Preparing for the worst
I was overwhelmed by the excellent and timely article by Johanna Ginsberg, “A Jewish right to die?” (April 4). The halachic approach (be it Orthodox, Conservative, or Reform) is that we do not control our “own” bodies. This view pits halachic-minded Jews against the western court-sanctioned and ethically sound notions of autonomy.
Far be it from me to take issue with Rabbis Faith Joy Dantowitz and Mark Mallach, who may see some wiggle room in the autonomy question and allow a different interpretation of what Judaism “allows” based on dignity and avoiding suffering. I’ve known them each to be humane, devoted, and ethical leaders of our community.
The push in so many states, including N.J., for assisted euthanasia represents to me a failure of medical care so I would have to side with Rabbi Benjamin Adler of Adath Israel. I applaud his suggestion that we support palliative care (and I would add hospice) by all means necessary so that in his words, “terminally ill patients can live out their final days in comfort, peace, and dignity.”
I would like to add a few points. Thank goodness, most hospitals in the U.S. now offer palliative care options and/or hospice but it sometimes takes the squeaky wheel to avail oneself of these services. The doctors and medical staff — whether because of their own biases or being too caught up with the exigencies of their own days to stop and see the big picture — sometimes passively or actively resist “end of life care.” Therefore, it is often on the patient and/or family to seek out this option of care.
Even when it comes to aggressive medication to control pain, some doctors resist. The opioid epidemic, which is all too real, has in my opinion become an excuse that some use not to prescribe when the medications are in fact medically indicated. Once again, the family and patient must seek these out if the medical team is resistant. There are nurses, nurse practitioners, administrators, and patient advocates who can run interference and breach the divide (if all else fails, email me at firstname.lastname@example.org for how best to understand your options).
It also takes two to tango, and as many times as I have seen the physician be the obstacle to appropriate medical care for the profoundly ill, I have also seen families unable to deal with irreversible decline and the eventuality of death. To help them, I articulate stock phrases like “hope for the best but prepare for the worst” or “no one lives forever.” I only hope and pray for the time when the medical community and the lay community can meet somewhere in the middle.
Dr. Joshua Schor
Medical director, Daughters of Israel