Thinking Ahead

My attorney, Irwin Goldring, is a wise man. Never pushy, never alarming. Fifty years in estate planning, you learn something about people.

"Hey, for me this is just a questionnaire," he tells me. "For you, it’s something more."

I’ll say. Irwin has sent me two legal forms stating when and who can act on my behalf, if need be. All I have to do is make choices, name names. I call these "thinking ahead" forms, a way of facing now what I might not later on. Five times he tells me, "May these forms never be needed."

Still, even hypothetically, it’s not so simple. How do I feel about life-sustaining technology? At what point, if ever, would food and water be a form of futile prolonging of life?

And what about hope? For loved ones, does it ever end? But would I want them to wait forever? Under what circumstances would I stop hoping to be "healed" and desire only kindness and care?

"I want to live my life with dignity and for my loved ones to have pleasant memories of my final days," reads the form called "advanced health care directive." Yes, indeed.

It’s not lung cancer, or at least not cancer alone, which gives these matters their urgency. It’s living. You’d think that as a middle-aged woman, I’d have faced it before: life’s a crapshoot. But reading Irwin’s forms, I try to imagine the potential decisions my legal designees might have to make on my behalf, and my heart is filled with gratitude, well in advance. May their judgment never be needed.

Can we talk about death? It sure is asking a lot. It’s easier to discuss sex, or money, or God — all famous sources of argument, disagreement and despair, but whose province lies squarely in life.

My husband, whose 15th yarhzeit I mark this week, denied the possibility of death, even from his hospital room. Never once uttered the word. Macho, maybe. Self-contained, perhaps. Fearful, certainly.

He continued to practice law from his bedside briefcase, between bouts of heart failure. He made out a will for his personal property. But he protested all the way. The subject was depressing, he said. It implied a lack of confidence in his immortality.

Now it’s my turn. My husband’s choice is not mine. I have my motives for talking about death here and now.

First, maybe I can be like the biblical Isaac, who grabs hold of his terrors of dying, prematurely blesses his sons and then lives a good, long time. Isaac knew that one way to get beyond anxiety is to deal with it.

Second, I want you, dear readers, to talk to each other about the Big D.

We are living in such a high-tech age, in which confusion over end-of-life issues grows by the day. Ignoring the challenge does not help. Yet vulnerability keeps us silent. Facing end-of-life issues, we know exactly how little we know.

These forms are important insurance against fate. The ancients feared death, as the Psalmist writes, "on that day his plans come to nothing." But we moderns rightly fear death in the midst of life. We cannot solve this by denial, and must be ready with surrogates to protect us against life on a tube.

For Jews across the denominational spectrum, the spiritual challenge can become intense. What is God’s will? Have I a right to prolong or shorten life by providing an antibiotic or refusing a respirator? Where there is no right and wrong, an open heart and clear thinking can go a long way.

I am sitting in the park with my friend, Dr. Ken Leeds. For 10 years, Leeds was on a Cedars-Sinai bioethics committee, applying Jewish values to end-of-life issues.

"Where things go wrong," Leeds tells me, "is when people don’t talk to each other. If there’s a disagreement in understanding what the patient wants, it leads to trouble." In the absence of agreement, the doctor is often put in the middle, opting to maintain life against the patient’s desire. It can turn ugly.

None of us should be alone in these difficult decisions. End the death taboo. Do not expect to have all the answers at once, but do get started. Get your forms in order. Talk to a rabbi. Talk to your children. Start the conversation. Discussion brings light.

And may your plans, once resolved, never be needed.