THE JEWISH NEWS

SEVENTY-FIVE CENTS

SERVING DETROIT'S JEWISH COMMUNITY

DECEMBER 27, 1991 / 20 TEVET 5752

General Motors Layoffs
Hit Non-Auto Community

CLOSE-UP

KIMBERLY LIFTON and
AMY J. MEHLER

Staff Writers

S

am Weiner's patients
come from all walks of
life. Yet 50 percent are
employed by the Big Three
automobile companies —
General Motors, Chrysler
and Ford.
Because many of his pa-
tients work for the auto in-
dustry, Dr. Weiner said his
chain of dental clinics,
Warren Dental Associates,
is facing financial trouble.
Last week's annnounce-
ment that General Motors
Corp. will close 21 plants

and slash 74,000 jobs by
1995 brought more gloomy
news to Dr. Weiner and
other Jewish professionals
who expect the layoffs to fur-
ther erode their businesses.
"Things will get worse,"
Dr. Weiner said. "But people
still need dental care. They
will continue to get the
basics, but won't get higher
priced dental work that they
think they can live without
— like crowns and den-
tures."
Once strong, with six
clinics, Dr. Weiner now
operates four offices in
Detroit, Utica, New
Baltimore and Warren. This
past year, the chain's gross

income dropped 35 percent,
he said.
"A good number of our pa-
tients work for the Big
Three," said Judy Schwartz,
who manages a dental office
in Clawson. "Business is
down. A good number of
those working for the com-
panies still have their jobs,
but it is tense. Dentistry to
them is an option they can
put off, and people are doing
that."
When auto companies are
hurt, professionals — like
dentists, advertising corn-
panies and consultants —
will also be hurt, said David
Littmann, senior economist

Continued on Page 25

Medical Rights, Halachah
May Clash Under New Act

ELIZABETH APPLEBAUM

Assistant Editor

ECHOES

of the

BIG

BANG!

Jews were expelled from Spain 500 years ago.
The shock waves still reverberate.

STORY ON PAGE 30

SOUTHFIELD: ATR/SE

SERIES CONCLUSION

LOOKING INTO THE
FLTURE

What is the final
destination for
Detroit's Jewish
community?

Page 40

O

ne month ago when a
patient entered the
hospital he was asked
to know everything from his
medical history to his social
security number.
Today, he's being asked to
be a biomedical philosopher
as well.
Beginning Dec. 1, all new
nursing home and hospital
patients in Michigan are be
ing advised of their right to
have a greater voice in their
medical care. New state and
federal legislation, called
the Durable Power of At-
torney for Health Care Act
and the Patient Self-
Determination Act, requires
that health care facilities
ask patients to consider
under what circumstances
they would wish to continue,
or end, their lives.
Though not obligated to
sign anything, patients will
receive a seven-page docu-
ment which poses such
possibilities: "I do not want
my life to be prolonged by
providing or continuing life-
sustaining treatment if . . . I
am in an irreversible coma
or persistent vegetative
state . . . I understand that
this decision could or would
allow me to die."

Incoming patients also will
be asked if they want to
name a surrogate to make
medical decisions should
they become unable to do so.
Jewish leaders are cau-
tioning patients to consult
with rabbis before signing
any of these new documents
addressing life-and-death
situations. For what may
appear to be the best alter-
native — opting, for exam-
ple, not to sustain a life with

-

A new law asks
patients to make
life-and-death
decisions.

medical equipment — may
run contrary to Jewish law.
The new acts are:

• The Durable Power of
Attorney for Health Care
Act, a state law that
obligates hospitals and nurs-
ing facilities to inform a pa-
tient of his right to refuse
medical treatment, food and
water, and to name a repre-
sentative to make medical
decisions should the patient
become unable to do so.
• The Patient Self-
Determination Act. Passed
last year in Congress, the
law obligates all hospitals
participating in Medicare

and Medicaid to advise pa-
tients of their rights as
outlined in the state law.
Rabbi Leonard Perlstein,
of Sinai Hospital's office of
pastoral care, says issues
such as whether to sustain a
family member on life-
support equipment need to
be examined on a case-by-
case basis, "and any person
of the Jewish faith must con-
tact an expert in Halachah"
before making a decision.
In instances where physi-
cians have determined a com-
atose patient has no chance of
recovery, one may not be
obligated to prolong his life,
Rabbi Perlstein said.
But Halachah will not
condone depriving a patient
of food and water or remov-
ing life-sustaining equip-
ment once it has been
attached, both of which a pa-
tient may request under the
Durable Power of Attorney
Act.
The Patient Self-
Determination Act was
enacted in response to the
1990 case of Nancy Cruzan
of Missouri.
Ms. Cruzan's parents re-
quested permission to
remove feeding tubes from
their daughter, who was in a
permanent vegetative state
following a 1983 car acci-

Continued on Page 24