Death, death and more death

When I was a synagogue rabbi, I bemoaned the fact that so much of what I did was death-centered. Well, the past couple of weeks have been a throwback to that time, due to a confluence of events: An interest by local organizations in having seminars on "end of life" care, and the Supreme Court of Canada's ruling, on February 6, that physician-assisted suicide should be legal.

The result is that this is the major topic everyone wants to hear about. So on Monday evening I spoke at a synagogue on Assisted Death, and Tuesday evening I spoke for a UJA program on end of life care. On Wednesday I have a lunch and learn at an accounting firm, and they want to talk about assisted death. Then, on Sunday of next week, I am to speak at another synagogue on End of Life care.

It's good that people want to hear Judaism speak to these issues, and I'm honoured to be asked, but boy... what I wouldn't give to be asked to speak about fertility treatments instead...

The Supreme Court of Canada Recognizes a Right to Die

This past Friday, the Supreme Court of Canada ruled that the federal ban on assisting suicide violates the rights of Canadian citizens. As they put it here, "The prohibition on physician‑assisted dying infringes the right to life, liberty and security of the person in a manner that is not in accordance with the principles of fundamental justice." They ruled that the prohibition is "of no force or effect to the extent that they prohibit physician-assisted death for a competent adult person who (1) clearly consents to the termination of life and (2) has a grievous and irremediable medical condition (including an illness, disease or disability) that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition." The Canadian legislature now has twelve months to re-write the law to accommodate the view of the Supreme Court.

This is not the space for a full treatment of this subject (feel free to come to my upcoming talk on the subject at Shaarei Shomayim in Toronto on February 23rd). I will not go into halachah here, other than to say that Jewish law is very clear in forbidding actively ending a patient's life.

In this space, I'd just like to point out a tried and true legal principle: Hard cases make bad law. It would be inhuman and un-Jewish to deny the wishes of people who are suffering without remedy - but crafting legislation to address exceptionally difficult situations will produce laws that endanger the rest of society.

Here are some of the challenges such laws would need to address:
* Will we impose age limits, or will we go the way of Belgium, which permits the death of minors? In the Netherlands, a 17 year old - who cannot be trusted to vote - can override parental  refusal and choose death.

* How will we avoid pressure on patients to choose assisted death? As Margaret Dore, a lawyer in the state of Washington, has testified from her experience with their legalized assisted suicide, the existence of this option leads to subtle and unsubtle pressure upon patients to choose death.

* Who will advise the patient in this matter? Will we ask doctors, who function as the protectors of our healthcare resources, to counsel patients on whether or not to tax those resources? [Indeed, the Royal College of Physicians and Surgeons of Canada notes that doctors must be able to "Appreciate the possibility of conflict inherent in their role as a health advocate for a patient or community with that of manager or gatekeeper".]

* Who will testify as to the patient's wishes, where the patient cannot speak? Paragraph 27 of Quebec's Assisted Suicide bill permits relatives to testify [only minors and members of the healthcare "team" may not do so]. Mind you, our Succession Law will not allow relatives to testify regarding the authenticity of a will, because of conflict of interest... but they could testify that a patient wanted to die?

* Will physicians be compelled to help end lives of patients? As noted by the College of Physicians and Surgeons of Ontario, physicians are not necessarily permitted to refuse to treat on moral or religious grounds.

* Who is going to pay for this - should OHIP (Ontario's provincial health insurance), which doesn't cover routine dental and eye exams, pay for death? [Paragraph 26 of Quebec's Act seems to say that Quebec's provincial health insurance does cover the cost of ending a patient's life.] And if not, then could a suffering person be denied death - a human right, per the Supreme Court - because he couldn't pay for it?

As I said above, we must find a way to help people who are suffering. But in my view, licensing assisted suicide is fraught with so many problems as to make responsible legislation an impossibility.

Immortality: Is it bad for religion?

Back in February, Time ran a cover story on Ray Kurzweil's prediction that technology will cure aging in the coming decades.

This evolution wouldn't actually equal immortality – plagues could erupt and take a toll before being brought under control, and people could die from physical trauma. Nonetheless, it will come as no surprise to you, if you've read any of my six previous posts labelled General: Death, that the idea of even this immortality-lite existence fascinates me.

I wonder: Would this form of immortality make religious practice weaker or stronger? Well, "religion" is a big place, so let's refine that: Would it make Judaism weaker or stronger?

My first thought is that immortality would weaken Jewish practice; many people embrace religion in a search for attachment to something larger than their own limited existence, or out of fear of what happens 'next', but in an immortal existence they would feel less pressure to opt for religion.

On the other hand, it might actually strengthen Jewish practice: One of the disincentives of Judaism is the heavy demand it places upon people's time, and the fear that observing mitzvot will translate into lost opportunities for fun and pleasure. Once we find the Fountain of Youth, though, the pressure to enjoy the moment dissipates.

