Theme- Jewish ethics and Values
Sermon on being an organ donor – April 18, 2020
This week as I have reached out to various congregants by phone in isolation, I spoke to Ilana Pekar. She is a bit of a modern miracle of science. She was born with a genetic kidney disorder, and has had 3 transplants over her lifetime. Doctors have repeatedly told her they could not understand how she has been able to survive but she has. How incredible that there is a process by which a kidney can transfer from one human being to another to save that persons life. What could be a higher value than saving a life? Indeed, when we pass from this world and our bodies enter the ground, do we merely wish to be remembered or do we wish to give the gift of life to others? For the medical, economic, and moral wellbeing of our society, and consistent with Jewish mitzvot and ethical guidelines, we ought to all sign up to be a donor and guide others to do the same.
Almost 20 years ago Robby Berman founded the Halachic Organ Donor Society, to educate and inspire the Jewish community to save lives. Many of us are confused by obscure teachings that Judaism was in some way opposed to organ donation for two reasons. One long held fallacy is that we would emerge in heaven missing that body party. A second misnomer is that it is a violation of the dignity of the human corpse. Nothing could be further from the truth; our bodies are intact in heaven. There are no Jewish sources that show that one must be buried with all of one’s organs to be resurrected and that there is only spiritual gain, not loss, in performing this mitzvah.
For the second one, The Nodah B’Yehuda, the great 18th century authority of Jewish law, teaches that saving a life – pikkuach nefsh – is such a high priority that it overrides the prohibitions against cutting into or desecrating a cadaver, overrides shabbat, overrides yom kippur, overrides every other of the 613 mitzvot. Extracting and donating an organ is one of the greatest of Jewish mitzvot.
Consider the current in Canada, thousands on waiting lists for organs and other transplant needs, which grows daily. Kidneys are the most common transplanted organs, but there are also people waiting for heart, liver, lung, pancreas, bone and joint, skin and heart valves.
Did you know that a deceased organ donor has the capacity to get eight people off the organ transplant waiting list, and help as many as 50 people through donations
Failure of the heart, liver, kidney, or another organ no longer has to mean the end of life. Most recipients live many fruitful wonderful years, decades after their transplant. However, while organ transplants take place every day, many others die on the waiting list before they receive a transplant.
Obviously, we have major health issues right now with the coronavirus, but while we are in quarantine right now, based on most scientific research we will eventually find a cure and many who are sick have recovered. Those on organ donor lists cannot use antiboides, aren’t waiting for a vaccine, and won’t recover unless they receive a donation.
On the positive side, 35% of Ontario residents are registered donors, that’s about 4.3 million of the 12.5 million Ontarians. April is Be a Donor Month. The goal of the Be a Donor campaign is to register 200,000 more donors this month. With busy lives on hold right now, maybe this is the time to go to the be a donor website and register yourself. Go to www.Beadonor.ca
Lets help get that percentage up to 50% of ontarians – imagine how many more lives will be saved!
In the Talmud, saving a life supersedes almost all other values, and thus organ donation is one of the great religious acts according to Jewish law. Mature religious thinking requires that we consider the big picture: our spiritual existence after our physical existence has expired. We should open up conversations with our loved ones about what we want to happen with our organs after we leave this world. We need more voices to advocate for positive change. We must be proactive and “choose life!”
Parshat Shoftim – Vegetarianism – September 7, 2019
Who doesn’t love a big juicy delicious hamburger. The meat, the bun, the toppings, to me it just might be the perfect meal. But lately I am feeling a little guilt about it – as I ask myself should I be eating meat? Should my desire for an awesome meal outweigh moral considerations? Eating meat has had a tumultuous ride both in our Jewish tradition and our modern sensibilities and its worth exploring this morning.
From a biblical perspective, there is a contradiction as to our right to eat animal flesh. Before creation our world was Tohu v’vohu meaning chaos, and then God made a certain sense of order. We as human beings, are part of creation, and need to behave as such. Animals and plants were created first, but we were to eat only plants not animals. “And to all the animals on land, to all the birds of the sky, and to everything that creeps on earth, in which there is the breath of life, [I give] all the green plants for food.” And it was so.”
