By Sandy Eller

By Sandy Eller

With lifesaving medical equipment in short supply and pressures increasing to forego treating elderly patients, Chayim Aruchim is urging every member of the Jewish community to sign a halachic medical directive to ensure that their religious rights are protected should they become critically ill, rachmonah l’tzlan.

An unprecedented number of people have found themselves dealing with a gravely ill family member as the coronavirus continues to spread throughout the world. Shortages of ventilators have had doctors and medical institutions forced to prioritize their equipment, creating situations where life-or-death decisions need to be made, often by those who do not share our reverence for human life. By completing a halachic medical directive, members of the Jewish community can ensure that their wishes are recorded for the medical community in a legally binding document which also designates one individual as a decision maker and specifies their chosen rabbinical authority.

Currently, Chayim Aruchim’s website has downloadable halachic medical directives for residents of California, Colorado, Connecticut, Florida, Georgia, Illinois, Maryland, Massachusetts, Michigan, Minnesota, Missouri, New Jersey, New York, Ohio, Ontario, Pennsylvania, Quebec, Texas, Virginia and Wisconsin. Chayim Aruchim president Rabbi Shmuel Lefkowitz said that over the last few weeks, multiple patients have received lifesaving treatments only because one of their relatives was able to produce a signed halachic medical directive.

“We are currently experiencing a terrible health crisis and every member of Klal Yisroel should sign a halachic living will and have it witnessed today,” said Rabbi Lefkowitz. “We are fighting very powerful forces, especially today, and by having a medical directive in place a person can make their wishes clear and ensure that decisions being made for them are in keeping with their religious beliefs.”

To download a halachic medical directive visit Chayim Aruchim online at https://www.chayimaruchim.com/Medical-Directives/c-1-121/.

Mr. Roger Severino, Director of the Office for Civil Rights at the U.S. Department of Health and Human Services, attending a Chayim Aruchim conference about civil and religious rights for the elderly and the disabled.

Chayim Aruchim, a project of Agudath Israel of America, urges everyone over 18 to complete and have an advance medical directive to ensure that if someone needs medical treatment and cannot make decisions for themselves, that medical decisions will be made in accordance with halacha.

Rabbi Gedaliah Weinberger, Chairman of Chayim Aruchim said, “There have been many cases in which not having an advance medical directive has resulted in a dispute within a family as to what medical treatment to provide a patient, or disputes with a medical facility as to what care should be provided to a patient”.

Rivie Schwebel, Vice Chairman of Chayim Aruchim said, “An advance medical directive provides a clear statement of a patient’s wishes, and can avoid inter-family disputes and in many cases help avoid disputes with medical facilities”. The advance medical directive can be obtained by going to https://www.chayimaruchim.com/ and clicking on “Medical Directives”.

All states have laws that provide for individuals to execute an advance medical directive. Having an advance care directive is not a guarantee that the patient’s wishes will be followed, but it does provide the patient’s designated health care agent or proxy with a document that can help them if a dispute within a family or with a medical facility should arise.

Members of our community who live in or plan to seek medical treatment in Texas should be aware that Texas has a law that states that even if a patient or the person responsible for making health care decisions for the patient is requesting life-sustaining treatment, if the patient’s attending physician has decided that such treatment is not appropriate and the ethics committee of the health facility has affirmed that opinion, if the patient is not transferred to another facility that will provide the requested treatment, the facility has the legal right to withdraw life-sustaining treatment 10 days after the physician’s decision has been provided in writing to the patient or the patient’s health care representative.

Rabbi Shmuel Lefkowitz, President of Chayim Aruchim said, “If your relative is a patient in a hospital in Texas, it is very important to have a Halachic medical directive to designate who the patient wants making medical decisions for them, and having such a directive will give the patient’s health care decision maker a legal basis for advocating for the care the patient.”

Having spent the last several years advocating for the rights of critically ill patients in hospitals and other medical facilities all over the world, Chayim Aruchim took to Albany to speak personally with key elected officials about the importance of defeating proposed legislation that would legalize physician assisted suicide in New York State.

L- R: Rabbi Shmuel Blech, NYS Assemblyman Richard Gottfried, Dr. Dan Berman, Rabbi Berish Fried

Among those in attendance at the March 20^th meeting were Rabbi Shmuel Lefkowitz, vice president for community services at Agudath Israel of America, Dr. Daniel Berman, an infectious disease specialist practicing at Montefiore Medical Center, Rabbi Shmuel Blech, a leading Lakewood New Jersey rabbi and a member of the New Jersey State Legislature’s ethics committee, Assemblyman Richard Gottfried, chairman of the Assembly’s committee on health, Senator Diane Savino, Assemblywoman Amy Paulin, Rabbi Berish Fried, Chayim Aruchim’s New York State project director and Leon Goldenberg, member of the board of trustees, Agudath Israel of America.

