Discussing End-of-Life Care Through a Jewish Lens
While 92 percent of Americans say it’s important to discuss their wishes for end-of-life care, only 32 percent have had such a conversation. Additionally, 95 percent of Americans say they would be willing to talk about their wishes and 53 percent even say they’d be relieved to discuss it. (The Conversation Project National Survey, 2018)
Many Jews think that to have a conversation about their end-of-life wishes with family members will cause undue anxiety, is inappropriate when one is alive and healthy and represents a lack of faith. Some may even be superstitious and consciously or unconsciously think that a conversation about how one wants to die may even cause one to become ill. They feel it is better to keep a positive frame of mind and deal with life ‘as it comes.’
However, nothing can be further from the truth. Failure to communicate one’s values to those they love most creates uncertainty as to how to make decisions in accordance with their values and needs. Furthermore, when families engage in these conversations, we not only learn much about their views on death, but also about how they see life. A comprehensive conversation includes their medical treatment options, what they hope their legacy will be — as well as how they want to be buried. Hear are some questions to discuss with your loved ones today: Here are some questions to discuss with your loved ones today:
• Do you have an ethical will that shares your vision?
• What are the things you love which make life worth living?
• Do you have an end-of-life plan that makes it clear to everyone where you want to spend your declining years and how you want to die? Do you want to be at home? Do you want to be in a hospital? Do you want to be in a hospice program?
• Do you have a will or estate plan that clarifies your wishes to avoid future moments of crisis, stress and family conflicts?
• Have you communicated your funeral wishes and made pre-arrangements?
We may not have immediate answers to each of these questions, but by discussing these topics with family members, clergy and trusted medical professionals our feelings will become clear. Planning ahead and considering these questions with ample time and space honors the sanctity of life. Further, the process makes room for an exploration of Jewish values, which can be used as a guide for sorting out the complexities of healthcare decisions and end-of-life care. Rather than making difficult choices hastily and under the pressure of a medical crisis, this important conversation can be done with trusted loved ones in a time and manner respectful to all involved. Jewish wisdom provides profound guidance that can have great impact when considered thoughtfully in conjunction with your personal values, goals and life choices.
Judaism teaches that studying and engaging in conversation about important issues is a way of clarifying values and deepening understanding. Openhearted dialogue strengthens individuals, relationships and entire communities. Honest and caring conversations about healthcare decisions follow the tradition of sacred dialogue. Many core Jewish texts include stories of people navigating possible courses of action based on their unique circumstances and experiences. This process is an apt model for Jewishly informed advanced care planning for the end of life.
The Story of Jacob
We first learn about the Jewish value of end of life decision-making from our patriarch Jacob. When the world was first created, the moment a person sneezed, he died. Before he died, there was no sign of illness or aging. Jacob prayed to God to grant him illness and as the Torah later states, it was granted. “Behold, your father is ill.” (Gen.48:1).
Why would one ever pray for illness or decline? Wouldn’t one prefer the sudden death? That Jacob wanted to be able to have the time to advise his children and to pass his values to the next generation. Indeed, the end of Genesis concludes with Jacob surrounded by his children, blessing them and detailing his burial wishes.
His vision may have been dimmed, but his life force was strong. Jacob, in death, was even more powerful than many in life. For this reason, the rabbis poetically state, “Jacob never died.”
Death is always tragic, but it is a fact of life. The question is whether we will have the courage to consider our own mortality and prepare ourselves for the final days. Will we own our own death, like Jacob, or will death own us?”
