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Is it Permissible to Pray for the Death of a Terminally Ill Patient Who is Suffering?

If one has a close friend or family member who is gravely ill and enduring a great deal of suffering, and the physicians have determined that the patient cannot be cured, it is permissible, or proper, to pray that the patient should die so he does not suffer any longer?

A possible Talmudic source for this kind of prayer is the story told in Masechet Ketubot (104) of the death of Rebbe (Rabbi Yehuda Ha’nasi). The Rabbi took ill, and all the Rabbis prayed on his behalf. Rebbe’s maidservant went to the roof of the house and cried, "The upper worlds want Rebbe, and the lower worlds want Rebbe. May it be His will that the lower worlds prevail over the upper worlds."

The maid went inside, and she noticed how terribly Rebbe was suffering. His illness forced him to make frequent trips to the restroom, causing him an inordinate amount of discomfort. The maid returned to the rooftop and cried, "May it be His will that the upper worlds prevail over the lower worlds." Once she saw Rebbe’s suffering, it seems, she changed her prayer, and prayed that Rebbe should die. Seeing that Rebbe remained alive in the merit of the Rabbis’ prayers, the maidservant threw a glass off the roof, and when it reached the ground and shattered, it made a loud, sudden noise that disrupted the Rabbis’ prayers. At that moment, Rebbe died.

The Ran (Rabbenu Nissim of Gerona, Spain, 1320-1380), in Masechet Nedarim, references this story, and draws proof from the maidservant’s prayers that in certain situations, it is proper to pray that a patient should die. Specifically, the Ran explains, such a prayer is appropriate if there is no longer any possibility of the patient recovering, and the patient endures suffering because of his illness. On this basis, the Ran explains the Gemara’s comment in Masechet Nedarim (40a) that visiting an ill patient is vitally important, because if one does not visit the patient, then he "does not pray for him – neither that he should live, nor that he should die." The Ran explains that one of the purposes of visiting the sick is to observe the patient’s condition firsthand so he will be aroused to pray. Sometimes, he will be aroused to pray that the patient should live, and in other occasions, he will be aroused to pray that the patient should die. Specifically, as in the case of Rebbe’s maidservant, if one sees that the patient cannot be cured, and endures suffering, he should pray for the patient’s life to end so he will not suffer any longer.

A different view is presented by the Ben Ish Hai (Rav Yosef Haim of Baghdad, 1833-1909), in his Ben Yehoyada commentary to the Talmud (Masechet Ketubot). He explains that the maidservant made these pronouncements not as prayers to G-d, but rather to relay to the Rabbis information about Rebbe’s condition. As she tended to the Rabbi’s needs, she knew about his condition and wished to convey the latest information to Rebbe’s colleagues. When she saw that Rebbe was suffering, she announced to the Rabbis that the time had come for the "upper worlds to triumph over the lower worlds" – meaning, that Rebbe should die. She was telling the Rabbis that they should stop praying, because their prayers were prolonging Rebbe’s suffering.

According to the Ben Ish Hai, then, one should not pray for a terminally ill patient to die, but one should instead stop praying for the patient to live, once the situation is such that the prayers would just be prolonging the patient’s suffering. This is in contrast to the view of the Ran, who ruled that one may actually pray for the patient to die in such a case.

Rav Moshe Feinstein (Russia-New York, 1895-1986), in Iggerot Moshe (Hoshen Mishpat 2:75), posits that even according to the Ran, this Halacha is extremely limited in scope. The Ran stated that one may pray for a patient to die only once it is certain that the patient will not recover. Apparently, Rav Moshe explained, Rebbe’s maidservant – who was known to be an especially righteous woman – had a unique power of prayer, and she sensed in this situation that her prayers would be ineffective and Rebbe would not survive. In such a case, the Ran maintains, it is appropriate to pray that a patient should die to avoid further suffering. In the vast majority of situations, however, we have no way of conclusively determining whether or not a patient will survive, and so such a prayer would not be appropriate.

Others, however, disagree, and maintain that just as we rely on doctors’ medical assessments in other areas of Halacha, such as when a patient should be fed on Yom Kippur, or driven to a hospital on Shabbat, we likewise rely on doctors’ assessments in this regard, as well. Accordingly, the Aruch Ha’shulhan (Rav Yechiel Michel Epstein of Nevarduk, 1829-1908), in Yoreh De’a (335:3), accepts the Ran’s view as practical Halacha, ruling that if a patient is suffering and it is certain that he will not recover, one should pray for him to die.

A third view is presented by Rav Moshe Sternbuch (contemporary), in his Teshubot Ve’hanhagot. He tells that Rav Shmuel Rozovsky (1913-1979), the great Rosh Yeshiva of Ponevezh, was very ill and endured terrible pain. A disciple visited him, and Rav Rozovsky asked the student to pray "that the Almighty shall spare me from suffering – either that I should leave, or that the suffering should leave." In other words, the appropriate prayer to recite in such a situation is that the patient should no longer suffer, and that G-d would decide how this should be achieved – either through the patient’s recovery, or through the patient’s passing.

This is reminiscent of the story told of a certain Lubavitcher Hasid who, like many Rabbis in Lubavitch, was sent by the Lubavitcher Rebbe (Rav Menachem Mendel Schneerson, 1902-1994) to a remote location to help facilitate religious life, but he had a very difficult time. The conditions were so harsh that this Rabbi endured poverty and poor health. Finally, after a number of years, he sent a letter to the Rebbe asking if he could be relieved of his mission, which was causing him great suffering.

The Rebbe wrote a letter back to the Rabbi saying, "Every person who comes into this world has a purpose to fulfill. Your purpose is this mission that I sent you on. Instead of asking to be relieved of your mission, you should be asked to be relieved of your suffering."

The Rabbi heeded the Rebbe’s advice, and decided to remain. With time, the condition improved, he was very successful.

In a similar vein, when a terminally ill patient is suffering, according to Rav Sternbuch, the appropriate response is to pray that the suffering should end, in the manner in which G-d sees fit. It is not for us to decide how the suffering to end; we should simply beseech G-d that it should end quickly in the way which G-d decides. It would seem that this is, indeed, the best approach to take in such a situation.

Summary: According to some opinions, it is permissible, and even appropriate, to pray that an ill patient should die if the doctors have determined that he cannot be cured and he is enduring great suffering. However, the preferred practice in this unfortunate circumstance is to simply pray to G-d for the patient’s suffering to end, in the manner which G-d decides is best for the patient.


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