By Moshe Borowski, LMSW
A Modern-Day Purim Miracle. Sylvia S., 78, has been beset with severe psychiatric issues for much of her life. While she never married, and her mental-health issues became progressively more debilitating, she managed to live on her own, while her siblings and their children kept in steadfast contact throughout the ups and downs of her life.
After years of battling various severe chronic medical illnesses, she reached a point where her only chance for survival was being attached to a ventilator and receiving nutrition through a feeding tube. She proceeded with those life-preserving measures, and was receiving care in a local hospital.
But unbeknownst to her family, during a period of great duress, Sylvia had listed a gentleman from her neighborhood in Brooklyn as her sole healthcare proxy. And then, at Purim time, he chose to step in to exercise his decision-making powers, instructing the hospital to disconnect Sylvia from the medical equipment that has become her lifeline.
Aghast, one of Sylvia’s nephews turned to Chayim Aruchim for direction and support. The organization, a program of Agudath Israel of America, helps patients, families, and hospitals to understand the halachic issues involved in medical care and has lobbied for the rights of the terminally ill in extremely difficult cases. Rabbi Shmuel Lefkowitz, a Chayim Aruchim board member and longtime advocate for the rights of the terminally ill, was made aware of the dire situation and knew just whom to contact: M. Avigdor, Esq.
It was Purim and everyone was focused on the joyousness and revelry of the day. Pikuach nefesh became Mr. Avigdor’s prime focus. It was a Sunday and the legal system was “off for the weekend.” The attorney, through great hashgachah pratis, managed to locate a judge who, in a rare move, signed a restraining order on a Sunday. Later in the week, in the spirit of Purim “turnabout,” the judge chose to award healthcare proxy status to an older sister of the patient.
According to the family’s lawsuit to retain this vital status, “It is anathema to Orthodox Jewish belief to shut down life support from a person in (her) condition . . . to do such would be nothing short of murder.” As her sister poignantly stated, Sylvia is a “living, conscious adult with a right to remain living.”
Though the court battle still rages on, Sylvia remains attached to life support. On the day that over two millennia ago became a day of salvation for the Jews of Persia, a Jewish woman in Brooklyn was saved, for now.
As a fascinating aside, the first names of the heroic individuals in this modern-day story of Purim salvation: Sylvia’s older sister, Esther, and her nephew Mordechai; as well as the indefatigable attorney, Mordechai Avigdor.
On a broader note, this case highlights the vital need for individuals to designate a healthcare proxy.
As the New York State Department of Health defines it: The New York Health Care Proxy Law allows you to appoint someone you trust—for example, a family member or close friend—to make healthcare decisions for you if you lose the ability to make decisions yourself. By appointing a healthcare agent, you can make sure that healthcare providers follow your wishes.”
Without a designated agent, in the event a person becomes incapacitated, someone will be making medical decisions on the patient’s behalf, and they may not turn out the way he/she would have wanted.
Since the Torah sharply engenders, “V’nishmartem me’od l’nafshoseichem—take great effort to maintain your health,” many aspects of critical medical care overlap with halacha. Some of those issues include (especially for patients deemed terminally ill):
• Signing orders/instructions for DNR (“Do Not Resuscitate”) or DNI (“Do Not Intubate”)
• Artificial nutrition or hydration (when a patient cannot eat or drink “naturally”)
• How long a critically ill patient should continue with attempts at curative care
• Administering pain medications (very high dosages may depress breathing to a dangerous extent)
• Administering antibiotics to terminally ill patients
• Signing organ-donation cards
• How to discuss a patient’s prognosis (especially if terminal)
• When, and how, to say Viduy (confession prayers)
• How to make a bikur cholim visit (visiting the ill, in a facility or at home)
• How to make a shivah visit (to comfort mourners)
For those who wish to have a Healthcare Proxy that takes halacha into account, speak to your rav, or contact Chayim Aruchim. Agudath Israel’s Halachic Healthcare Proxy has signers list their agent as well as the rabbi or organization to contact if any issues of halacha arise or are anticipated.
While Mordechais, Esthers, and others worked together to gain a reprieve for Sylvia, the ideal approach is to get a healthcare proxy whom you trust in the first place. As the old expression goes, “The life you save may be your own.” v
Moshe Borowski, LMSW, is the director of outreach and education for Chayim Aruchim. They have created a highly specialized team of physicians, mental-health experts, rabbis, and attorneys available as needed for consultations to patients, families, and medical institutions. They can be contacted at 718-535-9061. For further information, visit www.chayimaruchim.com.
Chayim Aruchim’s Machon Refuah V’Halacha has created a 24-hour hotline, 718-301-9800, which is now fully operational. This bold and revolutionary service allows patients or families to discuss medical issues and shailos with a knowledgeable expert to help them make important decisions.