Cultural Sensitivity + Government/Patient Advocacy + Halachic Guidance = Chayim Aruchim

It is possibly one of the most unique projects of Agudath Israel of America, where medicine, Torah, the legal system and government advocacy all come together, but at Chayim Aruchim walking fine lines and making the impossible happen are all in a day’s work.

old-eyesChayim Aruchim, the Center for Culturally Sensitive Health Advocacy and Counseling, was created in 2010 in response to the many calls that came into the Agudah office from individuals who felt that their loved ones were not getting the medical services they were entitled to, particularly in end of life situations. With the practice of medicine shifting away from doing everything possible to save a patient’s life towards evaluating if investing resources in a patient was a financially sound decision, more and more people were finding doctors willing to write off seriously ill patients, a decision that runs counter to halacha.

“When doctors feel that they can cure someone they do a very good job,” explained Rabbi Shmuel Lefkowitz, vice president of community services for Agudath Israel of America. “But when it comes to patients they can’t cure it suddenly becomes a very different story.”

Chayim Aruchim is a multi-faceted organization that operates on several levels. It focuses heavily on building relationships with physicians and medical institutions in order to improve cultural sensitivity and has also created the Machon, a 24 hour hotline manned by a group of seven rabbonim whose extensive medical and halachic training gives them the ability to render decisions on complex situations.

Because so many medical situations have legal components, high level government advocacy is another crucial element of Chayim Aruchim’s work. For many years, New York State’s Palliative Care Information Act required doctors to provide patients who were expected to die within six months with information and counseling about possible treatments but, inexplicably, only required doctors to present patients with a single course of action: palliative care, keeping patients as comfortable as possible, while making no attempt to improve their medical situation in any way.

Well known oncologist Dr. Yashar Hirshaut, a member of Chayim Aruchim’s medical advisory board, questioned why pain and symptom management was being presented to patients as their only choice, when aggressive care, pursuing all available medical options, might yield more productive results.

“Palliative care is just giving up,” said Rabbi Lefkowitz. “Why weren’t patients being given the option of choosing aggressive care?”

Chayim Aruchim concentrated its efforts on changing the Palliative Care Information Act to require doctors to present both options to patients, visiting with the chairman of the both the Assembly and the Senate’s health committee in Albany, as well as the State’s commissioner of health. All agreed that patients should be allowed to choose aggressive care and the bill was amended in February 2011 thanks to Chayim Aruchim’s intervention and the efforts of numerous elected officials.

Since that time, Chayim Aruchim has successfully intervened on behalf of many seriously ill patients who have been refused treatment on numerous instances, reminding physicians and hospitals of their legal obligation under the Palliative Care Information Act to allow patients to decide that they want to pursue appropriate medical treatment that is consistent with their wishes and beliefs.

Chayim Aruchim has also been involved in the fight against assisted suicide, which allows terminally ill, mentally stable patients to legally end their lives by taking a lethal dose of medication. The practice, which is already legal in five states, has raised considerable concern, with opponents noting that it sends a dangerous message that some lives are not worth living, could create a culture in the medical world that the value of life is measured in financial terms and potentially opens the door to legal abuse and discrimination against both the elderly and the disabled. Doctors have become increasingly worried by the growing movement in favor of assisted suicide which could place them in situations where they would legally be required to help patients end their own lives.

Chayim Aruchim has created a coalition with elected officials and the disabled community to fight this alarming and ever-growing trend.

“We are concerned that if seriously ill patients are legally allowed to legally end their lives, that hospitals will decide not to treat those patients,” said Rabbi Lefkowitz. “Once you have created an atmosphere that death is an option, then hospitals will feel that those patients lives aren’t worth anything. We are fighting very hard to prevent this from happening.”