L-R: Dr. Alexander Okun, Rabbi Kenneth Brander, Rabbi Simcha Scholar and Rabbi Mordechai Willig.
Sep 15, 2008 — The annual Yeshiva University Student Medical Ethics Society conference, held on September 14, focused on gaining greater understanding of the sanctity of life and the intersection of Jewish and secular law in dealing with palliative, or end-of-life, care. The third annual student-run conference was attended by 250 people from diverse professional backgrounds from both within and without the YU community.
“The conference held six breakout sessions, an adult end-of-life plenary session and a final pediatric end-of-life plenary session,” said Rifka Wieder, co-president of the Student Medical Ethics Society with Avi Amsalem. “We created an environment conducive to academic growth and intellectual stimulation in an intimate and comfortable setting to help people to gain a deeper understanding of the intricate issues at stake.”
Click here to see photos from the conference.
“There was no greater reward for the student board and volunteers than to watch eight months of planning and hard work materialize before our eyes,” said Amsalem. “Even though we planned every detail of the conference ahead of time, we were still amazed to see a finished product of such high-quality content and presentation.”
The thorny ethical issues associated with end-of-life challenges are further complicated when Halakhah [Jewish law] and secular law overlap. A diverse line-up of professors, ethicists, medical doctors, hospital administrators and, of course, rabbis delved into the issues surrounding assisted suicide, organ donation, pain management, health care proxies and do-not-resuscitate orders.
Rabbi Mordechai Willig, the Rabbi Dr. Sol Roth Professor of Talmud and Contemporary Halakhah and a Rosh Yeshiva at YU’s Rabbi Isaac Elchanan Theological Seminary (RIETS), indicated that within the rabbinic community “there are widely divergent views of our responsibilities to terminal patients.”
Serious pain is a consideration, Rabbi Willig said. He cited such revered decisors as the late Rabbis Moshe Feinstein, z”l, and Yakov Yisroel Kanievsky, z”l, who both said it was important to take into account pain with respect to withholding further treatment.
The general statement that a person must always fight for his last breath is not as simple as it appears, said Rabbi Moshe Tendler, a biology professor at Yeshiva College and a RIETS Rosh Yeshiva, who is one of the country’s leading experts on medical ethics issues as they pertain to Jewish law. He provided an example presented in the Talmud about the end-of-life issue presented by a person being burned at the stake. It is not permissible, Rabbi Tendler said, for the person to breathe in the fire, which would make him die faster, but it is permissible to remove the wet wool that had been placed around his chest to extend his life and prolong his suffering. Applied to current situations, Rabbi Tendler said, “Talmud interprets this as you can stop therapy, but you can’t hasten death.”
Joining the rabbinic experts were palliative care professionals and administrators from hospitals in the New York metropolitan area.
Dr. Alexander Okun, associate professor of clinical pediatrics at Albert Einstein College of Medicine and a pediatrician at Montefiore Medical Center, gave a moving presentation on the unique and very often heartbreaking challenges of pediatric end-of-life care. Dr. Okun spoke about the kinds of problems faced by parents who choose not to tell their children about the nature or severity of their illness, employing a kind of “benevolent deception” to prevent further mental anguish to the child.
Dr. Okun’s working assumption was that a child under the age of 18 is not yet an adult and must have an adult making decisions for him or her, but as an example of where Jewish and secular law differ, Rabbi Willig stated that at age 13 for boys, and at age 12 for girls, Jews are considered adults and deserve the right to be involved in decisions related to their own care.
Dr. Beth Popp, associate director of the Division of Hematology and Medical Oncology and head of the Palliative Care Program at Maimonides Medical Center, spoke about the challenges faced by Orthodox patients and how they interact with hospitals and hospital administrators in end-of-life situations. Dr. Tia Powell, director of the Montefiore-Einstein Center for Bioethics, discussed the diverse kinds of challenges faced by hospital bioethics committees.
Rabbi Kenneth Brander, dean of Yeshiva University’s Center for the Jewish Future, added a personal perspective to the conference with his account of the loss of a newborn child from a beta-strep infection. As a result of their loss, Rabbi Brander and his wife led a successful state and federal campaign to install practice protocols in neo-natal care to prevent future deaths from this preventable illness.