Rabbi Dr. Shlomo Brody, executive director of Ematai, will be in Teaneck speaking at Congregation Bnai Yeshurun on Sunday, June 11. The Jewish Link had the opportunity to speak with Rabbi Brody to discuss his organization and end-of-life issues through the lens of halacha.
Tell us about Ematai. How do you best define the organization’s mission, and what are its main goals and objectives?
Ematai (Ematai.org) was founded to enable Jewish families to navigate an increasingly complex health care journey, particularly in the dilemmas of aging and end-of-life treatment. Our name, Ematai, “If not now, when?”, is a call to action. We seek to upstream the necessary conversations that will facilitate meaningful choices later. Toward that goal, we offer many educational resources (videos, articles, webinars, lectures, etc.); individualized counseling for real-time questions or general advice for specific patients; and a range of advance planning tools, like Netivot, our new advance health care directive and conversation guide.
Ematai also explores the big moral questions that society needs to face as technological revolutions change the human experience. We are here to demonstrate how Jewish law and wisdom responds to the ethical dilemmas often found in health care innovation. To this highly relevant moral frontier, Ematai brings together leading rabbis, health care professionals, ethicists and communal leaders to represent Judaism with a wise and nuanced voice.
Why do you feel there is a need for an organization like Ematai in the Jewish world today?
As people age, medical interventions frequently raise difficult dilemmas, particularly when it comes to questions of weighing the possible benefits and harms from a certain treatment. Jewish families appreciate that the sanctity of life is a premier value. Yet we also understand that quality of life matters and that we don’t want to prolong or increase the pain and suffering of our loved ones. Ematai is here to help patients, their families, doctors and rabbis think about, through a halachic prism, the different pathways a person can take, particularly in the face of medical uncertainty.
Everyone instinctively wants to delay uncomfortable yet important conversations about our health care future for a later date—or to when it becomes urgent. We think that Judaism wants us to openly confront our mortality and start these conversations a bit earlier. This will help prevent some of the crisis decision-making in order to enable us to follow Jewish law and protect ourselves and our families from avoidable anxiety. Confronting mortality also allows us to think, well beyond medical questions, about the choices we can make to meaningfully live until age 120. This is why we ask: Ematai, “If Not Now, When?”
What is a living will, and why do you feel it is important for everyone to have one?
There are different models of a living will out there. We don’t believe in the model that tries to specify your preference for every given possible scenario and medical intervention. It’s impossible to predict all circumstances or how you would want to be treated in each one, especially since your preferences may also change. Our Netivot guide can protect your interests no matter what pathway your health care journey takes you on. Many studies, along with extensive anecdotal evidence from within our community, points to a Jewish living will to have two key components:
1. Advanced health care Directive: This is a formal legal document in which a person designates their proxy (and alternate backups) to make decisions if they can no longer make health care decisions for themselves. It declares to your medical providers that health care decisions should be guided by Jewish law and custom. We also allow a person to designate the rabbi you feel can best advise your proxy. Families have different rabbis in their lives. It’s important to clarify who should be called upon to help advise the proxy. Everyone over the age of 18 should complete this simple form.
2. Conversation Guide: As people age, providing the proper care for a patient often requires that the proxy, their rabbi, family and medical team know what matters most to the patient. We created a simple, easy-to-use conversation guide to help express what you believe is necessary to maintain a dignified life. This will help your proxy and rabbi to be aware of as many of your goals and preferences and to try to accurately apply them to each unique situation.
Together, the Netivot guide helps ensure your health care decisions will be made through a halachic prism, provide clarity to your loved ones and doctors, and prevent conflict or disagreements among family members.
Organ donation is a particularly controversial topic in the Orthodox Jewish world. What is Ematai’s position on the subject?
There is a major halachic debate on the criterion of respiratory brain-death. Ematai’s policy follows the lead of mainstream rabbis within the given area. Within the religious Zionist community in Israel, every single major Ashkenazic and Sephardic posek living today, following the lead of the Chief Rabbinate, supports posthumous organ donation after the determination of respiratory
brain-death. Rav Yaakov Ariel, Rav Shlomo Aviner, Rav Yosef Rimon, Rav Aryeh Stern, Rav Shlomo Amar, Rav Shmuel Eliyahu, Rabbi Dov Lior, Rabbi Yosef Carmel and Rabbi Re’em Hacohen all support organ donation. So we strongly encourage it within that community. No contemporary Haredi posek in Israel supports it, and so we wouldn’t push for it within that community. In Diaspora communities, there’s a deep divide on this issue and the matter became contentious.
