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I would like to ask for advice regarding the proper wording (or point me to a template text) for a halachic and legally sound “advance directives” document . Surely there are thousands of similar advance directives, but all I can find on the internet is “determinations to be made according to Jewish law, within a strict Orthodox interpretation”. What does that even mean? There are all sort of Orthodox Rabbis, especially so in the USA, and besides, there are different legitimate opinions.
I do not wish to donate organs, I do not wish an autopsy, I wish to receive medical assistance and I do not wish “hospice” which we know what it really means (with a few notable exceptions usually paid out of pocket, e.g. Jimmy Carter), however, I wish the document to have enough flexibility to avoid a million or multimillion funeral or futile pocket-padding surgeries, you get the idea. Also, it should leave room for halachic exceptions, which are few and far apart and consequently very hard to predict in advance.
Also, I would very much appreciate it if someone would recommend a posek who would possibly be willing to be named. Of course, certain decisions are best left to family if possible, and they will first consult the Rabbi, but, not having a large family, perhaps it is best to add someone else’s name “in case of”.
Thank you very much
What does hospice entail?
Regarding the financial issues, why would avoiding extraneous expenses be problematic in any way?
Call Chayim Aruchim at 718-535-9061. If you specifically want a posek ask for Rabbi Ausch
Look for the group Ematai on line. They hold on line and in person events in assorted Frum communities dealing with these issues.
Having run a family law and estate practice for decades, I found them to be an invaluable resource in this area.
All these situations define we’d a serious Orthodox Rabbi who is also experienced in Health situations and situations between life and death.
Cause halachically even if a health situation will cost millions of dollars to heal with serious operations and surgeries etc …. A person is still never allowed to choose death versus life although every person is given the gift of free will and to make their freedom of choice but not to choose death versus life when it’s based on the reason of financial money cost millions to get healed
Versus if a person’s health situation is extremely painful-no money issues involved-to stay alive and nothing is helping the pain he is currently in the there are situations that halachically permit a person to end his or her life.
Approach your local Orthodox Rabbi who is also experienced in Health situations for serious issues like this
Hatzlacha rabba and refuah shleima to anyone worldwide who needs it
People have this misconception about hospice care. If you’re not terminal,with a life expectancy of less than 6 months or if you want care that will possibly prolong your life, you do not belong in hospice care.
Hospice care doesnt mean you are taking or ending your life. That is fear mongering.
What it does entail is making your final days as comfortable, and as pain free as possible. My mother in law was admitted to hospice dying from a failed heart valve ( she was frail, age 99 ) and couldn’t have survived valve replacement surgery. She received good care, never regained consciousness and passed after 4 days. Nothing was done to hasten her death.hospice = doctors want to give up and not do anything. Unplug all machines, move them to another facility where they’re not fed for a few days, and move on.
But it is pain free with the amount of morphine you give them I suppose so they can go unconscious.@JDF007
You got it all wrong.
It doesn’t mean doctors don’t want to do anything. It doesn’t mean a move to another facility in many cases.
It does not mean the patient is not fed.We had Hospice care at home for my late mother, and mother in-law.
Their bodies were worn out and they could not have survived any more medical procedures. They were allowed to pass in dignity in familiar surroundings with family present.
My MIL passed at 10 PM on the third day of hospice care. She actually had a light meal at 6 pm. She was given light doses of morphine to ease her pain.
My mother’s body gave out at 98. Her cancer had eaten away her intestines and free gases were killing her. There was no additional procedure that could save her. We brought her home to die with hospice care. She fell into a deep sleep an Hour after the transfer and died two hours later.These are hard questions, hope you have someone to guide you through this… note that hospital values may be different frm ours. They can say that a procedure is too risky for an old person. When questioned, they say 30% chance of failure. This is while it is clear that without the procedure the chance of failure is 100% … when posed this way, they reply, the department is not going to take this risk even if you sign off ..
Or they say quality of life will be low. ..