In Deuteronomy in this week’s portions it continues this argument; we read that when we inherit our Land, build our own society, and become masters of our own domain that we must behave differently:
“לֹ֣א תַעֲשׂ֔וּן כְּ֠כֹל אֲשֶׁ֨ר אֲנַ֧חְנוּ עֹשִׂ֛ים פֹּ֖ה הַיּ֑וֹם אִ֖ישׁ כָּל־הַיָּשָׁ֥ר בְּעֵינָֽיו׃”
“You shall not act at all as we now act here, every person as s/he pleases.” (Deut. 12:8) On the other hand Genesis says that as humans were created last, we rule over everything that was created before us, including all the animals so we are also permitted to eat them. Moreover in Deuteronomy chapter 18 it says, we have permission to eat meat whenever we want. “But whenever you desire, you may slaughter and eat meat in any of your settlements, according to the blessing that the Adonai your God has granted you. The unclean and the clean alike may partake of it, as of the gazelle and the deer.” (12:15), furthermore form Chief Rabbi of Israel Rav Kook pointed out in I his commentary on this weeks portion that the Kohanim were given certain cuts of meat as their due from the people, supporting the idea that meat is not only allowed but encouraged.
There is a moral dilemma about the slaughter of animals for food. The passage from Deuteronomy while allowing consumption appears also to be a concession to the baser side of human nature, according to Rav Kook. “when you desire to eat meat” implies you have a craving for flesh – and you should not supress this desire. But if we did not have a craving should it be preferable then to refrain from eating meat. So therefore we can kill animals for food because we are in a state of imperfection, and we cannot perfect ourselves if we were to deny ourselves food that gives us strength. He says merely for the sake of our physical welfare we would not be justified in taking the life of an animal but the spiritual advance of humanity will bring about the overall elevation of the entire universe including the animals. Thus it is reasonable that animals also make a contribution to the struggle until the world attains its goal. That is the most fascinating response I have ever heard to justify eating meat. Kook also points out that the kohanim were not required to eat the meat they were given as their priestly due.
What does modern Judaism have to say about vegetarianism?
In the observant orthodox Jewish world, the moral part of the equation does not carry as much weight as halachik reasons to go vegetarian that might prove more acceptable. Rabbi David Rosen, writing in the Jerusalem Post wrote that “there is more understanding today within observant circles that the meat industry today involves transgressions of Jewish prohibitions. Rabbi Hershel Schachter of Yeshiva University was reported to have ceased drinking cow’s milk because of studies that were done among dairy cows that show that their internal organs are so distorted that it renders them treif. That’s the sort of thing that will have an impact within observant communities.”
And what about Reform Jews?
As the great Israeli Reform sage, Rabbi Moshe Zemer taught us, that we have an obligation to affirm Halakha as a developing and moral structure, flexible enough to accommodate the changing realities of each generation. We can easily live a vegetarian lifestyle without compromising our understanding of Torah and there are many environmental and health reasons to justify it. Rabbi Rosen makes the case even stronger.
“Enough of the horror stories! It should be evident to anyone with eyes in his or her head that virtually all animal products on the market today are the result of practices that categorically contravene Jewish law and ethics. And even if eating these products is considered a halachic obligation (which is not the case), under these conditions, it would be a mitzvah habaah baveirah, the product of illegitimate means which disqualifies the ends.”
In modern Israel today Tel Aviv is one of the vegan capitals of the world. In fact, Israel has become one of the leading vegan countries in the world, with 5.2% of the population eschewing all animal goods in their daily diet. This number has more than doubled since only 2010 when 2.6% of the population was vegan or vegetarian. Some are primarily motivated by improving their health, others by stopping cruelty towards animals and others by their concern for the environment.
Richard Schwartz, an activist and author of Judaism and Vegetarianism, explains that “I think that it is time to take very seriously that eating meat has become halakhically unjustifiable today because of the way animals are so severely mistreated and the very negative effects of animal-based diets.
This could be seen as part of the larger Israeli effort to work for peace and end cruelty to both humans and animals. Even the Israel Defense Forces has a group to promote veganism in the army providing vegan meals and alternative to leather boots, etc.
Israeli activist Ori Shavit explains that “No matter where you live, the greatest effect an individual can have on the world starts on his or her plate — so no wonder that people who understand that will try to make a better choice for their food.”