Further, people whose lives are limitless might feel a greater push to find meaning. In a brief existence, there is relatively little time available for introspection. Extend life by a few centuries, and perhaps more people to stop to think about why they are here.

Those are just beginning thoughts. What can you add?

Posthumous posting

[Interesting quote: "There is no need to be frummer than Bais Yaakov."]

I was going to write about this several weeks ago, but stalled as other things came up – and then Jack beat me to it with A few words about my death. But let it be known that I had the idea long before Jack [faux] did it.

The idea is simple: To post-date articles so that they show up on this blog only way down the line, quite possibly after I have moved on to a different world.

I'm not sure why I want to do this. It goes against my grain – usually, I want things I like to appear immediately. And if I don't like it, why publish it? And the Comments section would be pretty dull. And how would I defend my more controversial pieces?

And yet, I want to do it.

Part of me wants to do it because otherwise, the day I go will be the day this blog goes; it will ossify and become uninteresting [if it hasn't already...]. But if there is always the promise of a future post, then followers will still follow, and people will still visit.

Part of me wants to do it for the fun of being entirely out-of-sync when writing about cultural things. Imagine a future post which talks about sports or literature or just normal life, in a world which experiences those things entirely differently.

Part of me wants to do it because a major reason I blog is to tell my children about their ancestor, and they might read new posts even if they won't bother to dig into musty old archives.

Part of me wants to do it because I used to have an anonyblog which I kept anonymous to protect people who were described in it, until I got rid of it because I wanted to blog under my own name. Maybe I could take a bunch of those old posts, though, and put them on here in a century or so, when no one involved could be identified anymore.

Of course, there are risks involved; after all, Blogger may well be gone in 10 years, let alone 50 or 100; why write something, work on it, and withhold publishing it, only to have it disappear when Blogger does?

Nonetheless, I think I'll go for it. Stay tuned...

Dead for a moment

We’re having work done on some of the kids’ bedrooms, with the side effect of our bedroom becoming a storage center (Canadians: storage centre) for a whole lot of stuff. The result was that I had to sleep in the basement last night.

[Sleeping downstairs was not a bad idea anyway, given this heat. It seems the designers of this home and its A/C thought that we should all be moles and live underground; no discernible cold air reaches the air ducts on the second floor. Our children's toys are well-chilled.]

So I came upstairs this morning and found the Rebbetzin asleep in my bed. The switch made sense, given that hers was loaded down with assorted childrenswear, but it still threw me for a minute. When I opened the door and took in the scene, it was a Ghost-like moment, like I was gone… For a moment I felt like I was actually dead, and seeing the room from another plane.

I’ve always had serious death fears, and although I’ve come a long way, I still think about death a great deal more than is healthy. So this was a natural leap for my imagination.

I've done the same thing in traffic - after narrowly missing an accident, feeling momentarily like my body actually was in the accident, and now I'm moving along in spirit alone. [Am I the only one who does this?]

Spooky.

Defeating Necrophobia through a Dead Cow

Early in my Rhode Island years, I helped the chevra kadisha move the body of a young man who had passed away.

I’ve always had a death-phobia, but that was a particularly rattling experience for me; it reminded me that we don’t have 100% certainty about what occurs when we die. We have faith, but even the Torah’s pesukim don’t fully address our questions about what befalls both body and soul.

Of course, some people are congenitally immune to those fears, or have been exposed to death so often that they are desensitized, but many people share my reaction of a dozen years ago – death is fundamentally frightening. This is one of the reasons why the world has been so caught up in the recent death of the big ‘80s stars, first Farrah Fawcett and then Michael Jackson – the death of these people who were so vital and so much a part of public life - so recently a part of public life - is a scary reminder of our most basic questions about the invisible future.

In the Parah Adumah, though, I see a message for dealing with our death-induced fear.


The Parah Adumah (red heifer) is used in a ritual performed to purify people from contact with death. As we described it in this morning’s parshah, a red cow is killed, and then the carcass is incinerated. A small amount of the ash is then placed into specially prepared water, and that water is sprinkled on a person who is impure. This didn’t go on all the time, of course; the ash of the parah adumah lasts for generations, so that only nine parot adumot have been used in history.

This parah adumah is actually described twice in the Torah, in separate contexts:

• First: After the Jews crossed through Yam Suf, they traveled for three days without fresh water. Finally, they arrived at an oasis called Marah, only to find that the water was not potable. Frightened by their physical suffering they complained to Moshe, and Gd showed Moshe how to treat the water to make it sweet. Then, we are told, the Jews were taught חק ומשפט, which Rashi explains includes parah adumah, and so the parah adumah is eternally linked to the water of Marah.

