First Responders Join Last Line of Defense
Williamsburg, Brooklyn NY – Close to 100 devoted Williamsburg Hatzolah volunteers attended a presentation last Thursday, February 27th. It was a groundbreaking initiative to expand Hatzolah volunteers’ role in the struggle to keep patients alive after their arrival at the hospital even when medical professionals may be urging their families to “pull the plug” and take them off life-saving equipment as happens all too often in hospitals today. The evening was a collaboration between Hatzolah and Chayim Aruchim. Chayim Aruchim is a project of Agudath Israel of America that promotes awareness of the Halachic issues involved in end-of-life care.
The topic of the lecture at the Decorium Hall in Williamsburg addressed an aspect of the battle to save lives that often takes place after Hatzolah members leave. Lecturers discussed the predicament vulnerable families find themselves in, when barraged by hospital staff to sign a Do Not Resuscitate (DNR) or a Do Not Intubate (DNI) order.
Though this is known as the “end of life” dilemma, on numerous occasions, patients regain consciousness while on life-saving equipment and continue to lead productive and meaningful lives. Rabbi Meshulam Polacheck, shlita, Posek for Hatzolah Central, member of the Williamsburg Hatzolah and the Rav of Khal Meged Yehuda, described a very recent case that illustrates this.
A middle-aged woman with a history of health issues was hospitalized in critical condition. The doctors advised against putting her on life support. The patient’s husband called his rav and was advised that in addition to the obligation to save a life, it would be severe torture to withhold life support, since the patient was struggling to breathe. The rav told him to request that his wife be connected to a respirator. A week later, the woman regained consciousness and began to recuperate. The story would have ended very differently if the husband had followed the medical team’s advice.
Speaker after speaker, from both Hatzolah and Chayim Aruchim pointed out that notwithstanding the outcome of an individual case, according to Halachah, life – in any shape and form – is life, and cutting it short is tantamount to murder.
Despite this, Orthodox families and others living by this principle increasingly find themselves pressured to consent to have the plug pulled on their loved ones. The surge in such cases stems from a combination of factors, including the modern liberal view that weighs the value of of life against economic considerations or misguided application of compassionate care.
Critical Information: A Timely Response
Hatzolah coordinator Shea Bernath praised Chayim Aruchim for joining forces with Hatzolah and welcomed Rabbi Polacheck, thanking him for guiding Hatzolah to ensure “a hundred percent adherence to Halachah … This joint effort with Chayim Aruchim will help us ensure that our hatzolas nefashos isn’t cut short later on by the hospital in a way that is against Halachah.”
Reb Shlomo Yosef Waldman, Treasurer of Hatzolah, longtime member of the organization and a renowned askan, related an anecdote of a secular doctor who came to Rabbi Yitzchak Yaakov Weiss zt”l, the author of the Minchas Yitzchak, regarding a deceased patient who stalks him in his dreams demanding to know why he disconnected him from life-support. Rabbi Weiss explained to the doctor that one’s account of aveiros can be lessened or even completely cleared with every additional moment of life, even when one is unconscious. By shortening a life, one never knows what damage is done to the Neshama (soul). This is why ending life in any stage is tantamount to murder.
The Psak Explained
Rabbi Polacheck then spoke, explaining the psak halachah recently signed by the Hatzolah Rabbinical board on this subject. The psak states that one must be extremely cautious and check with a Dayan or Posek specializing in medical sheilos before signing a DNR or DNI or other medical directives. It also encourages patients to sign a Halachic Medical Directive, a legal form produced by Agudath Israel of America to ensure that all medical decisions will be made in accordance with Halacha.
Rabbi Polacheck conveyed a message from the other two rabbanim of the Vaad – Satmar Dayan, HaRav Yisrael Chaim Menashe Friedman, shlita, and Williamsburg Nitra Rav, HaRav Yitzchok Moskowitz, shlita, who were unable to participate. The two rabbanim called this an urgent matter of hatzolas nefashos and said that it would be a tremendous zchus for the members to encourage families to take these crucial, life-saving steps.
“Baruch Hashem, Yidden are zocheh to assist others. It is a zchus to be in such a crowd,” said Rabbi Chaim Dovid Zwiebel, Executive Vice President of Agudath Israel. Expanding on the psak, Rabbi Zwiebel said that a medical expert once pointed out to him that often, when a DNR or DNI form is in the medical record, “nurses take it as a DNT form: Do Not Treat.” Therefore, even in cases where halachah permits one to withhold treatment, one should still be careful not to sign the form, lest it is taken in practice in a far broader manner.
“You are doing the beginning of the mitzvah, by saving and reviving the patients,” Rabbi Zwiebel said. “Now we are joining so you should also finish the hatzolas nefashos, by encouraging patients to sign the Halachic Medical Directive that will be available in the ambulances.”
Chayim Aruchim and Hatzolah United
Rabbi Shmuel Lefkowitz, Vice President of Agudath Israel and Chayim Aruchim committee member, noted that having Hatzolah on board also adds immeasurable clout to the ongoing discussion with the hospital leaderships. “Whenever we tell them that we work with Hatzolah, it adds tremendous weight. The respect for Hatzolah is immense.”
Rabbi Lefkowitz said that Chayim Aruchim also assists by providing rabbanim knowledgeable in these sheilos, who can discuss each specific case with the doctors. To that end, seven young dayanim recently completed 34 three-hour sessions, with different doctors and specialists, to gain knowledge needed to assess each situation. These dayanim will serve the community under the leadership and guidance of HaRav Hershel Ausch, shlita, Yoshev Rosh of the Karlsburg Beis Hora’ah and a renowned expert in areas where halachah and medicine intersect.
“Hatzolah started in Williamsburg,” Rabbi Gedaliah Weinberger, Chairman Emeritus of Agudath Israel of America’s Board of Trustees and Chairman of Chayim Aruchim, said, “It’s fitting that this important initiative for hatzolas nefashos that will iy”H involve all Hatzolah branches should also start here in Williamsburg.”
“You, Hatzoloh members, are Stage One to save the life of the patients,” Rabbi Weinberger told the gathering. “The hospital liaisons to the community are Stage Two,” he added, acknowledging NYU patient representative and Williamsburg Hatzolah member Israel Rosman. He also thanked Rabbi Berish Fried, Chayim Aruchim’s New York project director and organizer of the event, and Rivie Schwebel, a committee member present, for his leading role in Chayim Aruchim.
One sentence by Rabbi Polacheck, addressed to the Hatzolah volunteers, still echoes.
“Who else knows as much as you how many yiddishe tzuros are out there,” he declared. “In the merit of the new hatzolas nefashos mission that you take upon yourselves, the Eibishter should help that all Yiddishe shtiber (households) should have only orah v’simcha v’suson v’ykor.”