Here in Ontario we have so many options, including the more recent vegetarian Meat craze, different companies providing plant based meat substitutes that taste and look like meat. I had some fake peperoni on a pizza from Pizza Pizza that was quite delicious. I have tried the Beyond Meat burger and even the Tim Hortons fake sausage patty in a breakfast sandwich is quite satisfying. And to be honest it felt good to try to eat less meat. I know it harms the environment, the impact of raising cattle and the hormones and the methane. I know while kosher animals are killed more humanely than non-kosher animals, the living conditions of these animals is horrific. I know humanity is better off with less meat consumption, and for sure the animals would prefer it. The word for treif means torn and I bet many of us are torn on this issue. There are some health benefits to meat such as iron in red meat and its got lots of protein and some find it delicious and leads to a more spiritual elevation. I’m not ready to go cold turkey, pardon the pun, as a vegetarian though its definitely something I’m considering.
As we spend these weeks reading Moses’ instructions to us as to how to set up our own ethical and just civilization, and as we enter the introspective month of Elul, let us evaluate our own behavior as Reform Jews to take seriously our commandments and work to apply them to the challenges we face as a community, a society, a country and to the world.
shabbat shalom
Medical assistance in Dying through a Jewish lens – Fall 2018
I was recently at the shiva house for Marvin, the father of two of my friends Tara and Lisa. As is customary at a shiva house, one waits for an appropriate time to approach mourners and quietly and gently express condolences. While there was great sadness in the room, I also sensed a different feeling. As I talked to Lisa and Tara about how their father died, I found out he had suffered from Parkinsons disease for many years. And then they casually mentioned that their father had chosen to die.
I nodded my head but inside I was shocked. Chosen to die. Committed suicide. A Jew? How could this be.
I tried to act nonchalant as they explained that he had followed the newly established guidelines for medical assistance in dying. Though I’d read a few articles about this new law, I’d considered its meaning and consequences in a more abstract sense. This was the first time I’d actually met family members who’d watched a loved one make this choice. Tara and Lisa were quite open about explaining the entire process, and about sharing their family’s story with you here today.
After Marvin was diagnosed with Parkinson’s, the disease slowly removed his ability to live the life he desired. Here’s what Lisa said in her eulogy:
“A man on the move became a man struggling to move. Then a man unable to move. It was clear to see how frustrated he became as his body refused to cooperate with his active mind. His voice lost volume, he struggled to articulate words and his train of thought became more derailed over time. His sleep became more and more disrupted. His body would become paralyzed like a tin man needing oil. But his greatest struggle was with pain. He was in pain almost all of the time – a symptom of Parkinson’s that isn’t often highlighted.”
It quickly became clear to me that managing the symptoms of Parkinson’s requires an endless trial of different combinations and doses of medications, often every 2 to 3 hours. At first, this involves full time caregiving. Over time, there are fewer options for symptom relief. While it’s different for every person, for Marvin, there was a steep and steady decline.
Marvin decided on his own to learn about Medical Assistance in Dying and explored the specific requirements to see if it was an option for him so end his pain and suffering. Also known as Bill C-14, MAID requires an evaluation by two independent health care professionals to ensure a number of conditions are met. First, the person must be 18 years or older. Second, he or she must be diagnosed with a serious and incurable illness. Third, the patient must be in an advanced state of irreversible decline, with intolerable physical and psychological pain, AND their natural death is reasonably foreseeable in the near future. Patients must also be capable of providing informed consent at the time that assistance is provided. Finally, there is a mandatory reflection period of at least 10 days that needs to occur between the day the patient signs the written request and the day assistance is provided. Unless these criteria are met, advance requests for dying are not permitted.
Bill C-14 does not compel medical personnel to assist a patient in dying, or even require them to refer a patient to another medical practitioner.
Marvin’s condition met all these criteria. He spoke about the possibility of an assisted death with his family and sought their support. Each member of his family reacted differently, at first. Eventually, over time, Marvin’s family agreed unanimously.
Once Marvin made this difficult decision, he spent his final weeks with his family. The weekend before he died, he invited all the people he loved to his cottage. Each person was invited into his room, one at a time, for a final conversation and goodbye. It was a special opportunity to speak from the heart, and to be together as a family one last time.