Can’t say whether this depends on the insurance you have
At the same time, it may not be necessary to start heroic procedures that will not really achieve anything but will be halachikally questionable to stop once started.Exctlawyer is exactly right. I don’t know where people like JD get their information from.
Patients aren’t forced into hospice, it’s their ( or their health care proxy’s) choice.
Doctors don’t give up; if anything they refuse to give up and want to to administer more powerful drugs or invasive surgeries.
Hospices don’t starve patients; that would be murder. My mil was on an IV. The goal of hospice is to make the patients last days as comfortable as possible. It’s difficult to be comfortable if your conscious and starving.Ex-CTLawyer – I speak from experience. That is exactly what they do/did. But that experience was in a very heavy openly christian values area, so maybe that is business as usual for them. I guess the lesson is don’t have any medical anything done by non-Jews in any non-Jewish area.
jdf007: Perhaps the most uninformed and dangerous post I’ve read here in a while. Sorry you may have personally had a really painful experience but the vast percentage of hospice care locations provide an incredibly important and vital service to the community and patients and their families in end-stage illness.
My experiences were at a Catholic hospital (hospital of choice where we lived in CT). No Jewish or government hospitals in the area and far better care than the university affiliated hospital.
As a family law trust attorney I dealt with hospices and associated issues for decades and did not run into what you experienced.
Certainly at the Catholic hospital every effort is made to keep the patient alive as long as possible.It is terrible to be put in the position to discontinue further medical procedures. It happened to me with the late Mrs. CTL. After coding three times in a few years, 140 surgeries, a dozen long term ICU stays in comas in life support, we were presented with one final medical procedure that could be attempted. Both the surgeon and nephrologist agreed with my observation that she could not survive the procedure. 100% medical opinion that she would die on the table in pain.
Decision made to start hospice care in ICU, remove artificial life support and let her die with me and daughters in dignity. Small doses of morphine to handle pain (not hasten death), she passed in two hours with no further suffering.The medical establishment would have been happy to keep billing insurance for things that could not have saved her life. Hashem had a way of let us know her time on earth was up
Just one note. There is a difference between hospice care in a facility and hospice at home. The hospice that my mil used offered both. The overall patient satisfaction rating was only 3 out of 5 stars , with in facility ( where my mil was ) getting 5 stars and at home getting 1 star. Why the difference? At home you still were responsible for hiring 24 hour aides, with all the complications if an aide cancelled . Similarly, doctors and nurses didn’t always show up on time. However, those issues never arise when you are in the physical hospice , where my mil received great care.
@anon
Different hospices, different rules.
The hospice agency we used in CT for in home, provided all the equipment and found the click arms, billing health insurance.
We hired no one and paid nothing out of pocketIn my area home hospice care schedules providers. This is a secular non profit. You can also choose to use their residential hospice program.
During my husbands last illness he chose home hospice. Their workers were professional, sensitive and compassionate.
EXCTL, as a lawyer, did you see differences between recommended paths for those with private insurance add-ons v. medicaid? This might show where the medical decisions are biased one way or another?
“EXCTL, as a lawyer”
Ex-lawyer.
(FTFY)
Apologies to CTL (the beginning of summer is slow.)
@AAQ
Absolutely no difference based on insurance
My mother was Title XIX Medicaid
MIL was traditional Medicare
Late wife a Medicare Advantage Plan through State ExchangeThree different hospice companies providing care
All at zero cost to patient providing a equipment and personnel
…………
Please look at ematai on line or Facebook
..
a childhood friend is director of the accociation of Hospices of the USA and has been invaluable proving guidance and law over the yearsHave you tried working with or making arrangements with the hospital clergy?
When my Mom was very sick in the hospital in Baltimore the Clergy was a Reform woman Rabbi. Seeing we were Frum she told us if we have any end of life questions she can call her go to Rabbi, Rav Heinemann to ask him about any issues.@UJM
I was asked to comment on experience in the past when I was a lawyer in CT
I am now an Ex-CT lawyer as I surrendered my license, but still licensed attorney in NY, MA and FLI just can’t legally identify as a lawyer in connection with the word Connecticut
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