By Rabbi Yerachmiel D. Fried

Dear Rabbi Fried,

With our mother/mother-in-law in an advanced state of dementia, we have spent a lot of time discussing the question of quality of life. It would help us a lot to understand the Jewish value of life even when life seems not to have any further worth, importance or significance.

— Eunice and Joseph J.
Dear Eunice and Joseph,
First of all, let me extend my prayers to your family — dementia is difficult to experience in a loved one.
Judaism teaches the inherent priceless value of human life no matter its present “quality.” The western culture’s concept of “quality of life” is anathema to traditional halachah, or Jewish law. For example, one is allowed and even commanded to desecrate the Sabbath (one of the greatest of all prohibitions in Jewish law) to save the life of another even if that person will never live to fulfill another Sabbath or perform any meaningful act. The priceless value of “chayei sha’ah” or even a fleeting moment of life, supersedes even the all-important mitzvah of Shabbos.
Allow me to quote the moving words of the renowned psychiatrist and Holocaust survivor, Dr. Victor Frankl at the closing of his book “Man’s Search for Meaning,” which capture the Jewish outlook on this subject: “ … life’s meaning is an unconditional one … that unconditional meaning, however, is paralleled by the unconditional value of each and every person. It is that which warrants the indelible quality of the dignity of man. Just as life remains potentially meaningful under any conditions, even those which are most miserable, so too does the value of each and every person stay with him or her, and it does so because it is based on the values that her or she has realized in the past, and is not contingent on the usefulness that he or she may or may not retain in the present.”
He further writes “…this usefulness is usually defined in terms of functioning for the benefit of society. But today’s society is characterized by achievement orientation, and consequently it adores people who are successful and happy and, in particular, it adores the young. It virtually ignores the value of all those who are otherwise, and in so doing blurs the decisive difference between being valuable in the sense of dignity and being valuable in the sense of usefulness. If one is not cognizant of this difference and holds that an individual’s value stems only from his present usefulness…one owes it only to personal inconsistency not to plead for euthanasia along the lines of Hitler’s program, that is to say, “mercy” killing of all those who have lost there social usefulness, be it because of old age, incurable illness, mental deterioration, or whatever handicap they may suffer.”
Dr. Frankl goes on to suggest that “confounding the dignity of man with the mere usefulness arises from a conceptual confusion that in turn may be traced back to the contemporary nihilism transmitted on many an academic campus and many an analytical couch… ”
Indeed, Dr. Frankl’s entire book is an amazing testimony to life’s potentially holding great meaning even in the the most horrific situations one could think of. This attests to his deep Jewish roots where, in our tradition, life is inherently priceless.
Now, having said this, I will add that this is the general Jewish outlook on the meaning of life, that life is to be treasured at all costs even when, as you say, a life may not seem to have much worth or importance. But I would also suggest that, in your specific situation, you discuss this issue with your rabbi or contact an expert rabbinical authority. They can provide further clarification about the Judaic view that would make sense to your family.
Rabbi Yerachmiel D. Fried, noted scholar and author of numerous works on Jewish law, philosophy and Talmud, is founder and dean of DATA, the Dallas Kollel. Questions can be sent to him at yfried@sbcglobal.net.