• Second, this week, we learn the specific laws of the parah adumah, and here the sages link the parah adumah with the Cheit haEigel. When Moshe disappeared atop Har Sinai for nearly six weeks, the people feared that they had lost their Divine protection and they created an Eigel, a calf, as a substitute, treating it as a quasi-god. We use a cow for purification to counter that idolatrous calf.

In both of those cases, the message is that the Jews experienced fear of physical or spiritual death, and Gd was there for them – and their message is the message of the Parah Adumah as well.


Marah and the Eigel provide the two basic components of the Parah Adumah ritual: We take the ashes of a cow, reminiscent of the Eigel at Sinai, and we introduce them into water, reminiscent of the water at Marah. We then sprinkle them on the person who has been close to death to remind her that we have been close to physical and spiritual death in the past, as a nation, and Gd has saved us.

Indeed, the whole idea of using a dead cow to purify someone from death is inherently paradoxical, but perhaps that’s part of the message – that even when we are brought face-to-face with death, we can conquer this fear because Gd will be there for us.

Just as Gd told Yitzchak, “Don’t be afraid – I was with your ancestors, and I will be there for you as well”;

Just as Gd told Yaakov, “Don’t be afraid – I was with your ancestors, and I will be there for you as well”;

So Gd tells every one of us, in our moment of greatest despair and fear, “Don’t be afraid – I was with your ancestors, and I will be there for you as well.”


The Torah underscores this message by connecting it with Miriam, placing it right before her demise, because she faced down death with trust in Gd.

Miriam was all of six years old, apprentice to her mother as a midwife, when the Egyptian Pharaoh ordered the two of them to kill all of the Jewish baby boys. She and her mother overrode any fear of man, defied Pharaoh and saved the babies. And so the conclusion of Miriam’s story follows the Parah Adumah, a lesson for all of us in how to deal with our own fear of death.


Forty years ago this month, with the entire world of their day as well as future generations watching, three men conquered their fear of the unknown, landing on the Moon in the Apollo 11 mission. They used training and simulators to get rid of the unknown; as Buzz Aldrin wrote, “True fear is the fear of the unknown, and all our training had been geared towards eliminating the unknown as much as possible.”

But when a human being confronts death, he can’t eliminate the unknown; there is no ‘death simulator’ available. Nonetheless, the Parah Adumah’s message is that any of us can conquer our fear of the unknown by remembering that just as HaShem was at our side at the waters of Marah, and just as HaShem was present at Sinai, so HaShem will be with us now to help us along.

-
Notes:
1. I am always loathe to suggest original ideas, and particularly regarding Parah Adumah, regarding which the sages teach that we cannot divine the explanation for some of its details. However, I base my comments on those of the sefer Or Avraham; he pointed out (based on the wording of a special tefillah for Parshat Parah) that Parah has the two elements of Marah and Eigel, and that the Eigel explanation is associated with Parshat Chukat but that other explanations would be necessary for Marah.

2. Of course, the gemara and most midrashim exclude parah adumah from Marah, offering other definitions of חק there, but parah adumah is the one that Rashi chooses to present.

3. I also wanted to do something with the ezov of korban pesach and tolaat shani of mishkan, but the erez is more problematic. Of course, the general bundle appears in taharat metzora.

4. Miriam is the Torah's icon of fearlessness in many more ways, but I left her larger story out lest it distract, and focussed specifically on the fear-of-death element.

5. Buzz Aldrin's comments are found here.

On the death of a child

[I feel like I’ve had too many death posts of late; I apologize, but it's the order of the day.]

I don’t use profanity; the gemara is very clear about how repellent it is when a person cannot control his tongue, and uses his gift of speech for base purpose. Presumably, the same applies to the keyboard. So I won’t say what’s on my mind.

And there’s nothing meaingful to say, anyway. What would you say?

What do you to someone who carries a baby to term, only to discover upon birth that it is not viable? What do you say when you stand there in the NICU and look at a baby, born yesterday, that will not see tomorrow’s sunrise? What do you say afterward, as the body lies, still, on a table designed for serving up life and joy and celebration?

Forget what you say to the family, to the mother. There is nothing to say; you’re just there.

But what do you say to yourself in order to shut out the image, so that when you look at your own happy children you don’t see those closed eyes, the miniature fist that should be clenched, not lax?

What do you say to calm your mind, so that when you look in the mirror you are not awash with guilt for having been spared this calamity?

What do you say to relax your nerves so that every pregnant woman doesn’t suddenly seem to be a disaster in the making, so that when you finally drift off tonight – eyes closed like the baby, don’t you know - you won’t see visions of what you saw today?

And what do you say to others, to people you meet who waste their breath and time and happy moments on turf wars and pride and who-did-what-to-whom? Or to people who have done nothing wrong, beyond being concerned with a passing, comparatively trivial matter at time when you are enveloped in this?

