M., 25, is about to die. The young haredi woman, who resides in an isolated community in Jerusalem, has been refusing to undergo an urgent hysterectomy to remove a tumor that has spread in her uterus because it will mean losing her ability to give birth.
M. was diagnosed with endometrial cancer over a year ago. The doctors told the young women, who has yet to give birth, that in order to save her life, they would have to remove her reproductive organs.
The surgical procedure in these cases of cancer, which rarely appears in women below the age of 40, usually requires the removal of the entire female reproductive system, including the ovaries and Fallopian tubes.
Other than losing the ability to give birth, side effects may include symptoms of menopause such as heat waves, dry skin, and mood swings.
Some women also have to undergo radiation therapy, chemotherapy and hormonal treatments in order to make sure the cancer does not come back.
When the doctors sat down with M. to explain the difficult procedure, they were surprised by her reaction – she simply announced she will not have her uterus removed and refused treatment of any kind.
For long months, the doctors tried to convince M. to undergo the surgery, to no avail. I cannot continue living if I cannot give birth, she told the doctors.
"It was heart wrenching," said one of the young woman's caregivers. "We all stood there, and were unable to do anything to reverse the death sentence she gave herself."
Without treatment, M's condition deteriorated and last week she was hospitalized at Shaare Zedek Medical Center in Jerusalem.
"Her tests indicate that the tumor has become large and aggressive," said head of the gynecology department at Shaare Zedek Prof. Uzzi Beller.
"The family did not realize the severity of the situation, and so we explained that there was no other choice, and we have to operate immediately. After our last conversation, in the presence of the parents and husband, and after reiterating the need for surgery, the patient simply got up and left the hospital," he said.
In light of the unique circumstances, the doctors decided to fight for M's life – even if it was against her own will.
Rabbi still contemplatingIn an unusual step, Doctor Rina Rosenberg of Clalit HMO requested to convene a national ethics committee that will discuss unconventional means to deal with the life-saving case.
The medical team asked the committee to find a solution that will allow giving the young women the necessary treatment.
An ethics committee including legal councils, doctors, social workers and the Chief Rabbi of Clalit HMO Menachem Rosenberg reviewed M's medical file and decided to approach the rabbi of the community where M. resides, despite her and her family's refusal to do during her hospitalization.
Recently, Rabbi Rosenberg met with the aforementioned rabbi, who requested a second opinion from a doctor affiliated with another hospital.
The doctor concurred with M's diagnosis, but as of Tuesday the rabbi has yet to rule on the matter.
On Tuesday, medical personnel tried to approach the young woman again, but the family said they refused to operate without a clear directive from the rabbi.
A Clalit HMO senior official said on Tuesday, "We will continue to do whatever we can in order to convince this young woman to undergo the operation that will save her life."
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