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Grappling With a Nightmare, Hamodia
The Hamodia Editorial Page presents a concise overview of the pressing concerns that create the need for a Halachic Living Will.

By Yekusiel
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 EDITORIAL                                                                                        

Grappling With a Nightmare

It’s a family’s nightmare.

An elderly grandmother is hospitalized in critical condition. The much-adored bubby is no longer able to recite her beloved Tehillimor even communicate with her chil- dren. The doctors, having given up hope of recovery, are urging that a Do Not

In addition, it is crucial that all decisions in these areas are guided exclusively by halachah, and not by the personal — and often mistaken — beliefs of individuals, whether they are patients, family members or medical professionals.

As Mordechai Biser Esq., the Associate

 LETTERS                                                                                           

Keeping Up With the Times, Halachically

Resuscitate order be signed.

Family members are torn. On one hand they can’t bear to watch their grandmother suffering, and they are tormented by the idea of putting her on a respirator. On the other hand, they are desperate to keep her alive, with them, in this temporal world.

Down the hall in the same hospital lies a frumman. He has fought tenaciously for years with what doctors insist on referring to as a terminal illness. As he drifts in and out of consciousness, his family and the medical team are grappling with similar questions: At what point should they stop giving him treatment that is causing him so much discomfort? Should he be placed on a feeding tube?

These issues are difficult to read about, and even more difficult to talk about. It is a depressing topic, one that we all daven should be only theoretical.

But it is a topic that must be addressed.

During the recent acrimonious debate surrounding the health-care bill, one oft- heard charge was that the bill would bring in its wake “death panels,” bureaucrats who would decide, based on a subjective judg- ment of their “level of productivity in socie- ty,” whether patients were still entitled to health-care treatment. “They are pulling the plug on Granny” was a rallying cry in the long

General Counsel of Agudath Israel pointed out in a formal comment on the regulation, the bottom line is that decisions involving withdrawing or not providing care and treat- ment are ethical and not medical decisions. Individuals should be free to make their own choices, rather than being pressured by doc- tors into making choices that conform to the doctor’s personal preferences.

Every frumYid, regardless of age or med- ical condition, ought to fill out a Halachic Medical Directive,a document prepared by Agudath Israel of America. On this form, to be signed by the individual and two witness- es, one names an agent who will make med- ical decisions on his or her behalf in the event of incapacitation. The form specifies that all end-of-life and post-mortem deci- sions will be decided according to halachah, and leaves space for the name of the Rav who is to be consulted.

Signing a directive that differs in content and direction from the halachic one could have disastrous consequences. Halachic questions regarding the end of life are com- plex, and call for a comprehensive under- standing of halachahas well as medical ter- minology. For instance, where there is a halachic obligation to resuscitate, the pre- mature signing of a DNR order can be tanta- mount to taking a life. In other situations a

Hamodiahas reported the TSA’s recent imposition of full-body screening and/or aggressive pat-downs of passengers at U.S. airports. Yet I do not believe there has been any serious discussion about the appropri- ateness of these measures from a halachic perspective. Our community strives to be assiduous in shemiras hamitzvos and must frequently address the challenges new tech- nologies create for the frum public. To date, we have not focused on the halachic implica- tions of these draconian travel restrictions.

How does full-body scanning fit with the laws of tznius? What images are produced by the scanners? Who has access to them? Even if scanners are equipped with software to protect, in some small measure, the privacy of passengers, how secure are those safe- guards? What is the protocol for pat-downs? Who administers them? Where are they done? How invasive are they permitted to be? Gender issues? What impact will radia- tion exposure have on our health? And so on…

We have a sacred responsibility to investi- gate and seek halachic direction and guid- ance as to how to proceed. As a start, the national Orthodox rabbinic leadership

ought to meet with John Pistole, TSA Administrator, to find out the parameters and methods of implementation of these new regulations. Then our Gedolim could be in a position to pasken on the she’eilos raised. True, the outcome of inquiry might be unpleasant — perhaps air travel will no longer be acceptable, except under extenu- ating circumstances — but that should not stop us from finding out the facts and reach- ing the proper halachic conclusions.

This is not a matter of convenience, but of maintaining our Torah standards in the face of a new and problem-creating reality. The secular world is rightly showing concern about the Constitutional and health implica- tions of these new measures. These points are certainly legitimate. For our part, should we not be pursuing our unique halachic mandate with at least the same intensity of purpose?

