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Important Conversations about Health Care


Articles in the media are recommending a certain kind of “conversation.” In an article in the Philadelphia Inquirer in 2010, Michael Vitez describes in detail how a palliative care team brought a family into a comfortable living room for repeated discussions about their mother who had been hospitalized for confusion and falling. Over and over again, they were offered the choice of discontinuing her “aggressive” medical care, but the family held out. They continued her medical treatment.

But in spite of the fact that their mother eventually woke up and went home, the family is not being held up as a good example. Rather, their decisions are being questioned. The article implies, look what they put her through, look how much it cost. A palliative nurse is quoted as having raised a “hard question,” whether her treatment was worthwhile, because maybe she’d end up in a nursing home.

The contrast with our Jewish beliefs could not be greater. We believe that life is precious in or out of a nursing home. In fact, we believe that the treatment would be worthwhile even if it just extended her life for a few minutes. Moreover we believe that omitting this woman’s treatment would have been tantamount to murder.

Make no mistake. This is a war of ideas.

The reasoning of the palliative nurse and the innuendos in the newspaper article about the woman’s suffering and the expenses are, to us as Jews, completely unacceptable.

Since, to us, letting her die would have been equivalent to murder, it is truly preposterous to assert that sending anyone to a nursing home is so terrible that a family should consider letting a patient die for that reason.

Even the palliative care nurse doesn’t really believe that. Would they agree to put to death everybody who needs a nursing home? Of course not.

But, having long, seemingly intimate discussions with medical professionals on various questions like this confuses a family, and is intended to create a feeling that it would be rude to refuse to compromise.

So what if the expenses were so high? That happens sometimes in a difficult case. They paid their premiums. They’re entitled to treatment. That’s what medical insurance is supposed to do – pay for expensive treatment.

Why does our society take the amount of the bill so seriously? No one would claim that we don’t need all this expensive testing equipment in the hospital. It doesn’t really cost the hospital a large amount every time they use the equipment. Her test didn’t wear the machine out. It will still be there for others. The amount paid for her treatment didn’t really go just for her treatment – it funds the hospital which is doing all sorts of good things for other patients as well.

Families facing this sort of pressure shouldn’t think, “We are being selfish. We’re making our loved one suffer and costing society a bundle to satisfy our own beliefs.” That is the secular view.

Instead, they could be inspired to think, “G-d loves the Jewish people. He gave us the rules that are the best not just for us but also for the entire world. It is not for the doctor or any human to determine when someone will die. We are not allowed to acquiesce in the taking of a human life or to sign a document to deprive a human being of what he needs to survive. Maybe my loved one will die or maybe he will live, but that is not my choice. All I can do is follow the Torah.”

The important questions for the family to consider should be: “Which Rabbi should I tell about my loved one’s medical problem so that he can help us if we have a medical decision to make?” “Has my loved one signed a halachic health care directive indicating that he wants to be treated according to Jewish law as interpreted by our Rabbi?” “If my loved one ends up in a nursing home, how can I make his life as happy as possible?”

Our job is to help our loved ones get medical care, visit them, take care of them, encourage them, and pray for them.

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Articles in the media are recommending a certain kind of “conversation.” In an article in the Philadelphia Inquirer in 2010, Michael Vitez describes in detail how a palliative care team brought a family into a comfortable living room for repeated discussions about their mother who had been hospitalized for confusion and falling. Over and over again, they were offered the choice of discontinuing her “aggressive” medical care, but the family held out. They continued her medical treatment.

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