After a brief introduction by Rabbi Lefkowitz who stressed the importance of viewing the issue of physician assisted suicide from an intellectual instead of an emotional perspective, Dr. Berman spoke passionately about analyzing the proposed legislation by weighing the associated risks with the expected benefits.

Referencing a study done by the Journal of Emergency Medicine, Dr. Berman explained that  there is a significant discrepancy between the preferences of healthy individuals who advocate for death with dignity, and the wishes of those who are living with severe medical issues. According to the study, only 18 percent of doctors and nurses said that they would want to live if they had sustained a debilitating spinal cord injury, while 92 percent of patients with that type of injury said that they would choose to go on living despite their medical challenges.

The lesson is clear, noted Dr. Berman.  Physicians often present options for medical treatment based on their own value system instead of considering their patient’s preferences, making it extremely risky to enact legislation that would allow doctors to be influenced by their own views when offering patients medical options.

Enacting legislation that would legalize physician assisted suicide in terminal patients is “a slippery slope,” warned Dr. Berman.  Several European countries who originally offered assisted suicide only to terminal patients  have now relaxed their criteria, offering euthanasia as a choice to those who are disabled, mentally ill or suffering from non-fatal illnesses.  Other alarming trends in the medical world are palliative care specialists who try to convince patients to end their lives and financial incentives being offered for hastening death in certain patients.

Dr. Berman concluded by drawing on his thirty years of experience with patients in end of life scenarios and noting that the risks of assisted suicide far outweigh the intended benefits.

The final presenter of the meeting was Rabbi Blech, who expressed his concerns that legalizing assisted suicide would undermine the sanctity of life while sending a clear message to the disabled and infirm that their lives have no value.

Enacting this legislation would give the vulnerable feelings of hopelessness and uselessness and could even be construed as intellectual intimidation, explained Rabbi Blech.  Even more disturbing is the notion that physician assisted suicide supporters appear to be motivated solely by the idea that a life that is less than perfect is not worth living.

“The moral compass, which forever remains steady, is now subject to the strange messages that we have allowed ourselves to communicate,” said Rabbi Blech. “We have unwittingly become the victims of a pervasive cultural sleight of hand.  I deeply respect the work that has gone into the preparation of this legislation … but yet cannot say in honesty that the reason for physician assisted suicide is the underlying illness suffered by the patient.”

Rabbi Blech also emphasized that for generations, optimism has been the hallmark of the United States, a quality that has allowed our country to enjoy unparalleled success in a relatively short period of time.  Rabbi Blech mentioned several prominent Americans who rose above significant challenges to live remarkable lives;  Helen Keller triumphed over multiple handicaps in her lifetime, but if she were living today, death with dignity advocates would likely attempt to persuade her to end her life because of her physical shortcomings.

That same American spirit of positivity was evident during Rabbi Blech’s formative years.

“Challenges were opportunities for growth,” said Rabbi Blech. “This is the message that I received and one that I would like to transmit to my children.”

Dealing with life and death issues brings with it great responsibility, one that should not be taken lightly, advised Rabbi Blech.

“We must proceed with great caution, with the full realization of the enormous consequences that our decision may affect,” said Rabbi Blech.

On Monday over 30 local rabbis gathered at Cedars-Sinai Medical Center to participate in a workshop about medical issues and Jewish law. The program was sponsored by Chayim Aruchim, the Rabbinical Council of California, Ateres Avigail of Los Angeles, and Cedars-Sinai Medical Center’s Spiritual Care Department.

Rabbi Jason Weiner of Cedars-Sinai, welcomed everyone to the conference and explained its importance and relevance. Chayim Aruchim’s senior counselor, Rabbi Eliezer Gewirtzman of Lakewood, New Jersey, provided in-depth training. In addition to reviewing common medical questions and strategies for navigating hospitals and the healthcare system, the 5-hour session covered many complex medical conditions. The attendees praised for this important and engaging gathering and are already organizing further similar sessions.

Chayim Aruchim is Agudath Israel’s center for culturally sensitive health advocacy and counseling. It receives over 350 calls a month to assist with complicated medical situations, ensure Jewish patients are treated in accordance with Jewish law, and answer complex questions.

(Author: Rabbi Shmuel Lefkowitz, Vice President for Community Services)