In an ideal medical world, patient care would mirror the teamwork of a baseball game. Just as players in the field collaborate to prevent the opposing side from scoring, a healthcare team would work together to ensure the best outcomes for their patient. The pitcher, catcher, infielders and outfielders have distinct roles, but their collective effort focuses on one goal: stopping the opposing team from scoring runs. Similarly, a multidisciplinary healthcare team—composed of a primary care doctor, specialists, nurses, social workers, dieticians and therapists—could proactively address the patient’s needs, each doing his or her assigned task, but in close conjunction with one another. This team would aim to prevent illness, halt disease progression, and mitigate long-term consequences, treating the whole person rather than isolated symptoms. While this level of care may seem impractical due to the high cost and scheduling challenges, it represents an ideal worth striving for.
As the director of community outreach for Ematai, I have been working with our executive committee to share our mission and vision within the Jewish community. Ematai envisions a world where individuals and families navigate the inevitable challenges of aging and end-of-life care in a framework that honors personal values and adheres to Halacha (Jewish law). True to our name, derived from the phrase “If not now, when?” Ematai encourages the prioritization of having proactive conversations about these sensitive topics, encouraging families to address them as acts of care and preparation in advance, rather than at times of crisis.
Our workshops empower participants with knowledge about healthcare proxies, ethical wills, and how to engage in meaningful discussions about aging and mortality. With this information, difficult conversations about illness and end-of-life issues can be transformed into practical, thoughtful and spiritual experiences. Our team includes Rabbi Dr. Shlomo Brody, our executive director, a sought-after scholar in the area of medical Halacha, ethics, organ donation and end-of-life care; and Rachel Secunda, PA-C, our associate director, who ensures that our content is research-driven, accessible and engaging. I am proud to work with these professionals and present interactive communal workshops on these subjects which are user-friendly, inviting and comfortable for all.
Recently, we adopted a multidisciplinary approach to educate the community on the complexities of end-of-life care. Using a panel format, we have presented realistic scenarios in various communities to illustrate the interplay of medical, emotional and halachic factors.
Take the case of Miriam, an 82-year-old woman with advanced heart failure and moderate dementia. Living in a skilled nursing facility, she has been hospitalized multiple times in recent months. Her condition is now end-stage, and her healthcare team has recommended palliative care. However, Miriam’s family is divided. Her daughter insists on continuing aggressive treatments to prolong her life, while her son advocates for hospice care to prioritize comfort and dignity. Miriam has no advance directive, and her own wishes thus remain unclear.
This is where a multidisciplinary approach becomes essential in addressing the complexities of end-of-life care. Each discipline brings a unique perspective, offering guidance and support to ensure a comprehensive approach.
Rabbinic guidance plays a crucial role in helping families navigate these deeply emotional and ethical dilemmas from the point of view of Jewish values and Halacha. A qualified rabbi can help the family balance the imperative of pikuach nefesh (the preservation of life) with the recognition that alleviating pain and suffering is also a significant Jewish value.
Medical expertise offers clarity about the realities of the situation and the potential outcomes of different courses of action. A palliative care physician or nurse can explain the progression of Miriam’s condition and outline what to expect as her heart failure worsens. They can discuss the benefits and risks of continued hospitalization and aggressive interventions versus a transition to comfort-focused care. By presenting these realities, the healthcare professional helps the family make informed decisions, emphasizing that palliative care can enhance comfort and dignity even without curative treatments.
Emotional support provided by a social worker or psychologist is critical for navigating the emotional strain that these decisions create. Families often experience intense emotions—grief, fear, guilt, and even resentment—when facing the imminent loss of a loved one. By facilitating meaningful dialogue, the family can be convinced to find common ground, reducing conflict and ensuring that decisions are made with empathy.
Together, these multidisciplinary voices provide a holistic approach to care, addressing not only Miriam’s physical condition but also the religious, emotional, ethical and spiritual dimensions. They underscore the necessity of collaboration among the experts in the various disciplines to ensure that the patient and family are supported comprehensively. This model highlights the fact that end-of-life care is not merely about managing symptoms or adhering to protocols; it is about honoring the patient’s humanity and wishes within the framework of Halacha.
By bringing these perspectives together, we educate the community about the importance of multidisciplinary cooperation to address the complexities of end-of-life care. It is an approach that adheres to Halacha, understands the medical realities, and cares for the patient and family with compassion and sensitivity.
On Sunday, January 12, at 8 p.m., Ematai, in partnership with Congregation Bnai Yeshurun and the RCBC, invites you to a panel discussion on end-of-life care at Bnai Yeshurun. For more information, please contact me at [email protected]. Let’s work together to create a compassionate, informed and Halacha-driven approach to healthcare and end-of-life decision-making. Let’s not be afraid to “talk about it.”
Bassie Taubes is the director of community outreach for Ematai, an organization dedicated to integrating Jewish wisdom into healthcare decision-making. She is the owner of Wellness Motivations in Teaneck, where she works as a health coach, fitness instructor and advocate for well-being. Additionally, Bassie serves as the rebbetzin of Congregation Zichron Mordechai in Teaneck, combining her professional expertise with her communal leadership role.
