Embracing Life & Facing Death:
A Jewish Guide to Palliative Care.
Authors:Brenner, Blanchard, Fins & Hirschfield
A 55 year-old man with leukemia asks, ?Should I continue with chemotherapy even though it doesn?t appear to be working?? A family taking care of a loved one with Alzheimer?s debates, ?What should we do in the case of an irreversible coma?? An 85 year-old woman with lung cancer wonders, ?Should I pursue an experimental treatment??
Millions of older Americans and their families now face these challenging ethical decisions about their medical care. Often, their concerns are related not only to the complications of aging, but also to the presence of a serious chronic or terminal illness. Yet, as the options in medical technology multiply, the questions become more complex: How do you balance the desire for ?quality of life? with a desire for longevity? What risks in experimental treatment are worth taking? How do you decide whether or not to let your doctor intervene in the last stages of terminal illness?
Now these critical issues are explored in a groundbreaking new book on palliative care for patients, their families, health professionals, religious and community leaders, and others. Embracing Life & Facing Death: A Jewish Guide to Palliative Care, written by CLAL Rabbis Daniel Brenner, Tsvi Blanchard and Brad Hirschfield, together with one of the U.S.?s outstanding physicians, Joseph J. Fins, M.D., Director of Medical Ethics at the New York- Presbyterian Weill Cornell Medical Center, combines the wisdom of the Jewish tradition with contemporary ethical and spiritual concerns in a reader-friendly format.
Acclaimed by Senator Joseph Lieberman in the Preface, the book has been described as a key addition to the palliative care movement. Covering such topics as pain management, the life cycle of illness, advance care planning, end-of-life ethics, and making peace, Embracing Life & Facing Death is an essential companion for those facing life-threatening illness ? particularly as the American population ages. ?Palliative care is becoming increasingly important as Americans live longer. In the next decade, the need for this type of care will increase five-fold,? said Rabbi Brenner, the director of the project.
?However,? he continued, ?while all religious traditions have a belief in the sanctity of life, they have very different approaches to end-of-life issues, including spiritual concerns, ways of coping with pain, ethical guidelines and ritual practices. Palliative care information is vital for anyone facing severe illness, but it is especially true for the Jewish community, which has a higher percentage of elderly members than the general public.?
Palliative care is defined as the best possible quality of life for the patient and family over the course of a life-threatening illness. As a new field of medicine, it helps patients and families face the difficult choices, assuring that comfort will be a priority, values and decisions will be respected, spiritual and psychosocial needs will be met, and practical support will be available. (American Board of Hospice and Palliative Medicine, 2000.)
?The role of palliative care is to find the right balance between cure and care,? stated Dr. Fins. ?While cure may eradicate disease or keep it at bay, care addresses the impacts that disease may have physiologically, psychologically and spiritually.?
Mixing Jewish humor, stories, personal experiences, and texts with professional medical perspectives, Embracing Life & Facing Death creates a framework in which patients and their families can evaluate decisions regarding the ?quantity? and ?quality? of care. Issues of forgiveness, reconciliation, and developing a new perspective are addressed, and a list of additional resources for hospice care, assisted-living, as well as Jewish resources is provided.
?In the Jewish tradition we learn that if people lived lives of purpose, integrity and meaning, they will have a more complete vision of themselves as they get closer to death, ? said Rabbi Blanchard, Ph.D. ?How they lived will provide the spiritual foundation for how they approach death, and it is important for caregivers to help them to reconnect to that vision.?