Promoting Options for the Dying


[Editor’s Note: This is the second of two or more entries looking at topics in the realms of ‘Planned Dying’, Suicide, ‘Assisted Suicide’, Euthanasia, and a ‘right to die’. These entries look at the subject from different perspectives. The thoughts expressed are those of the author(s), and do not necessarily reflect the positions (if any) of Expired and Inspired, the Gamliel Institute, or Kavod v’Nichum.]

The California State Legislature is having a Special Session on health care issues, which will include consideration of the End of Life Option Act, ABX2 15. Modeled after an Oregon statute, the Act would allow an individual with a terminal illness to obtain a prescription for medication that could hasten the end of his or her life. The bill was introduced partly in response to the action of Brittany Maynard, who moved from California to Oregon when she had terminal cancer in order to have the option of using the Oregon law to limit her end-of-life suffering. (She eventually did make use of that option.)

Death has become the subject of increased public discussion in recent years. As medical science has created more and more methods of extending life, many are looking at what the appropriate role should be for government and the medical establishment in determining, limiting, or expanding the choices that individuals make regarding end-of-life options.

Religious concerns often play a significant role in how people view their own end-of-life choices, but many people realize that, as with issues such as abortion, their own personal preferences need not govern their attitudes about what public policy should be. For instance, a woman can believe that she would never have an abortion, and yet strongly support the right of another woman to make a different choice. 

Similarly, while Jewish law often comes down strongly against what might be called suicide, the line between “assisted death” and palliative care is a fuzzy one. I (Dan) know this from my own experience from more than 35 years ago, when my late wife was dying. Doctors offered no hope for her recovery from a brain tumor that was draining every bit of her control over her body and causing her to moan, even through her near-coma state. But the doctor who treated her during her last months was reluctant to increase her pain medication. “It might kill her,” he said.

I was appreciative of the advocacy assistance I got at the time to help persuade the doctor to provide sufficient medication for pain relief. Eventually, he did authorize an increase in her morphine, and eventually, she did die. Did the morphine hasten her death? If so, was the increase still the right decision? Nobody will ever be sure of the answer to the first question, but for me (Dan), the answer to the second is as clear today as it was then. Prolonging her needless suffering was not what she wanted and not what I wanted for her.

For us, the deciding factor regarding the End of Life Options Act, as with abortion, is personal choice. Under the proposed legislation, nobody will be pushed into a decision he or she doesn’t want to make. There are numerous safeguards, including the requirement that the individual be able to self-administer the medication and obtain approval from two physicians (and a psychiatrist if there is a history of mental illness or depression in the individual’s record). The individual must make two oral requests, a minimum of 15 days apart, and a written request to his or her attending physician. All treatment and pain control options must be discussed. Patients must meet in private with medical evaluators, who are charged with deciding whether the individual is acting out of his or her own free will or being pressured by others to act.

In Oregon, roughly a third of those who have obtained prescriptions under the law have never used them, but they have drawn comfort from knowing that this option is available if their suffering becomes unbearable. Californians deserve the same choice.

 

Nina Fendel is a lawyer and legal educator. She has worked in a wide variety of areas of public interest law, including mental health and patients’ rights. She is co-author of California Workers’ Rights, published by the Center for Labor Research and Education at UC Berkeley.

 

Dan Fendel is co-founder of the Chevrah Kadisha at Temple Sinai in Oakland, CA. He is also co-author, with Rabbi Stuart Kelman, of both the Expanded Third Edition of Chesed Shel Emet: The Truest Act of Kindness: Exploring the Meaning of Taharah and Nichum Aveilim: A Guide for the Comforter; and lead organizer of the East Bay Chevrah Kadisha Consortium, which promotes cooperation and sharing of resources among the dozen or so Chevrah Kadisha groups in the greater Oakland/Berkeley area. He serves as Dean of Students of the Gamliel Institute, and is a member of the Board of Kavod v’Nichum.

 

  


 

UPCOMING GAMLIEL INSTITUTE COURSES

Starting in October:

Chevrah Kadisha: History, Origins, & Evolution (HOE). Classes weekly Tuesdays from October 13th to December 29th, 8-9:30 pm EST/5-6:30 pm PST (12 sessions), with an online orientation session Monday October 12th (same hours).

The course is an examination of the evolution of the institution of Chevrah Kadisha, starting from Biblical and Talmudic source texts, examining medieval development including the establishment of the “modern” Chevrah in Prague (1626) and on, through history and geography, as the institution was imported to  North America, including a focus on major developments beginning in the latter part of the 20th century. We will look at how the Chevrah has changed over time, with readings that include text study and emphasize history, sociology, politics, government, and many other factors.

Winter 2016:  

During the coming Winter semester, the Gamliel Insitute will be offering two courses. Chevrah Kadisha: Taharah & Shmirah (T&S), and Chevrah Kadisha: Ritual, Practices, & Liturgy [Other than Taharah] (RPL). These courses will begin in January, and will each run for 12 sessions. More information to come, or visit the “>Kavod v’Nichum website.

NEW CLASS TIME OPTION:

We are considering the options of either offering courses mid-day (East Coast time) or morning (West Coast time) as a convenience to those who have scheduling issues with the evening times now in use (including those overseas), or providing links to the recorded sessions of the evening classes (to be viewed at the student’s convenience) with a weekly online discussion section at another time of day. This is anticipated to be the same online format and material as the courses that have been offered in past, but at a time that works better for some than the evening (Eastern).

If you are interested in either of these options, please be in touch by November 1st to let us know: we need to assess the level of interest as we determine whether to incorporate these options. Contact us for more information about scholarships, or any other questions. info@jewish-funerals.org or call 410-733-3700.

You can “>jewish-funerals.org/gamreg.

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