How do you make a life-or-death-decision?

With medical care issues more and more on the front burner, there is a focus on the elderly. But health care issues are not just about the elderly, and serious or sudden illness can debilitate a family. A sudden injury, a childhood disease, a newborn infant with problems, and the like often force regular folks to make life-and-death decisions. And often they can’t because they don’t have all the information needed to do so. They are under stress, lack knowledge, and can only hope they make the right choices — and all of this is complicated further for Orthodox Jewish families, for whom halachah sets precedent. And that precedent is often different than one might imagine. It is not always the case, for example, that extreme measures need to be taken to save a life. Sometimes you need to let a person go. But how do you know when? And how do you decide?

Frank Buchweitz and others will discuss emergency medical decisions Saturday night.

To help people make these difficult decisions, and to prepare them for the worst, a conference on these serious life-and-death topics will be held Saturday evening at Congregation Bnai Yeshurun in Teaneck. A panel discussion will feature topics such as: Halachic Considerations with Rav Hershel Schachter; Ethical Wills/Trusts and Estates with Rabbi Shalom Baum; Medical Challenges and Concerns with Beth Popp, M.D.; Legal and Financial Aspects-with Eytan Kobre, Esq.; and Family Support Services with Rabbi Jay Yaakov Schwartz, MSW.

For me, these issues hit home.

My father, a fervently religious Orthodox Holocaust survivor was dying of cancer. He was just 66. My mother wanted doctors to give him a hyper-alimentation shunt — to insert a tube into his neck to feed him nutrients — to prolong his life. He was already on a respirator and in constant pain. His systems were failing. He was retaining fluid and his lungs were filling up. The morning my mother wanted the procedure, he told me, "Dayenu, it’s enough."

Six months earlier we had discussed my final exam in a Jewish ethics course I took at Brooklyn College. The questions raised on the exam included: Do you separate Siamese twins who share a heart and a half? Though most of the class didn’t know it, the subject had been thoroughly covered in The Record (Bergen County), when a decision was made to separate such twins born to an Orthodox Jewish family in Lakewood, NJ.

Rabbi Moshe Feinstein and his son-in-law, Rabbi Moshe Tendler made the decision to operate, and C. Everett Koop, later the Surgeon General of the United States, performed the surgery in Philadelphia. Both babies died. One immediately, and the other after prolonged suffering that included meningitis. This had not been the first such conjoined twins case. Another set of twins had been separated in Switzerland with the same results.

I told my father I disagreed with the rabbis, who supported the surgery, because the surgery seemed to cause living creatures incredible pain and suffering. The twins would have had some quality of life for about two years or more without it. I asked him to let me know when he’d had enough. He did.

But what about the halachah? According to Jewish law, could I prevent the prolonged suffering that my father would have had to endure if a shunt was inserted?

I called my old professor, an Orthodox Jew who was very well-respected for his knowledge.

"You do not put salt on a dying man’s lips," he said.

He listed chapter and verse from the Talmud and other sources about why extreme measures were not warranted in this case. Rabbi Feinstein was consulted, and the procedure wasn’t done. My father died a few days later in relative comfort and with dignity. But the kind of access I had to halachic information is rare. Hence the OU program at Bnai Yeshurun.

Frank Buchweitz, who organized the program, says good information is hard to find. It was the Terry Schiavo case that prompted him to set up a series of seminars with the Orthodox Union on exactly these issues. What he found when discussing the Schiavo case was that there was a tremendous lack of knowledge about what to do in case of a medical crisis.

Most people, he said, had no idea that they needed to make decisions that affected every area of their lives — from health care to finances to legal issues. "Education is power. And this," Buchweitz said, "is a form of empowerment. There are so many vital things at stake, including the patients’ life and the financial security of a family. Do you know what you are signing? What is a power of attorney? What does a DNR (do not resuscitate) really mean?"

For more information, call Buchweitz, the OU Director of Community Services, at (‘1′) 613-8188, or email frank@ou.org. For assistance on these issues contact Yedid Nefesh at (718) 759-434’ or Rabbi Jay Yaakov Schwartz at (718) 630-‘509. This is first in a series of educational programs on these issues. The conference will start at 8:15 p.m.

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