Ematai’s policy respects all sides. We follow the lead of the Beth Din of Sydney (led by senior Chabad poskim), the Bet Din of Johannesburg (led by Haredi and Mizrachi dayanim), and the Office of the UK Chief Rabbi to allow people the choice to donate after discussing the issue with their rabbi and family members. This model has worked there, and we think can work well in North America, which doesn’t have centralized batei din. Jews who have lost their loved ones, frequently suddenly and unexpectedly, should be embraced by the community and provided with full emotional and halachic support regarding any decisions made on organ donation.
What is the role of health care providers vis-a-vis end-of-life issues, and how can we make them more aware of religious sensitivities that may exist?
Ematai believes that health care providers and rabbis can work in tandem, not in conflict, toward pursuing the patient’s interests, which include their religious values. Jewish law recognizes the expertise of health care professionals, while affirming that the Torah’s ethical teachings can wisely guide modern Jews in the complex dilemmas posed by 21st-century medicine. Modern medicine offers many powerful therapies whose implementation must be guided by an ethic that respects the dignity found in all creatures created in the Divine image.
At times, health care providers find themselves in tension with Jewish patients and their families. Sometimes these strains relate to typical conflicts that can occur with any patient or family. At other times, they relate to specific cultural sensitivities found within the Jewish community, where matters of life and death are thought about in distinct manners. Ematai is here to bridge that gap and make sure that Jewish patients get health care in consonance with our values.
Do you feel that rabbis receive enough training in rabbinical school about end-of-life issues? How can Ematai help fill the educational void, and provide additional resources to rabbis in this area?
Rabbis can play a critical role in their congregants’ health care journey. They provide pastoral counseling in challenging times, offer halachic guidance, visit the ill in their homes or hospital rooms, and comfort the bereaved. They are also frequently called upon to provide halachic guidance in helping people make complex choices regarding end-of-life care. Many rabbis have not received sufficient training for this role, and certainly not while in rabbinic school, when they aren’t yet interacting with real cases.
Ematai is committed to empowering rabbis with greater tools in counseling their members. Our continuing education programs will help provide them with a fuller understanding of the halachic, medical and emotional issues surrounding end-of-life care. Beyond our Netivot guide, our planned resources include help completing end-of-life care directives, webinars explaining different types of medical interventions, classes on positive communication skills with health care providers, and continuing training in pastoral care.
Who are some of the members of your medical advisory group and rabbinic advisory group? What role do you see them playing in the organization?
We’ve got an all-star rabbinic advisory group of leading figures in Jewish medical ethics who are all themselves doctors or regularly work within medical centers and are trusted by today’s senior poskim. Rabbi Prof. Avraham Steinberg, Rabbi Dr. Aaron Glatt, Rabbi Dr. Edward Reichman, Rabbi Dr. Jason Weiner, Rabbi Dr. Judah Goldberg, Rabbi Mordechai Torczyner, Dayan Yehoram Ulman, and Rabbi Dr. Avi Rosenberg are all on our rabbinic advisory board. The first names are all well-known experts to Jewish Link readers, while the latter two are major figures in Chabad circles who should be better known! Our excellent and growing medical advisory board are religious doctors who are experts in their fields and want to make sure that both health care providers and Jewish patients can get the best care in consonance with their values. Both of our advisory boards play critical roles in helping us set policy as well as helping in case-by-case consultations.
You have a real-time consultation program as part of your organization. How will that function?
Patients and their families, rabbis or doctors can sometimes need assistance on the spot. You can’t always reach your rabbi, posek or some other expert. Using today’s best technology, we can provide you with 24/7 immediate rabbinic assistance on life-and-death matters, including a way to immediately speak with your doctor. You can also book through our website a general consultation appointment over Zoom when you don’t have an immediate question but realize that you are nearing a health care journey crossroads and want to make sure you know the halachic options available. This helps avoid crisis decision-making and to ensure that all family members are on the same page. A good conversation goes a long way to reducing tension and ensuring that health care decisions are done according to halacha.
Rabbi Brody will be speaking at Congregation Bnai Yeshurun in Teaneck on Sunday, June 11 at 7 p.m.. He will be addressing end-of-life issues and halacha, and will be releasing a new advance health care document. For more information about Ematai, please visit www.Ematai.org
Michael Feldstein lives in Stamford, Connecticut, and is a contributing editor for The Jewish Link. He owns his own marketing consulting firm, MGF Marketing, and can be reached at [email protected].