On a sunny Tuesday afternoon, Marvin enjoyed a corned beef sandwich from Wolfie’s, and his granddaughter Jaimie’s peach cobbler, with ice cream. A short time later, after having said everything he needed to say, he died peacefully, surrounded by the love and support of his family. His daughter Lisa said:
“I don’t know how much more blessed and beautiful an end you can possibly get. He didn’t want it to be a secret. We are incredibly grateful that my Dad was able to make his own choice. He is an unintentional pioneer. This was the right choice for him.”
As I left the shiva, I saw clearly that they were very much at peace with the decision and their father’s death. And even though assisted dying is a new and controversial issue, his daughters wanted everyone to know it was a family decision, and continue to speak openly about it.
Since Bill C-14 became law in Canada in June 2016, almost 2000 gravely ill adults received medical assistance to end their lives. Almost 30 percent of these deaths have taken place in Ontario. According to CBC News, most patients who’ve opted for assisted death have suffered from serious conditions such as cancer or neurological diseases.
While this ground-breaking Canadian law has clearly been embraced by some, and seemed to be the ideal choice for Marvin, we Jews, of course, must ask, is this the right way to die? Is it the Jewish way?
Not surprisingly, the issue is complex and diverse. But I want to explore it and share my position on this sensitive issue, and how I’ve reached this conclusion, because it is a fundamental topic, and may very well effect you personally.
In addition to my words today, we have organized two sessions, in October and November, to discuss it as a group, led by myself along with three professionals in the field– Monique Charlebois, a lawyer specializing in this area-, Jill Steiman a representative of the Ontario government – and Julie Appleton, a palliative care nurse. I hope you can join us then, but right now let’s examine the normative Jewish position – and that is that for the most part, taking your own life goes against Jewish law. In Talmud Sanhedrin, it is clear “whosoever destroys a single soul of Israel, it is as though they have destroyed a complete world”. When a person takes their own life, they are also destroying any life that could have possibly come from that person. Moreover, survivors of the person who dies, carry grief, pain and guilt often for the rest of their lives, completing the ripple effect far beyond the grave.
The preservation of life is paramount. All of us are formed in the image of God. Life has an infinite value regardless of its duration or quality. God made us. We all have a destiny. Who are we to alter our lifespan? Life is sacred. Only God can take it away. We can make choices and have personal autonomy, but taking our life is not within this scope.
Suicide is often the result of unbearable stress, mental illness or depression, and is not a premeditated act. Medically assisted dying is the opposite of suicide. It is a premeditated thought-out, conscious act, so Halakah cannot accept it. Jewish law does, however, offer some compassionate measures that can be taken to end suffering and hasten death. DNRs or “Do Not Resuscitate” orders are acceptable, and death-prolonging treatments such as chemotherapy or antibiotics may be discontinued. Pain relief
medications such as morphine may be administered, despite the risk they may induce cardiac arrest or other fatal events. And Halakha permits the invocation of a prayer that God take the person out of their pain and misery. All of these acts are seen to fall far short of actively terminating life.
Consider the Talmudic story of the death of the great sage Rabbi Hanina Ben Terdion. He was being burned at the stake by the Romans for the crime of teaching Torah and was suffering excruciating pain. His students, who were witnesses to his execution, urged him to open his mouth and let the flames enter so that he could die more quickly. Ben Teradion refused, responding, “Let the One who gave me life take it away.”
In a similar vein, Rabbi Meir in Talmud-Smachot says, “a dying man is like a flickering lamp, the moment one touches it, he puts it out. So too, whoever even closes the eyes of a dying man, is accounted as though he snuffed out his life”.
While Jewish tradition goes in one direction, Canadian law clearly goes in the opposite direction. Both perspectives teeter on the balance between the sanctity of life and the primacy of compassion. So which way should we tip the scale? I believe that there are Jewish reasons that we can lean towards compassion when it comes to end of life decisions, a position supported by many of my Reform rabbinical colleagues.
In an article in the Canadian Jewish News, Rabbi Michael Dolgin of Temple Sinai in Toronto wrote: “From a Jewish perspective, we can’t even talk about assisted dying, but that finality is an inadequate Jewish response. There are many situations now where people’s existence is extended to a point that we must ask if we are extending life or if we are extending suffering?”
