Neilah: Medical Directives
It is Neilah and again I stand before you to speak, carrying on a tradition begun by Rabbi Aronson, of blessed memory, when he retired forty nine years ago. Each year this occasion provides an opportunity not only to say Shalom u’lhitraot “Good by, till we see each other again”, but also to put into words a thought to hold onto during the coming year.
The major topic on the public agenda is health care. It has resulted in a bitter debate that has sharply divided the American public. I would like to discuss one aspect this evening that I think has major implications for everyone. A proposal was made to pay a doctor to meet with a senior patient to discuss what course the patient would want to be followed if he or she is sick with a life threatening disease. Those opposed to the health care plan charged that this would be a death panel whose purpose it was to deny treatment to older patients and thereby to save the government money. The charge was meant to frighten the elderly into opposing the health care bill. I don’t know how successful this tactic will be, but I do think that all of us should try to understand the basic issue, for it touches each and every life.
I recently received a copy of the Minnesota Health Care Directive in the mail. My doctor sent it to me requesting that I read it carefully, fill it out and return it, for the Directive, gave me the right to control my health care decisions. The material in the booklet was not new to me, for the Committee on Jewish Law and Standards of the Conservative movement, which I chaired, had spent several years drawing up a Jewish Medical Directive for Health Care, which dealt with the same questions from a religious Jewish viewpoint.
The Medical Directive reflects two viewpoints, one adhering to a stringent viewpoint of the Halakha, Jewish law. The second incorporated a more lenient approach to medicine and Jewish law. The interesting thing was that the points of agreement vastly outweighed the differences. However, where they differ, the Jewish Medical Directive leaves the choice to the individual, who may instruct the person to whom he or she has given the power of attorney to make decisions should one be unconscious and not able to communicate with one’s physician.
When, I read about the proposal to pay for a meeting with a doctor to discuss end of life decisions I realized that it had been ten years since I last looked at the Medical Directive I had filled out. I decided that it was time to review the document. I set up a meeting for my family and myself with a doctor. We sat and reviewed both documents, the Jewish Medical Directive and the Minnesota Health Dare Directive. It was an eye opening experience. I read the directives as though they were entirely new. Even though the Jewish Medical Directive that I had filled out had not changed, I had grown older and looked at life in a different way. I filled out the documents again, and prepared copies for the family and for my physician. I now feel, more at ease as I face the future.
I believe that each of us, no matter our age, should use the stimulus provided by the current discussion on the Health Care Bill to review Medical directives and to make intelligent and informed decisions about what we want done if we are not able to communicate when we are seriously ill. We should share our thinking with the members of our family and with our physician.
Time is short, so at the beginning of the Jewish year 5770 Joan and I bid you farewell, for we will be leaving Minneapolis in several weeks for Maryland. In saying goodbye, I paraphrase Garrison Keeler, “Zei Gesund, Be well, do Mitzvot, good deeds, ulhitraot, stay in touch”.
