Monday, January 3, 2011

Here is a little secret: we're all going to die

I don't think that by stating this inevitable fact I'm bringing on the grim reaper or evil eye, but just in case: poo poo poo. I don't mean to be morbid. I also don't mean that we're all going to die NOW. What I mean is quiet simple: sooner or later, each in our own time, our lives will end in death. After all, did we not learn anything from Disney's "The Lion King" about the circle of life?

My week in London was surrounded by Jews and learning. I was at a 6 day conference with over 2200 people and >400 sessions to choose from. It was kind of like summer camp for grown-ups, expect on steroids. We woke up early to pray and learn, kept our noses in text all day, and then chatted, sung, and danced late into the night.

Many of the sessions I attended related to medical ethics. I went to one on Talmudic tips for breast feeding (one should breast feed up until age 2, tsniout is not an issue), another on sexuality outside of marriage (the realization that humans are inherently sexual), another on what the torah has to say on resource allocation in socialist health care (we are obligated to save lives), another on whose life are you obligated to save (2 people, 1 water bottle...), etc...

However, the sessions on halakhic organ donation, on brain death vs. heart death, and on assisted dying are the ones I feel compelled to talk about here. The common theme in these sessions, and something that I see often in medical school, is that our culture is afraid of death. We're afraid to think about it and talk about; as if doing so will make it happen to us. Doctors seem to be the worst at this: often scared to admit that we can't save all our patients from their inevitable death. However, this fear isn't helping anyone. It means that rumors and superstition are allowed to spread rampant, loved ones are left to make choices without guidance, and that end of life care is much more invasive and costly than is necessary.

I believe this all can be changed with a few simple steps. I urge you to consider doing 1 or all of the following:
1) Think about becoming an organ donor. Get the truth on Judaism and organ donation. We don't want to think about dying young or about someone taking out parts of us; but remember that saving a life is the BIGGEST mitzvah one could do. Also, that livers have been donated from people in their 90s! Signing up to be a donor doesn't mean your destined to become one; if this were the case, there wouldn't be an organ shortage.
2) Talk to your family and friends. Let them know how you feel about end of life care and about what you decisions you hope they would make for you. Have these conversations often and under the auspice that our choices will evolve as our lives evolve. By having these conversations, you'll save your loved lots of grief and confusion; allowing them to know their living out your will.
3) Create a living will. Assign a medical power of aterny/health proxy. Use the legal framework in your favor to know that your wishes will be upheld in the event that you are unable to make the decisions yourself.

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