I know pediatricians, hospitalists, NICU personnel; they see this more than I do. I want to ask them, but I don’t want to know the answer. I know many, too many people who have endured this personally and managed to live life, sometimes birthing more children, sometimes adopting, sometimes not, but finding a way to survive.

I don’t want to know that you can’t learn to live with it. But I certainly don’t want to know that you can learn to live with it.

Death hurts, but it's not unfair

It’s been another deathfest these past couple of weeks, after a good two months in which, thank Gd, people stayed mostly healthy. I’ve lost some great friends and role models.

And, as inevitably happens at these times, I’ve heard people say, “It’s unfair.”

I have to disagree (although I would never say so aloud; to insult a mourner in his time of grief would be the cruelest stupidity).

I, too, am stabbed by pain. I hate eulogizing people, I am tired of the grieving process. Why do we have to lose anyone, let alone such good people? They were in the prime of life, or they were just about to enjoy retirement, or they were anticipating the birth of a grandchild, or they were doing good things, or they didn’t have a chance to say Goodbye…

But I do disagree with the “unfair” label.

Of course, from a Jewish perspective I disagree because we are taught to say ברוך דיין האמת, Blessed be the Judge of Truth, upon hearing of a death. We express this religious sentiment, which we hope we will come to feel in the course of the grieving process. We long to heal the ruptured relationship with Gd, to see through the immediate grief and agony and appreciate the good we were given.

But, beyond that longing for reunion with Gd, I think saying “it’s unfair” is illogical.

I see four logical arguments regarding Gd’s role in life and death:
1. Gd creates life as well as death.
2. Gd creates life, and not death.
3. Gd creates death, but not life.
4. Gd neither creates life nor death.

There may be gray areas in between, such as the idea that Gd is responsibility for “big picture” but not for details, but I don’t see that those shaded ideas contribute anything new here, so I omit them.

View #2 (possibly supported by Rava in Moed Katan 28a) says that death is the agent of unknowing fortune, and so it can hardly be termed “unfair” – “unfair” suggests a decision was made.

Similarly, View #4 assumes that no decision was made, and so death cannot be “unfair.”

View #3 strikes me as entirely against any idea of Gd I might conceive. I could sooner understand total atheism. So I discount this as well.

That leaves me with only View #1, which is the traditional Jewish view. If View #1 is true, then everything we received until this point is a gift… and how can I call rescension of a gift “unfair”?

I am in pain, but I concede that I have received far too much to ever say that the end of this gift is unfair.

ברוך דיין האמת.

[This week’s Haveil Havalim is here.]

Amortality: A Consequence of Early Mortality

Catherine Mayer writes in Time about one of Ten Ideas that are Changing the World: Amortality. She writes, “The defining characteristic of amortality is to live in the same way, at the same pitch, doing and consuming much the same things, from late teens right up until death.” Ms. Mayer observes that this is more than a result of boomer age-resistance; it’s actually a separate (if related?) phenomenon.

I have noticed this “amortality” in myself, although I have tended to write it off as a product of life on the early side of middle age. I have assumed that my desire to pretend I am still in college is either some form of mid-life crisis, or some immaturity I will outgrow, or both.

But, in any case, I think Amortality is a consequence of Early Mortality, of the death-cult envelope in which every member of the developed world now lives.

From the earliest ages, we are super-aware of death and its causes:

• Posters in our local pediatrician’s office show pictures of slim children and obese children, and list the statistical likelihood of illness and death for each.

• The ebullient BNL song, “If I had a million dollars, I would buy you a fur coat, but not a real fur coat, that’s cruel – I would buy you an exotic pet, like a llama or an emu – We wouldn’t have to walk to the store, we’d take a limo ‘cause it costs more” is sadly irrelevant. If I had a million dollars, I’d stick it in a CD or a mattress and wait for the market to improve, so that I’d be able to afford long term healthcare.

• News websites feed our hunger for statistics as well as fear, plugging us with numbers on the top ten causes of death in our country, state and hometown, broken down by age, demographic and social status.

We worry about diet, exercise, retirement accounts, long term care insurance, war and terrorism, global warming, social collapse, anxiety disorders.

We start forestalling death in our youth, with everything from college-prep pre-schools to pre-arranged funerals.

So it’s only natural that, with death constantly on our mind, we live every moment to its desperately youthful fullest, to the best of our ability, resisting any change, any concession to the grave. We are afraid to do otherwise.

The irony is that this desperate amortality is, itself, a contributing factor for those anxiety disorders. As the Talmud teaches, one who is forever worried about tomorrow’s bread has no life at all.

We might do well to acknowledge the grave even as we forestall it; acceptance tends to be a healthier option, physically, than denial.