Tough health decisions more important than ever in New York State

Halachic living will

By Tova Ross

Issue of March 26, 2010/ 11 Nissan 5770

The healthcare reform package that President Obama signed on Tuesday over bitter opposition isn’t the only medical game-changer to become law in recent days.

Governor David Paterson signed New York State’s Family Health Care Decision Act. It requires hospitals to grant the life and death power of medical proxy to a friend or family member of an unconscious patient.

Surrogates are empowered to make life-or-death decisions for the patient, including withholding food and water. Since such actions effectively kill a patient, Halacha (Jewish law) generally prohibits them. However, exceptions are possible and each case is different, making consultation with a qualified posek (Halachic decisor) essential.

However, there is no obligation on the part of a hospital to choose a proxy who would faithfully follow a patient’s unwritten wishes that the dictates of Halacha be followed in overseeing his care. For that reason, major Jewish groups, including Agudath Israel of America, opposed the new law and are now urging Orthodox Jews to make certain to sign a valid Halachic Living Will and health care proxy.

“You don’t have to look past the front pages of any newspaper to know that healthcare is a pressing issue for most Americans today,” said Agudah’s director of public affairs, Rabbi Avi Shafran. “Combined with the weakened economy, hospitals are looking to cut their budgets, and the financial implications of keeping people at the end of their lives alive is not conducive to cost-cutting measures, leading to a situation of life being devalued by some doctors and hospital administrators.”

“It is important for Orthodox Jews to take action so that their loved ones’ medical care is determined by them — not the state, and not hospital personnel,” Shafran warned.

A halachic living will is a document that clearly defines the wishes of a potential hospital patient should he or she become too ill to make decisions. That document can state what measures should be taken in that event, and which family member has the power to make decision on that patient’s behalf.

Recently, a hospital placed a “Do Not Resuscitate” designation on an elderly, incapacitated Orthodox woman, over the objections of her son, because the hospital claimed that is what the women expressed for herself before she became too ill to say otherwise. Had the son possessed a halachic living will beforehand, that scenario could have been avoided.

“Without a halachic living will, there is a risk that if you cannot make medical decision for yourself, decisions will be made on your behalf contrary to basic halachic principles,” said Robby Berman, founder and director of the Halachic Organ Donor Society.

Despite the importance of possessing any kind of healthcare proxy, the Orthodox Union estimates that only one in five Americans have taken measures to have a written document clearly stating their wishes for medical treatment in place.

While old age may seem far off in the future, it’s important to remember that accidents and many illnesses do not discriminate between young and old.

Frank Buchweitz, the Orthodox Union’s national director of community services, said, “In light of Governor Paterson’s actions, it is incumbent upon everyone, no matter what age or in health status, to write a healthcare proxy/living will so that their wishes are honored in accordance with halacha.”

Dr. Alex Mauskop, a third year resident at a hospital in New York City, has seen this play out, first-hand.

“In my relatively short time as a physician, I have already seen several cases of disagreement among family members as to the course of action for an incapacitated patient. Ensuring that patients have designated healthcare proxies in place before any potential accident or illness occurs can save a lot of heartache during what is often a difficult time for families.”