END OF LIFE ISSUES—7 DO’S AND DON’TS YOU MUST KNOW
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718-535-9061
1) Do learn as much as possible about your condition in order to get the best possible care.
If necessary, designate a family member to oversee your care and treatment, if you are unable to do so yourself. It is important for the patient and/or the designee to learn as much as possible about the condition to help get the best possible care, to learn about the Halachic ramifications of a selected course of care, to make decisions and interact with the medical professionals who are directly responsible for the care.
2) Do choose a Rabbi to be your Halachic advisor
In the event of an illness which chalilah, in the worst care scenario, may require end-of-life decisions, it is incumbent upon patients and their families to familiarize themselves with all potential options and to present these options to the family Rav, Posek, or a competent Halachic authority for guidance.
3) Do not relinquish your right to treatment without fully understanding what your treatment options are and how they may help you.
As a matter of policy, New York State gives patients significant rights with regard to their medical care. Health care facilities are required to accommodate “every patients civil and religious liberties” and must “encourage and assist in the fullest possible exercise of these rights”. To the extent that a patient’s religious beliefs mandate a certain course of treatment, the patient’s family may need assistance to have the health car facility accommodate those wishes.
4) Do not sign any of the hospital-offered advance care directives, or any such directives obtained from a lawyer’s office or other sources without consulting a Rav. Do sign a Halachic Medical Directive.
Advance directives typically include DNR (Do Not Resuscitate) and DNI (Do Not Intubate) orders. Be careful not to make decisions about any of these matters without consulting your Rav. The patient should sign an Agudath Israel of America Halachic Medical Directive. It helps ensure that all health care decisions for a patient will be made according to Halacha.
5) Do not accept an offer from your health professional to discuss end-of-life options unless your Halachic advisor is involved in the process.
Legislation was recently passed in New York State requiring doctors and nurses caring for patients diagnosed with a terminal illness to offer information and counseling on the available options for palliative and end-of-life care. You may legally decline this offer. If you do choose to accept the offer, it is vital that your Rav be involved in the counseling session.
6) Do not choose palliative care and/or hospice services unless the provider respects Halacha and considers the Rabbi an integral part of the team.
If you choose palliative care and/or hospice services according to Halacha, then nutrition, hydration, and other Halachic requirements should be provided. It is important to choose a palliative care/hospice that is sensitive to the needs of the religious patient, encourages the patient/family to consult with their Rav, or Halachic authority, considers the Rav an integral member of the team, will consult with your designated physician regarding the dosages for morphine or other pain killers, and where there is ongoing supervision to assure continued adherence to Halacha.
7) Do call Chayim Aruchim
For appropriate counseling and advice that is based on Halacha, or for a free copy of the Agudath Israel Halachic Medical Directive, plese contact the Chayim Aruchim Center for Culturally Sensitive End of Life Advocacy and Counseling. The program coordinator, Rabbi Aron Wajsfeld, can be reached directly at 718-535-9061 or by email at