Posted tagged ‘Debilitating Diseases’

Silver Linings and Rays of Hope: A COVID Reflection of Hope

May 23, 2020

This Shabbat, when we read Torah, we began our journey through its fourth book; the Book of NUMBERS.  As you may or may not know, the meaning of the Hebrew names of the books of the Torah do not necessarily match their English names.  The Book of NUMBERS is a perfect example.  In English, it is called “NUMBERS” because in its beginning, it does a deep dive into the taking of a census of the Israelites before they enter the Promised Land.  Its Hebrew name – BEMIDBAR – delivers quite a different message.  BEMIDBAR means “In the Wilderness.”

As I contemplated our entering the text of BEMIDBAR, I could not help but grasp the parallel with our own lives at this juncture of history.  For, like the newly liberated Israelites, we find ourselves wandering in a wilderness.  Just like our ancestors who were faced with the challenges of needing to traverse their wilderness, with all its difficulties and dangers, we, too, find ourselves faced with the challenges of needing to traverse a wilderness all our own.

Our wilderness is not like theirs.  It is not a wilderness which stretches across miles.  Its difficulties are not the burning desert sun, rough roads to travel, thirst and hunger.  Its dangers are not the fear of attacks from wild beasts, snakes, scorpions, and marauding tribes.  The difficulties and dangers of our wilderness come from this highly contagious and lethal disease which afflicts us today.  They are the difficulties embedded in our need to change our lives so dramatically in order to protect our lives; masks, physical distancing, sheltering at home, shortages at the grocery store, massive unemployment and the poverty and deprivations it entails, the upending of our world economy, the severely diminished education of our children, our inability to be in the physical presence of loved ones and friends, and, of course, the uncertainty of what the future holds for us – the new normal – and when that future will arrive.  As for the dangers, they are self-explanatory, or at least they should be, but for some inexplicable reason there are too many in our society who refuse to acknowledge them.  They are the dangers of our enormous vulnerability to a horrible disease which has the power to inflict unbelievable and prolonged suffering, and possible death, not to mention that unless we behave carefully and responsibly, we could bear the guilt of inflicting all of this upon others, including the people we love.  This is our wilderness.

Yes, the wilderness can be dark and dangerous, whether it be the wilderness of our ancestors or our own.  But even in its midst, there are silver linings and rays of hope which can be found.  Next Thursday evening, we as Jews will commence the celebration of one major silver lining, one major ray of hope, which our ancestors encountered in their wilderness. That silver lining, that ray of hope, changed the world and the history of humanity for all time, and changed it for the better.  The celebration I speak of, of course, is Shavuot, the festival of our receiving the Ten Commandments.  It was in the wilderness, with all its hardships, pain, and suffering, that our ancestors found themselves standing at the foot of Mount Sinai, and there, receiving directly from God, the ten most important rules which would, from that time forth, serve as the guiding principles for the advancement of humanity.

Like our ancestors, as we traverse our wilderness of COVID, there are silver linings and rays of hope to be found.  They do not diminish the hardships we must endure, just as the Ten Commandments did not diminish the hardships endured by our ancestors, but they can redeem our wilderness sojourn from being bereft of any meaning whatsoever, just as, in the same way, God’s gift of the Ten Commandments redeemed the wilderness sojourn of our ancestors.

Some may wonder:  What are these silver linings and these rays of hope which manifest themselves now, in our darkest hours?  They are rays of hope which have the potential to light the path to a better future in what eventually will be a post-COVID world.  But what are they?

One of them is that it has been determined that as a result of the pandemic and the restrictive changes in behavior that it has required of us, the amount of greenhouse gases in our atmosphere has been reduced by 17%, dropping to the levels of 2006.  This is but one of several positive impacts our lockdown has had on the environment, as we have been allowing nature to heal itself.  It shows us that if we can choose to change our behaviors, we can begin to ecologically repair our planet.  While it should go without saying that we cannot maintain lockdown protocols forever in order to save our planet, still we can change our attitude of “business as usual” and seriously engage in environmentally responsible behaviors, such as truly committing to the pursuit of alternative clean energy sources.  We have it within our ability to turn back the doomsday clock.

Another ray of hope found in our wilderness is that after 72-years of an ongoing Middle East conflict, it has taken this pandemic, with all its pain and suffering, to start to open a door for, at least a new beginning of Arab-Israeli cooperation.  Three Arab states – states that for all these years have been sworn enemies of Israel – the United Arab Emirates, Bahrain, and Kuwait – have turned to Israel for assistance in their struggles against the COVID-19 virus.  This is in no way a resolution to the Arab-Israeli conflict, but it is a glimmer of a recognition of how the countries of the Middle East need each other in order to survive and prosper.  It is but one step toward a resolution of this tragic conflict.  As we march into the future, this moment should not be lost or forgotten by its players, Hopefully it will serve as a building block toward a kinder, gentler Middle East.