Let me point to another Talmud story about the great Sage, Yehuda Hanasi, the compiler of the Mishna. The Rabbi lay dying and his disciples surrounded his deathbed, praying unceasingly– in essence preventing him from dying. The Rabbi had long suffered and his unnamed maidservant, who had been with him throughout his life, understood the extent of her master’s pain. She climbed up to the roof and threw off a large a jug which smashed to the ground. The shattering sound momentarily distracted the students from their prayers, and the soul of their revered teacher immediately departed. The Talmud concludes the story by stating that on that day the angels triumphed over the righteous and the maid’s place in the world to come was guaranteed. Here, mercy for the suffering triumphed.
And my previous story, about Rabbi Ben Teradion being burned at the stake and refusing to die quickly, has an unusual ending. The Roman executioner asked the Rabbi, “If I raise the flame so you die quickly, can I go to heaven?” The Rabbi agreed. Does this mean an executioner, a murderer, goes to heaven alongside our most revered rabbinical teacher? Rabbi Aaron Freedhoff explains that the reward is for the act of compassion, allowing Ben Taradiyon to avoid suffering.
Rabbi Jordan Cohen of Anshe Sholom Congregation of Hamilton wrote a wonderful sermon on this topic and asked an important question: “If someone is in great pain and it is their wish to die through medical assistance, should I stand in the way? Alleviating suffering is also a way of valuing life. Of course, those who can and want to endure to their last breath, deserve our support and often they don’t have the choice. It’s up to the family. But who are we really considering if we force someone to stay alive when he or she wishes to let go? “
Rabbi Jonathan Romain, a leader of the interfaith group of clergy in favour of assisted dying, reminds us that in Ecclesiastes 3:2 we are told that, “There is a time to be born and a time to die’— but it is noticeable that this verse does not stipulate who chooses that moment. Until now, we have always assumed that it was God.” But we humans can also have a part.
Our medical professionals do choose to intervene to prolong life, through surgery, medicine, blood transfusions, organ transplants, induced comas, feeding tubes and breathing tubes. At the same time, we ought to be able to bring life to a gentle close within the limits and safeguards of the law. The Talmud also says the life of the righteous ends like a hair being pulled through milk. Those who wish to avoid suffering and pain should be able to do so — as a human right but also in keeping with religious ethics.
When I listened to the story of Marvin and learned he spent his precious time telling his family how and when he wanted to die, and how he brought everyone together, I didn’t think about whether it was right or wrong. I appreciated how his family let him make the decision for himself, how they supported him, and were at peace with it. I don’t know if this would be my decision, if the time came, and I could never make the decision for anyone else.
I believe in the sanctity of life and trying to save and support life, but I also support people who choose assisted dying, according to the new law, within all the proper safeguards.
Yes, there are valid concerns. Namely, if assisted death is permitted in this country and if clergy allow it, vulnerable people might be influenced into dying, by social pressure, unscrupulous relatives, seeking an inheritance payout, or relatives who no longer want to care for their ill family members.
However, I think Bill C-14 provides more than adequate safeguards to prevent non-consensual death. This is something we will cover in our sessions in October and November with legal and medical professionals. I have learned that there is no evidence, so far, to support the notion of a slippery slope that will lead to the killing of people to save money, or the ending of lives of people who are unable to grant consent. Our legal criteria seem quite clear and fairly comprehensive.
In our reading from the Torah on Yom Kippur, from Parshat Nitzavim (Deuteronomy 30:19), Moses proclaims, “This day I call heaven and earth to witness regarding you: life and death I have set before you, blessing and curse… choose life.” Rabbi Cohen interprets this to say that our Jewish tradition is grounded in binary paradigms: tohu u’vohu, order and chaos, good and bad, heaven and earth, light and darkness. And yet, no one among us can deny that, in the intersection of life and death, there is a vast realm of uncertainty and unknowing. Things are not always as black and white as we want them to be.
As the legal landscape has now shifted in our country to permit medical assistance in dying, I cherish and thank the wise, anonymous maidservant of the Talmud, who, through her
compassion and understanding, allowed her master to make his own choice as to when he wanted to die. Now, she is bound up in the bonds of eternal life next to the righteous and the holy. The wise women and men of our Canadian Supreme Court have removed the barriers for us to be able to offer those whom we love and honour that same great chesed – that same great mercy. I believe we should, in turn, give our loved ones the same choice.