in the presence of the dying person and he would therefore not become aware of it, it is permissible — B.Yos. and BaḤ. However, on the eve of the Sabbath one must be very careful not to open a grave unless there would be sufficient time to bury the corpse. Cf. O.Ḥ. § 547, 9; BaḤ a.l. Mish. Le-Melek, Yad, Ebel IV, 5. It is [likewise] forbidden to dig out any grave to be [left] open until the next day, in which the corpse will not be buried the same day, and there is danger in this.¹⁵R. Yeruḥam on the authority of R. Yehudah the Ḥasid — G. It is likewise forbidden to cause [aught] to hasten the death of one who is in a dying condition, e.g., one who has been in a dying condition for a long time, and could not depart, — [the law is that] we may not remove the pillow or the mattress from under him [just] because some say that there are feathers from some fowl which cause this [prolongation of death].¹⁶Where there exists a possibility that if a certain cure or medicine is administered the patient may live or it may have the opposite effect of hastening his death, the law is that it is permissible to give the medicine or the like after consultation with medical experts — Resp. Binyan Ẓion. One may offer prayers that the suffering person die — RaN (Ned. 40a). He may likewise not be moved from his place. It is also forbidden to place the Synagogue keys under his head in order that he may depart.¹⁷These are all forbidden on account of moving the patient which may hasten his death — TaZ and ShaK. supra n. 7. However, if there is aught which causes a hindrance to the departure of the soul, e.g., [if] near that house there is a knocking sound, viz., a wood-cutter, or there is salt on his tongue, and these hinder the departure of the soul, it is permitted to remove it therefrom, for there is no [direct] act [involved] in this, since he merely removes the hindrance.¹⁸Hag. Alfasi (295b) to M.K. III — G. TaZ contra ShaK. forbids removing salt from his tongue, since in this case too, the patient has to be moved. A.H. agrees with ShaK.

(2) One who is informed, 'We saw your relative in a dying condition three days ago,' is bound to mourn for him,¹⁹Thus Tur, R. M. of Rothenberg, Asheri and Mord. in accordance with Git. 28a: ‘Most of those in a dying condition die.’ For it is certain that he has already died.²⁰For only when the person in a dying condition is in our presence is he regarded as a living being in every respect. Otherwise, he is not — ShaK. P.Tesh. for other opinions on this question. Nevertheless, when such a report is brought, the wife of the person who was found in a dying condition, may not remarry nor should she observe mourning rites, nor should the children recite the Kaddish — A.H.

(3) Ẓidduk Haddin¹ Glos. is recited when the soul departs,²¹T.H. If a fire breaks out, one is dutibound to remove a person in a dying condition from the burning house. So too, a corpse takes precedence in such a case over saving Holy books; a living infant takes precedence over a corpse, and a healthy person over one dangerously ill — R. A. Eger on the authority of Sefer Ḥasidim. and when he reaches [the words] 'Judge of Truth,' the mourner rends his garments.

(4) As soon as he feels death approaching, they should not separate themselves from him, lest his soul depart whilst he is alone.²²Kol Bo. For the soul suffers grief when it has to leave the body alone. And it is a religious duty to stand near the [dying] person during the departure of the soul, as it is written,²³Ps. XLIX, 10. 'That he should still live alway; that he should not see the pit. For he seeth that wise men die, the fool and the brutish together perish etc.'²⁴Hag. Alfasi ibid. — G.

(5) It is a custom to pour out all drawn water in the neighbourhood of the corpse.²⁵Kol Bo. By this act people will know that someone has died, and it will avoid a direct announcement — ShaK. Other reasons have been advanced. Cf. Kol Bo(G), pp. 24-26 for a thorough analysis of this custom.