New Cedars-Sinai Form Rooted in Biblical Tradition with Wide Latitude for Care Options

BY DANIEL GAITAN | daniel@lifemattersmedia.org

Cedars-Sinai Medical Center has created a new advance health care directive to meet the needs of the nation’s diverse Jewish population.

The Cedars-Sinai Jewish Advance Care Directive provides a range of options to help ensure Jewish patients receive end of life care that honors their individual faith, values and wishes.

“The document is drawn up in a manner that is acceptable by the strictest interpretations of Jewish law while, at the same time, not obligating patients to follow Jewish law if that is not their wish,” writes Rabbi Jason Weiner, director of the medical center’s Spiritual Care Department, in the Jewish Journal.

The advance directive encourages individuals to appoint their own rabbi or Jewish institution to assist with end of life decision-making. Patients can also document their burial wishes and choose who they want to make decisions on their behalf in instances of illness or incapacity.

While patients nationwide have received an influx of cross-disciplinary cues in recent years to participate in advance care planning, it was Judaism’s oldest sacred text which first highlighted end of life planning’s importance.

The first Jewish advance health care directive made its appearance in Genesis, the first book of the Hebrew Bible, according to Sarah Rosenbaum, a student rabbi studying at the Hebrew Union College Jewish Institute of Religion in Los Angeles.

Nearing death, Jacob called for his favorite son, Joseph, in order to plead with him that he not be buried in Egypt. Jacob requested to be carried to the land of Canaan and buried with his forefathers.

Joseph promised that he would honor his father’s wishes.

Before his death at age 147, the patriarch of Israel delivered blessings and curses to his 12 sons in order of age. Jacob, also known as Israel, reiterated his burial wishes. According to the 49th chapter of Genesis:

Then he charged them, saying to them, ‘I am about to be gathered to my people. Bury me with my ancestors.’

Jacob wished to buried near Abraham and his wife Sarah; Isaac and his wife Rebekah; and his first wife, Leah.

When Jacob ended his charge to his sons, he drew up his feet into the bed, breathed his last, and was gathered to his people.

Jacob made repeated efforts to plan for his burial and ensure that his possessions were appropriately distributed.

“The way we care for those who are seriously ill has advanced since Jacob spoke with Joseph about 4,000 years ago,” Weiner writes. “Our practices have changed a great deal, as well, in the decades since contemporary Jewish advance directives first were drafted in the early 1990s. These modern efforts, building on the foundations of our biblical ancestors, underscore how the need remains more crucial than ever.”

Rosenbaum told Life Matters Media that the story of Jacob and Joseph is “an example for us to look toward,” as family decision-making is prized by followers of the Jewish faith.

Rosenbaum once served as a chaplain at Rush University Medical Center in Chicago, and she said that her experience at the bedside informs her special appreciation for the new form .

“We’re creating a space for people to talk about these important issues,” she said. “People need to be given space and time and a push in the right direction. It’s much better to think about these things when you’re not sick.”

The document is divided into six easy-to-use sections:

My Health Care Agent and Rabbi

My Health Care Goals, Values and Preferences

How Strictly Do I Want My Advance Health Care Directive Followed?

Organ Donation and My Wishes For After I Die

Identifying My Physician

Signing My Advance Health Care Directive

According to Rosenbaum, “This document leaves a lot of room for people to make decisions based on their personal interpretation of the tradition.”

Image: Jacob Blessing the Children of Joseph by Rembrandt, 1656