I recently met an Orthodox palliative care nurse working on the West Coast who discussed the implications of her work.
She discussed how various stages 4-5 cancers are already about choosing a good death rather than the power of doctors to keep one alive. Does one want to die from a narcotic shot after having lots of tubes inserted or does one want a non-invasive death? (We already discussed some of these issues here.)
She claimed that 20% 25% of all cases would not get into a brain stem death or heart death situation if there was more palliative care. On the other hand, she said that the organs of those who die from aggressive cancers are never used for organ transplants, they always inform those who do transplants of the deaths and they are never chosen. (These are her statistics; I cannot verify them. I am neither doctor nor medical ethicist).
She mentioned that Orthodox Jews are the biggest believers in the medical model that things can always be solved even when it is empirical that a stage 5 cancer cannot be helped. And that the Rabbis are playing doctor rather than chaplain.
I was surprised when she discussed a Chabad seminar in medical ethics that she attended and she said it was great. It was given by a Chabad rabbi who is in the forefront of knowledge of palliative care. The rabbi discussed palliative care cancer patients as terefah and had a real empirical based category of goses. She compared this with the NY orthodox rabbis who have a 1965 image of medicine based on Dr Kildare who can solve everything. (For those too young to remember, Dr Kildare was a TV show in which the doctor always knew best and more medical treatments were always good things.) Now we live in a world where people tell the joke “why do they seal the coffin? To stop the doctors from continuing to administer the profitable chemotherapy.”
The nurse compared the lack of knowledge of the Yeshivish and Centrist rabbis to this Chabad rabbi. She did not remember his name and I could not find it online in any combination of the words Chabad, medical, rabbi, seminar. I do want to know who it is and if Chabad is developing their own medical ethics. I had never heard that Chabad was getting into original medical ethics. If anyone knows, then let me know. She found this Chabad rabbi relevant with real categories of terefah and goses, which acknowledge that we all die.
She compared this with the local rabbis who when consulted on end life care insist on painful procedures that bring no benefit. She told a story of an Orthodox woman who said “her husband was good so he cannot die. He did everything right he cannot die.” When I asked her how does she explain it, at first she would not answer the question and then only answered it with my repeat of the question. She said that the Orthodox (in this case referring to a Engaged Yeshivish or Centrist Orthodoxy) are more irrational than other patients. They have a complete dependence on a certain life, and the woman with the dying husband was dependent on husband. No contingency, no sense of end of life.
Finally, she noted the increasing convergence with Catholics positions, for example that food and hydration is necessary. And both need more actual knowledge of the end process of each specific disease or end life situation. (See my prior post here on the convergence).