Mishnah
Mishnah

Halakhah for Pirkei Avot 4:22

הוּא הָיָה אוֹמֵר, הַיִּלּוֹדִים לָמוּת, וְהַמֵּתִים לְהֵחָיוֹת, וְהַחַיִּים לִדּוֹן. לֵידַע לְהוֹדִיעַ וּלְהִוָּדַע שֶׁהוּא אֵל, הוּא הַיּוֹצֵר, הוּא הַבּוֹרֵא, הוּא הַמֵּבִין, הוּא הַדַּיָּן, הוּא עֵד, הוּא בַעַל דִּין, וְהוּא עָתִיד לָדוּן. בָּרוּךְ הוּא, שֶׁאֵין לְפָנָיו לֹא עַוְלָה, וְלֹא שִׁכְחָה, וְלֹא מַשּׂוֹא פָנִים, וְלֹא מִקַּח שֹׁחַד, שֶׁהַכֹּל שֶׁלּוֹ. וְדַע שֶׁהַכֹּל לְפִי הַחֶשְׁבּוֹן. וְאַל יַבְטִיחֲךָ יִצְרְךָ שֶׁהַשְּׁאוֹל בֵּית מָנוֹס לְךָ, שֶׁעַל כָּרְחֲךָ אַתָּה נוֹצָר, וְעַל כָּרְחֲךָ אַתָּה נוֹלָד, וְעַל כָּרְחֲךָ אַתָּה חַי, וְעַל כָּרְחֲךָ אַתָּה מֵת, וְעַל כָּרְחֲךָ אַתָּה עָתִיד לִתֵּן דִּין וְחֶשְׁבּוֹן לִפְנֵי מֶלֶךְ מַלְכֵי הַמְּלָכִים הַקָּדוֹשׁ בָּרוּךְ הוּא:

He was wont to say: The born, to die [i.e., one who has been born is already destined to die], and the dead, to live [they are destined to live and to arise for the day of judgment — these for eternal life and these for shame and for eternal infamy], to know [from others], to apprise [others], and to affirm [within themselves] that He, the Almighty, is the Artisan, [all of the world being in His hand like matter in the hand of the artisan, for] He is the Creator, [who created the entire universe ex nihilo, wherefore He can do with it as He pleases], He is the Understander [of all the deeds of men, wherefore] He is the (optimum) Judge [and He brings them into judgment before Him], He is the Witness, He is the Prosecutor [of the sinners], and He is destined to judge them [for the world to come]. Blessed is He, for there is before Him no wrong, and no forgetting, and no favoritism, and no taking of graft, for all is His (and there is nothing to bribe Him with). [He shows no favoritism even to an absolute tzaddik, not (refraining from) punishing him for even a slight transgression that he may have committed and not taking the "graft" of a mitzvah to overlook a sin. But He rewards for a mitzvah and punishes for a transgression. (Thus, Rambam)]. And know that all comes to an account. ["A p'rutah (a small coin) and a p'rutah add up to a great sum." In the same way, slight transgressions, when there are many of them, add up to a great sum.] And let your (evil) inclination not delude you into thinking that the grave is your refuge. For, perforce were you formed [The soul resists leaving the pargod (the Divine partition, a pure sphere where the souls reside) to enter a woman's womb, an impure abode, but an angel comes and removes it forcibly and places it there], and perforce were you born, [being forced by an angel to leave the womb], and perforce do you live. [Sometimes a man is so steeped in afflictions that he wants to die — but he cannot], and perforce are you destined to render judgment and accounting before the King of the kings of kings, the Holy One Blessed be He.

Gray Matter III

Rav Shlomo Zalman (Teshuvot Minchat Shlomo 1:91:24) maintains that we withhold these extreme life-saving measures if so requested by the gosseis. He adds that although this is permissible, it is preferable to explain to the patient that Torah philosophy advocates living as long as possible even if one experiences pain, as is indicated by the Mishnah in the context of a sotah3The Torah states that a sotah (woman suspected of adultery, see Bemidbar 5:11-31) who is found guilty will die a hideous death. However, if she has “merit,” Hashem will grant her a few extra years of life, during which she will slowly deteriorate and experience difficult illness. This indicates that it is preferable to die a slow and painful death rather than die immediately, as the Mishnah teaches that the extra years of life involving great suffering result from merit. (Sotah 3:4; also see Rambam Hilchot Sotah 3:20) and the Mishnah (Avot 4:22) that states, “One hour of teshuvah and good deeds in this world is better than all of the world to come.”4See, however, Ketubot 33b, Sotah 46b, Rashi’s comments to Shemot 15:5 s.v. Kemo Even, Teshuvot Igrot Moshe Y.D. 2:174:3, and Rav Hershel Schachter’s B’ikvei Hatzon 34 for situations in which it seems it is preferable to die immediately rather than suffer a prolonged, painful death.
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