by Debra Rubin
NJJN Bureau Chief/Middlesex

March 18, 2008

Dying is a natural part of life’s journey that should be handled with dignity and compassion, according to a rabbi who works with the sick and dying.

“There is certainly an understanding in Judaism that this world is not all there is,” said Rabbi Amy Bolton. “This world is a vestibule to the world to come. If you look at it that way you see death as part of the journey. When a person is journeying out of this world we have to think about how to handle it with the utmost kedusha, the utmost holiness.”

Getting congregants and community members to face the difficult choices on that journey was the subject of a March 11 program on end-of-life issues held at the Highland Park Conservative Temple-Congregation Anshe Emeth.

In interviews held after the event, Bolton, founder of the health, wellness, and healing center at the Jewish Family Service of Bergen County, and fellow presenters said they sought to shine a light on subjects many people would rather not think about, and do so through the lens of Jewish tradition.

“We felt there was widespread concern about these issues and a need to study traditional texts and commentaries to learn more about it,” said David Siegman, who cochaired the program with Judith Richman.

Bolton, who has a Conservative ordination, used both Orthodox and Conservative sources during the program to point out the choices and dilemmas facing individuals and families when death nears.

She noted the distinction, as understood by Halacha, or Jewish law, between “saving a life and prolonging the dying process.” With technological advances making it possible to prolong life, questions of when to continue care and when to withhold it have only become more difficult.

“What if you have a feeding tube that has become infected and needs a procedure? Do you clean the infection when you have an 89-year-old with dementia and end-stage cancer?” she asked. “Halacha is more complicated than just saying we should or shouldn’t allow hydration or nutrition.”

Bolton’s advice, however, is simple. “Definitely, the bottom line is to consult your rabbi,” said Bolton, the founding chaplain and co-bereavement director of the Martin and Edith Stein Hospice on the Wilf Campus for Senior Living in Somerset.

Following Bolton’s presentation a panel discussion featured Barbara Sorkin, clinical director of the Stein Hospice, and Sara Culang, its director of volunteer services.

Sorkin said that hospice care, whether given in a patient’s home or at a facility, is designed to provide both the family and patient with a sense of dignity.

“I tell my team that we develop a sense of intimacy with our families and patients,” said Sorkin. “Dying is a fearful time of life and we help both patients and families face their fears. I’ve had people tell me once the hospice team came, a great weight was lifted off their shoulders.”

Members of the team — including social workers, a chaplain, nurses, and a volunteer coordinator — care for both the physical and emotional needs of those affected, she added.

Culang focused on advanced-care directives and healthcare proxies, stressing that “no matter how much we think we know about our disease or condition, our condition can stray from our directive.”

As an alternative, she suggested that individuals assign a trusted proxy to express their wishes.

“A lot of Orthodox Jews defer to a rabbi who has a halachic understanding, rather than a friend, because ultimately this is an ethical decision over such issues as removal of life support or artificial nutrition,” said Culang.

Whatever the choice, Culang recommended that directives be updated as conditions change or people age and that copies be given to lawyers and proxies.

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