MEDICINAL MARIJUANA

News item: The United States Supreme Court has agreed to decide
whether "medical necessity" can justify the distribution of marijuana
despite federal laws prohibiting such an act.

The case was brought by the Clinton Administration to stop a
California group from allocating "medicinal marijuana," which some
patients say relieves their suffering, but which the federal
government considers an illegal substance with questionable
therapeutic value. California is one of several states which over the
past few years has enacted laws legalizing possession of marijuana for
medical purposes. However, the laws leave unclear exactly how patients
are supposed to obtain the drug.

Let's shift the venue away from the Supreme Court (which the justices
might welcome; they've gotten quite a workout lately with the election
business.) Suppose a panel of rabbis were hearing the case, with
Jewish law (halacha) and tradition as their only guides. How might
they decide? How does Judaism view this issue?

It views it with a decidedly "therapeutic" eye as it balances the
sometimes competing values of compassion, love, social welfare and the
sanctity of human life.

Let's start with compassion, which is one of our tradition's paramount
virtues. Why? Because it is one of God's paramount virtues, as many of
our holy texts can attest to. Compassion, in fact, is one of the first
of God's 13 Attributes of Mercy that is mentioned in the Torah (Exodus
34:6-7), and that we recite in unison three times on both Rosh
Hashanah and Yom Kippur.

If a doctor is not compassionate, he's probably not worth his weight
in tongue depressors. And his bedside manner probably leaves something
to be desired. But he still has a sacred obligation to heal, a
requirement that our Sages derived from various Torah passages,
including "You shall love your neighbor as you love yourself
(Leviticus 19:18), "You shall not stand idly by the blood of your
neighbor" (Leviticus 19:16) and another one mandating the healing of
someone injured in a quarrel (Exodus 21:18-19). Meanwhile, one of our
greatest thinkers -- the 12th and 13th century philosopher, Sage and,
yes, physician Maimonides -- drew a parallel between the binding
obligation to return lost property (Deuteronomy 22:2) and an equally
binding obligation to restore lost health.

The halachic imperative to heal also is a reflection of Judaism's
belief in the absolute sanctity and inestimable value of human life, a
belief embodied in the Talmudic adage that if one saves a single life
it is tantamount to saving the entire world (Sanhedrin 37a).

"The value with which human life is regarded in the Jewish tradition
is maximized far beyond the value placed upon human life in the
Christian tradition or in Anglo-Saxon common law," wrote Rabbi J.
David Bleich in the book "Jewish Bioethics." So deeply rooted is this
value, he added, that it takes precedence "beyond virtually all other
considerations."

As a result, virtually any Jewish law -- and by extension most secular
laws -- can be violated in order to save a life or even prevent a
potentially life-threatening situation from developing. For example,
the otherwise binding laws of Shabbos or kashrus must be overridden in
the interests of preserving life. Likewise, Jewish law would permit
the distribution of an illegal drug, such as marijuana, when someone's
life is clearly at risk.

The efficacy of the drug would not necessarily be an issue. A
substance's "placebo" effect alone, according to some opinions, might
be beneficial enough to warrant its use in life-threatening
situations. Marijuana commonly is used to treat loss of appetite and
weight related to AIDS; nausea resulting from chemotherapy; and
glaucoma, a condition which according to Jewish law can potentially
endanger one's life.

What about non-life threatening situations? Advocates of medicinal
marijuana claim it is useful in treating a wide array of debilitating
but non-lethal maladies, ranging from chronic back pain to
fibromyalgia to migraine headaches. In theory, Judaism might also
permit the use of medicinal marijuana in such cases -- provided no
other effective remedy is available. It's difficult, however, to
generalize; the specific facts of each case would have to be analyzed
carefully before a ruling was issued. Nevertheless, it's worth noting
that the halachic obligation to heal is not limited to saving lives,
but extends to the alleviation of pain and suffering.

Would health risks associated with a drug be a factor in determining
its halachic permissibility? Two sources (the Beit Meir and the Shevut
Yaakov) allow the use of even hazardous drugs if the patient's death
seems imminent. Another source, the Sefer Hasidim, prohibits the use
of such substances unless all safe, conventional alternatives have
been tried. Opponents of medicinal marijuana laws argue that effective
alternatives are sometimes available. They also maintain that
marijuana is not necessarily benign and therefore its use should be
governed by sound medical evidence rather than ballot-box sentiment.
They say comprehensive clinical trials are lacking. Based on those
arguments, Judaism would be hesitant to allow the use of medical
marijuana in certain cases, especially where viable treatment
alternatives exist.

Complicating the discussion is the fact that our tradition encourages
Jews to be law-abiding citizens, a concept that can be traced to the
early Talmudic period when most Jews were living in exile. Under this
framework, Jews are required to give up some autonomy in order to help
preserve the social fabric by obeying secular laws, including those
that prohibit the distribution of controlled substances such as
marijuana. Judaism obviously would come down hard on the unregulated
use of hard drugs.

But there is a distinction here. As much as Judaism values a lawful
society, it places an even greater value on preserving and nurturing
life. That means there probably are select cases in which it would
permit the distribution of medicinal marijuana - under carefully
controlled circumstances, of course -- unless that would somehow cause
greater suffering than it would alleviate.