Still another ray of hope is born out of the very anguish of our wilderness.  This public health crisis has only accentuated some of the social problems that long existed before the world ever heard of the Coronavirus.  Specifically, the fundamental injustices inherent in the vast socio-economic divide which exists in our nation and the dire consequences of our failure to humanely address that divide.  As we watch how this virus has devasted members of our economically disadvantaged community, way out of proportion to their numbers in our society, we can no longer ignore or turn a blind eye to the evils of runaway, abusive capitalism, the maintenance by way of neglect of a permanent underclass, and the innate evil of systemic racism.  These are intolerable conditions in a society which claims to be great, enlightened, and just. – “With Liberty and Justice for ALL.  If, after the nightmare of witnessing what this pandemic has done to the disadvantaged of our society, we do not commit ourselves to closing the socio-economic divide, then the guilt rests on our shoulders.  If nothing else, this crisis has shown us the necessity of our building a more just society, but we need to choose to act on it.

Still another ray of hope coming out of our current dilemma is that we can no longer afford to think in nationalistic terms.  Yes, we can be patriotically proud of our nation, but we cannot continue to view our nation as being superior or separate from the community of nations.  Last week, I watched Rachel Maddow interview Governor Andrew Cuomo of New York.  She asked an interesting and insightful question – “If you could turn back the clock to a time when you could have done something different in your response to the virus, when would that be and what would you have done differently?” His response was even more insightful. He said that while he was tempted to say March or February, actually he would have turned that clock back even earlier, to when we first were hearing about the outbreak in China.  With the wisdom of hindsight, he continued, saying that as soon as he heard of the Corona Virus outbreak in China, he would have started to prepare for its coming to New York. For, as he pointed out, in today’s world, when a virus strikes anywhere in the world, it can strike here tomorrow. All that is necessary is for one infected person to board a plane.  This pandemic should have taught us that we can no longer afford the foolishness of naively ignoring that we live in a global society.  Like it or not, we are intimately and inextricably bound to each other. Indeed, this is not new wisdom. As far back as 1624, the poet John Donne spoke of this reality when he penned his famous poem, “No Man Is an Island.” If, as a result of this pandemic, we can embrace this sense of international interdependence – that as a human race, we are at our best when our nations work together to build a better world – then the future we will build will be brighter and better than we ever dreamt.

Even in these dark hours, let us come to recognize and work to realize the lessons to be found in the silver linings and the rays of hope that, too, are products of this tragedy.  They cannot compensate for the suffering and the loss of life we have and we will endure, but they can show us the way to build a better world for tomorrow.  They redeem these days from the cruel fate of being totally meaningless blips of horror on the timeline of history.

A Jewish Perspective on the Ethics of End of Life Decision Making

April 29, 2013

My congregation – Temple Emanuel of Davenport, Iowa – has started hosting a series of panel discussions on contemporary ethical issues.  For these panels we bring in local experts on varying aspects of the issue.  After introducing the topics and the “players,” each program starts off with me offering a 10 minute presentation on the topic from a Jewish perspective.  This year we experiments with two such programs; one on the Ethical Challenges Facing the Media and the other on the Ethical Challenges Facing End of Life Decision Making.  While my presentation of the Jewish perspective on the topic of media ethics was made from an outline (and therefore far exceeded my 10 minute limit), for time and efficiency sake, I decided to prepare my presentation for end of life decision making in a full text format.  It is that text which I share with you now.  However, before I do so, let me offer a few disclaimers:  1) This presentation is far from exhaustive on the topic, nor could it be considering the presentation’s time limit of 10 minute.  2) For research sources, I relied heavily on responsa literature coming out of the Reform movement.  While a more evenhanded approach would have been to pull from responsa across the Jewish spectrum, being a Reform rabbi primarily speaking to a Reform congregation, I felt, and feel, completely justified in restricting my sources to those coming out of Reform Judaism.  3) As an adjunct professor at a local university, I try to be sensitive to issues of plagerism, however I am not always certain of some of the fine lines which define it.  I have tried to give appropriate credit to my sources in my footnotes.  If I have an any point crossed that line into the universe of plagerism, I apologize in advance for it was never my intention to “steal” intellectual property from another.

Several years ago one of our congregants suddenly collapsed and was rushed to the emergency room.  She had several arterial blockages which the doctors tried their best to clear.  However the damage was so extensive that there was considerable loss of oxygen to the brain.  So she was placed in intensive care and put on a respirator.  She never regained consciousness and it was not long before it was clear to the doctors that she never would.  At best, her brain activity was minimal.  So her loving family was faced with the very difficult and painful decision as whether or not to artificially keep her alive by means of the respirator although there was infinitesimal, if any, hope of her ever recovering, or remove her from the respirator and place her life into the hands of God.

So the family sought my advise, as their rabbi.  I told them that they needed to choose what they thought would be best for their loved one and for themselves, and that whatever that decision would be, Judaism would support it.  So they decided to take her off the respirator.

After they had made that decision, but before they had actually taken the action, they were visited by the local Chabad rabbi.  When they told him their intentions, he was emphatic in expressing his opposition, claiming that in the eyes of the Jewish religion, what they were proposing to do would be nothing short of murder.

