More than 50 people from the East Brunswick/Highland Park/Edison community came to the Young Israel of East Brunswick (YIEB) to learn about “Healthcare Proxies and End-of-Life Care for You and Your Parents: Halachically Informed Conversations With the People We Love” on Sunday, May 4. Presented by Bassie Taubes, attendees learned the basics and importance of having an understanding of the decisions that may be involved at the end of a person’s life. Taubes, a former oncology nurse, is currently the director of community outreach at Ematai, an organization dedicated to helping individuals and families navigate healthcare decisions guided by Jewish wisdom and halacha.

Sponsored by the YIEB sisterhood and put together by Faigie Cornick and Judy Goldrich, the YIEB program comes a week after a similar program was held in Highland Park at Congregation Ahavas Achim. According to Cornick, plans for the workshop had been in the making since February when the organizers met Taubes at the Ematai booth at the Chemed Medicine and Ethics conference in Connecticut.“I appreciate that the presentation acknowledges that Halacha and medical decisions can work in tandem. When dealing with sensitive issues, Halachic guidance can alleviate the fear and guilt of making a potentially wrong decision.”

Goldrich added that she hoped the material will be of help to the community as “the importance cannot be overstated. Every family will be confronted with an end-of-life situation, but it is the least covered topic.”

Following an introduction by Rabbi Yehoshua Hess of YIEB, Taubes began by acknowledging that the topic is somewhat depressing but extremely necessary. “The perspective of end of life in the medical community differs from the Jewish approach. Medical professionals often consider death to be the absence of brain activity and view things in the context of pain and suffering.”

Most Talmudic and post-Talmudic sages agree that the absence of spontaneous respiration is the only sign needed to determine death, while a minority opinion would also require cessation of heart action. But all would agree that dealing with decision-making in a time of crisis exacerbates the problems. Determining and documenting preferences for such concerns as pain management, levels of acceptable risk levels associated with medical procedures, organ donation, and who will make decisions for you in the event of incapacitation, are best done well in advance. Taubes presented a comprehensive sample ‘Healthcare Proxy and Directive’ and stressed that the document should be considered a starting point and can be updated, revised and changed as the document owner’s life may change moving forward.

While the documents provided are valid for use in most of the United States, consideration should be given when people have second homes. Israel, Canada and the United Kingdom have their own document requirements (available at the Ematai website: www.ematai.org) and those who live part of the year in different states should consider having a person close to each location serve as the healthcare proxy, rather than have someone make a medical decision from a thousand miles away.

Taubes stressed the importance of selecting the right person to be the decision-maker as a healthcare proxy. It is not necessary that the proxy be in the medical field or be related to the person they will be making the decisions for. It is necessary that the healthcare proxy be able to be firm in their decisions. Additional helpful tips include noting proxy alternates (important in case the primary person is unavailable), having one person with final say in decisions (other family members can have input in discussion, but only one person should make the decision), and listing rabbinical consultants (providing peace of mind for the proxy that decisions are made in compliance with Jewish law). None of the proxy determinations should be made in a vacuum; all family members should be made aware of who the proxy will be, and the proxy should be asked ahead of time if they will accept the responsibility.

Interestingly, the percentage of Jewish organ donors is higher than for any other group. Whether due to publicity by such groups as Renewal for kidney donation or other reasons, it is important to note on the proxy (or other organ donation) forms that any organ donation be done according to Jewish law and custom. As with the entire document, there are full, easy to understand directions for preparing and completing the proxy and directive.

Taubes closed by saying attendance at the presentation can be the icebreaker to begin discussing these issues with family members by starting with “I was at a presentation….” She cautioned not to bring the topic up randomly at other family events when the focus is elsewhere. Even with the entire family gathered for Thanksgiving dinner, bringing up sensitive topics during a festive time can cause more ill will than positive feedback. “Too often, people avoid difficult conversations about aging and end-of-life care—but these are the very moments that call for clarity, compassion and halachic guidance.”

Hess described the presentation subject as “one of the taboos of Jewish life. Nobody wants to discuss end of life. Forums such as this are important to bring the subject matter to our attention and help to recognize its importance in recognizing what our loved ones want.”

Highland Park’s Dr. Shira Goldberg, of VNA’s Visiting Physicians Services, said that “it is key to have the introspection and conversation ahead of time to be empowered to discuss things with your loved one’s medical care team and avoid the stressful moments involved in crisis decision-making.”

Gary Cornick, an elder care attorney, described the presentation as “incredibly valuable with information that is important for yourself, but [knowing your preferences] is also a great gift to your family.” A visit to the Ematai website can help make navigating any healthcare journey less difficult. The website lists valuable resources for patients/families and healthcare providers to learn more and plan ahead, as well as quick links to useful information. A hotline for information in real time is accessible at (646) 599-3895.

Deborah Melman is a staff writer at The Jewish Link.