2018-05-09 / Editorial

Grappling with the issue of aid in dying to the terminally ill

By RABBI RICHARD F. ADDRESS

At present, the New Jersey legislature is examining a piece of legislation that will allow for terminally ill patients to choose the time of their death. This “Aid in Dying for the Terminally Ill” act, a version of which has been passed in several states and the District of Columbia, places the power of choice in the hands of the individual and their family. There are serious restrictions on who may obtain a prescription for this medication. The legislation, A1504 and S1072, allows for a terminally ill adult who is mentally capable, and who has a prognosis of six months or less to live, to ask for and get medication which would allow their life to end if the circumstances that surround their illness, become unbearable. It is not for everyone, nor is it meant to be. It is meant to be a means to provide another option to people and the option is recognized to be one of great importance, meaning, as well as spiritually and emotion- ally challenging. It is a piece of legislation that demands an encounter with the most powerful circumstances of one’s own life. I write in favor of this bill.

The reason for this position is based upon several factors. I am well aware of the positions of several religious groups, many of which are from our own Jewish community. I respect these positions, as they are based, for the most part, on a theological foundation rooted in traditional interpretations of Jewish texts. These hold that our bodies and life come as a gift from God and that the ultimate decisions about our body and life must evolve from God. My rabbinate, however, has been shaped by a different approach. All rabbis, regardless of their training, will affirm that the Torah, and all that this concept represents, is an evolving and changing concept. The differences between denominations rest on the issue of the ultimate authority for our actions as human beings. There are those who affirm, based on the belief in Divine Revelation, that the authority rests with God. Others, myself included, believe that the authority for our actions as human beings and Jews rests within the context of the community. Judaism, I believe, is very much a contextual religious civilization and its power and beauty, in many ways, rests within the belief that we are able to adapt and, at times, innovate new forms of Jewish practice, belief and life.

The choice in dying discussion is an example of how the different approaches exist. As part of my work with Jewish Sacred Aging, we regularly engage in discussions with congregations and organizations on how Judaism informs us on how to make a sacred decision as life ebbs. The mood of contemporary Judaism accepts the use of medication to relieve pain and suffering, even at the cost of shortening a life when that life is ending. That mood favors Hospice Care and Comfort Care. We are encouraged to allow a life to end in dignity and in sanctity. The challenge to us now is how far do we extend that “fence of Torah” given the continually emerging realities of medical technology. How much “choice” in extreme situations can the Jewish community accept? Is it my choice or God’s choice? Indeed, given the changes in medical technology and issues associated with the realities of long term illness and care, it may be time for our community to revisit traditional terms and categories that have been used to speak to the years, months and moments that lead to life’s end. Again, these are not easy questions and, I suggest, there needs to be an understanding that each case may be different, each context unique.

The reality of personal choice within the limitations of the current bill will create enormous challenges for our community. These are good and necessary challenges and we must not be afraid to meet them. This bill will require us to educate our people on what the tradition has to say about end of life decision making. We will need to teach our community the varieties of texts and the theological foundations for those texts. At present, the vast majority of American Jews do not know the richness of the tradition on this subject. They deserve to know what the texts say and to make their decisions based on that foundation. These discussions will hopefully lead to greater conversations within families regarding one’s wishes at life’s end. There are a plethora of documents and on-line resources to aid in these conversations, yet too few people actually engage in them. Again, the denominational moods accept the concept of an Advanced Directive, a health care power of attorney and the growing use of POLST (Physicians Order for Life Sustaining Treatment) forms. As medical technology continues to push the envelope of sustaining “life,” does it not make sense to provide the Jewish basis for decision making to our people? Yes, there will be differences of approach between different rabbis and denominations and all of that is good. There is no “one answer” and by teaching what we have to say we empower people to make the decisions that feel comfortable with them. The “slippery slope” that so many fear is the “slippery slope” of not knowing one’s options, rather than empowering people with information and, we hope, knowledge. s

Rabbi Richard F. Address, D. Min, is the founder and director of Jewish Sacred Aging, LLC, www.jewishsacredaging.com

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