Two rabbis and two dramatically different opinions on a very personal and difficult subject.  Which one of us was right?  Actually, both of us could make that claim.  For when you look at the traditional literature on such difficult end of life questions, you can find argumentation in both directions.  You see, we think of these questions as being relatively contemporary but in Judaism rabbis have been debating these issues for centuries, indeed for almost two millennia; as far back as the MISHNAH, which was put in its final form approximately 1,800 years ago.

Before we can look at where we disagree, we need to spend some time looking at our areas of agreement.

Firstly, there is unanimous agreement among the rabbis that life is more than just a biological function.  Rather it is a gift from God.  As such, it must be viewed as sacred and therefore must be treated with great care.[1]  Needless to say, Judaism fundamentally rejects murder – the taking of a life.  This is as old as the Torah itself.  It is one of the Ten Commandments.

The rabbis later extended the Torah’s definition of murder to include suicide.  The Talmud makes this point very clear when it tells the story of Rabbi Chananiah ben Teradion, a second century rabbi who was part of the Bar Kochba rebellion against Rome.  The Romans captured him and condemned him to be burned at the stake.  His loving students urged him to breathe in the flames so that he could die more quickly.  He refused, giving the reply, “It is best that He Who hath given the soul should also take it away; let no man hasten his own death.”[2]

Yet another point of mutual agreement is the prohibition against the practice of euthanasia or assisted suicide – taking positive steps to advance death regardless of whether or not the individual is terminally ill.[3]  There is uniformity among the rabbis that this is but another form of murder, even if the “victim” is a willing participant, choosing to terminate their own existence.

There is also agreement that while taking positive actions to advance death is prohibited, that there is a clear distinction between such positive actions and indirect actions, primarily using negative means, in order to remove barriers which might hinder a natural death.[4]  So, for example, the rabbis agree that it is acceptable to stop praying for the recovery of someone who is terminally ill.  While we today may think of that as a minor matter, for the rabbis it was not, for they fully believed that prayers make a real difference.  In fact the Talmud relates a powerful story to this effect.  Rabbi Judah HaNasi – the redactor of the Mishnah – was dying with great suffering.  Yet the other rabbis insisted upon standing at his window, offering continual prayers for his life.  Finally, in empathy for her master, Rabbi Judah’s servant woman climbed onto the roof and dropped a clay jug right over where the rabbis were gathered.  The crashing of the jug on the ground startled the rabbis, interrupting their prayers.  No sooner did they stop praying then Rabbi Judah was released from his suffering and died.[5]

It is on this point of making a distinction between positive actions that advance death and those actions which serve to remove the barriers to natural death that the rabbis part company.  They do so over the very difficult question of boundaries.  When does one’s actions cross over from actively terminating a life to removing that which artificially prolongs life and interferes with a natural death?  This can plainly be seen in a debate across time between two famous commentators, Moses Isserles (1520-1572) and the Taz, David HaLevi Segal (1586-1667).  Isserles held that it was permissible to remove salt from the tongue of a terminally ill patient on the grounds that it was a stimulant which was preventing him from relaxing into death.  The Taz challenged Isserles’ position, claiming that the removal of the salt was an overt act which hastened death.[6]

It was on this question of boundaries – when do we cross over from actively terminating a life to removing an impediment to death – that the Chabad rabbi and I disagreed in the situation that I described in the beginning of these remarks.  To reference the debate between Moses Isserles and the Taz, I stood on the side of Isserles while he stood on the side of the Taz.  So as you can see, their debate continues today as we find ourselves struggling in our search for ethical answers for these end of life decision.

Not only will it continue, but it will grow in intensity and complexity as medical technology continues to advance our ability to prolong the length of life but not to the same degree, the quality of life.  As a rabbi, I visit the sick and the shut in of our community on a regular basis.  Among those I visit are those who are suffering from horrible diseases such as Alzheimers, which methodically strips them of their intelligence, their personality, their ability to communicate, until they reach a point when their body is here but all that made them who they were as human beings is no longer with us.  I leave those visits deeply depressed for I miss the people who inhabited those bodies and I deeply dread the very real possibility that such would be my ultimate fate as well.  And I cannot help but ask myself the fundamental question: When does life end?  When the body no longer functions or when the individual who populates that body no longer exists and for whom there is no hope of return?  Tough and frightening questions present themselves to us today and will continue, and multiply, in the coming years.  We will need to struggle with the ethics of our responses.


[1]Euthanasia, American Reform Responsa, Central Conference of American Rabbis, 1950.

[2] Ibid.  Tractate Avoda Zara 18a, Babylonia Talmud.

[3] Euthanasia, American Reform Responsa, Central Conference of American Rabbis, 1980.

[4] Ibid.

[5] Ketubot 104a, Babylonian Talmud; Allowing a Terminal Patient to Die, American Reform Responsa, Central Conference of American Rabbis, 1969.

[6] Allowing a Terminally Ill Patient to Die, American Reform Responsa, Central Conference of American Rabbis, 1969.