Rabbi Daniel Greer Menahel, Yeshivah of New Haven

New Haven, CT

Ed. note: Please see Agudath Israel’s relat- ed opinion on page D31.

but eventually unsuccessful attempt to block passage of the bill.

DNR order may be appropriate. Only a com- petent halachic authority can guide patients’

The Man Behind Peninim Al HaTorah, Living Memorial

In reality, the clause referred to didn’t call for any sort of death panels, but rather allowed Medicare to pay doctors to give con- sultations about end-of-life care. The clause was dropped from the law that was signed by the President, but the Obama administra- tion has quietly accomplished the same intent by including it as part of a Medicare regulation.

The new rule says that as part of the rou- tine annual examination, Medicare will cover “voluntary advanced care planning” to discuss end-of-life treatment. Doctors will

families.

A family member or close friend should be appointed to act on behalf of the patient, someone who is familiar with medical terms so he knows how and what to ask the posek.

Agudath Israel has announced a new project, Chayim Aruchim, to assist individu- als and families facing difficult end-of-life challenges.

A joint effort of askanim,attorneys, and prominent Rabbanim with expertise in this field, Chayim Aruchim is a center for cultur- ally sensitive end-of-life advocacy and coun-

I read with great interest the article about Rav Dessler and the Hebrew Academy of Cleveland. As a former Clevelander and an Academy alumnus, I was happy to see the school get its due respect as a leader in Jewish education.

However, the article does not give recog- nition to a person whose accomplishments are mentioned in it.

The person behind Peninim Al HaTorah

and The Living Memorial project is my rebbi,Rabbi A. Leib Scheinbaum. Rabbi Scheinbaum has been writing the Peninim for 20 years, and has worked tirelessly on the Living Memorial project along with a great group of people. I think that it’s only proper to mention him in discussing these great achievements.

NL

be paid to provide information to patients on how to prepare an “advance directive,” clari-

seling. It works with health-care providers to ensure that decisions are implemented in

Refurbishing Jewish Cemetery

fying how aggressively they wish to be treat- ed if they fall so ill that they can no longer make health-care decisions for themselves.

While this is a far cry from the “death pan- els” depicted by some of the administration’s critics, some aspects of this regulation are cause for concern.

For one thing, having detailed discussions about end-of-life matters with elderly indi- viduals or with the seriously ill could be harmful to their health. Even if it is approached in a tactful and sensitive way, talk of respirators, resuscitation, and feeding tubes could cause tension and depression. A patient may easily misunderstand and think his situation is far more dire than it really is, and that fear alone could bring the end clos- er.

accordance with halachah, and can put the family in touch with knowledgeable poskim. If a hospital says it can no longer help the ter- minally ill patient, Chayim Aruchim will help find a setting in the New York area that will .

This resource will be of great assistance and comfort for those who may need it.

Please be aware that there are people in our community with no immediate family; distant relatives and even acquaintances have to provide care and guidance. We can- not rely on the assumption that “someone” is taking care of it (“someone” may be making the same assumption about you!).

May all the ill merit a full recovery, and may all of Klal Yisraelmerit good health and happiness.

It was with great pleasure that I read your recent article about the life of Reb Menachem Mendel of Visheve. I would like to add a footnote.

My family has undertaken the costly project of refurbishing the Visheve beis hachaim,with its 1300-1500 matzeivos. Many illustrious people are buried there. (At his petirahReb Menachem Mendel was buried there as well, though after the war his aronwas moved to Eretz Yisrael.)

Hamodia welcomes letters to the editor but can only print submissions that come with a name, address and phone number. Names will be withheld upon request. Submissions can be sent to

Hamodia via regular mail, or via e-mail to letters@hamodia.com. We reserve the right to edit letters.

Last summer most of a new concrete fence was installed, and 200 matzeivos

received new cement foundations. This past November, work commenced clearing the remaining underbrush. We would like to complete the restoration of the remain- ing matzeivos.

For further information, please email us at aimprogram@aol.com. Tax- deductible donations may be made out to “Avoseinu” and sent to Chaim Bruder, 145 Mineral Spring Avenue, Passaic, N.J. 07055. Thank you very much.

C.Bruder

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