Metro

(EV NI !IOM[ & YANG SERVICE!.

When The Time Comes

Outlining Jewish end-of-life choices
to a roomful of 'hospice heroes:

Join us!

Celebrating a
Century of Caring
1907-2007

Sunday,

September 30, 2007

at the

Detroit Opera House
5:30 in the evening

Event Chairpersons

Pearlena Bodzin, Hannah Moss
Joel Smith, and Howard Tapper

Honoring

Carol Rosenberg

Executive Director

Proceeds front this event
will benefit
Acts of Loving Kindness
Gemihtt Chasadim

20

September 6 • 2007

I Judith Doner Berne
I Special to the Jewish News

D

ying well, that's the goal, Dr.
Barry Kinzbrunner told more
than 100 health care profes-
sionals, rabbis and hospice representatives
gathered to discuss end-of-life choices for
those who follow Jewish law.
Whatever is done, he said, "should be
done in a way that's beneficial and avoids
harm. What you have to do is what that
patient needs"
Kinzbrunner, a medical doctor who
became an Orthodox rabbi, was fram-
ing "Jewish Ethical Choices at the End of
Life: Where Judaism and Medicine Meet"
for those attending the recent session at
Jewish Family Service, on Maple west of
Drake in West Bloomfield.
The program was co-sponsored by

So although Orthodox Jews comprise
only a reported 11 percent of American
Jewry, "when people are nearing the end
of life, they often want to move toward the
traditional."
Kinzbrunner quoted a former patient
who said: "I'm not observant but when it
comes to life and death, I want to go by the
book."
End-of-life medical decisions made by
Orthodox Jews must be consistent with
what they believe to be God's law, often
with guidance from a rabbi knowledge-
able in the area, Kinzbrunner said.

By The Law

Jewish law recognizes terminal illness
as the prognosis of a year or less to live,
Kinzbrunner said. A terminally-ill patient
who is strictly following Jewish law may
be voluntarily limiting his medical choices.
Calling terminal
Photo Credit: Michael Haines
illness, "a Jewish con-
cept," he quoted King
Solomon: "There's a
time to live and a time
to die:' At the same
time, "the Torah never
describes someone
dying'
Abraham "asked for
old age to differentiate
himself from Isaac,"
Kinzbrunner said.
Jacob asked for illness
before death "so he
Rabbi E.B. Freedman with Dr. Barry Kinzbrunner
could bless his children
prior to death. King
Hezekiah (Book of Kings) asked for pos-
Jewish Hospice and Chaplaincy Network
sible recovery from illness, so one would
(JHCN), the Jack and Miriam Shenkman
Caregiving Fellowship Team, the Michigan be motivated to repent."
In discussing what to tell the terminally
Board of Rabbis and VITAS Innovative
illiewish law does permit withholding
Hospice Care, which has a Southeast
information if it would contribute to the
Michigan branch.
welfare of the patient," Kinzbrunner said.
Kinzbrunner, based in Miami, is VITAS
"When people want to know, they ask
executive vice president and chief medical
you," he said. "Those answers should be
officer. "He's one of my favorite hospice
heroes',' JHCN director Rabbi E.B. (Bunny) honest and give people hope. That hope
might be that the pain can be managed
Freedman said in introducing him to "the
and that some symptoms get better. It's
many hospice heroes in this room:'
about resetting goals for people.
Orthodox Jews are the most bound
"Patients may refuse treatment only if
to Jewish law, when it comes to medical
it's not proven, clearly futile or entails great
choices, Kinzbrunner told his audience.
suffering or significant complications. If a
"As you move along the spectrum
– Conservative, Reform, Reconstructionist, cure is offered, they are obligated."
"Euthanasia (under Jewish law) is con-
Secular —they make the decision closer
sidered an act of murder',' he said. "One
to what the general society is doing',' he
may not hasten death, but one may with-
said.

hold or remove treatment (under speci-
fied conditions):' Some secular ethicists
equate withdrawing and withholding. In
Jewish law, withdrawing and withholding
are different.
"Under Jewish law you can't remove
ventilators once they're in place','
Kinzbrunner explained. But placing a ven-
tilator on a timer allows some flexibility in
that rule.
In the last days of life, "all basic needs
are required, including food and water','
Kinzbrunner said. "IV (intravenous) nutri-
tion and hydration — that's the big issue.
Judaism considers it as basic care.
"Competent patients may refuse artifi-
cial hydration or nutrition," he acknowl-
edged."Respect that, but caregivers should
try and convince patients to accept the
intervention."
On the other hand, CPR (cardiopulmo-
nary resuscitation) can be withheld or
refused by a terminally ill patient, he said.
Or they can say they want it.
"Judaism doesn't believe pain and
suffering is a virtue," Kinzbrunner said.
"Treatment of pain is mandatory. And
Judaism also recognizes the importance of
treating mental anguish and suffering."

Weighing In

"Sometimes dying is worse than death,"
Rev. Curt Roelofs, a Providence Hospital
chaplain and associate pastor of North Hill
Church in Troy, said during a short ques-
tion-and-answer session.
"The good death is an oxymoron,"
Kinzbrunner agreed. "God equates death
and evil. We want to make it as tolerable a
process as possible.
"No one wants to need hospice but
when you need it — it's there," he added.
"Jacob [in the Bible] didn't go to the
ICU although they had [access to] some
medical care. He died surrounded by loved
ones. That's what most Jewish people
would want:"
Rose Fenster, who identified herself as
a Jewish nurse with St. John Home Health
Services, said the session was important
because it drew "so many people not of the
Jewish faith but caring for Jewish patients.
"They're impressed with how the Jewish
community takes care of its own," the
Huntington Woods resident said. "I think
the seminar interested them in learning
more." I