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New Jewish Advance Healthcare Directive Unveiled

Rabbi Jason Weiner

Rabbi Jason Weiner, senior rabbi and director of the Spiritual Care Department, oversaw the drafting of an Advance Healthcare Directive tailored to the specific needs and traditions of the region's diverse Jewish community. The Cedars-Sinai Jewish Advance Healthcare Directive is the first of what he expects will be others created here that reflect the needs of other faith traditions. Here, he discusses why this effort is so important.

The first Jewish advance healthcare directive made its appearance in Genesis, when Jacob, nearing the end of his life, implored Joseph to bury him with his forefathers.

The way we care for those who are seriously ill has advanced since Jacob spoke with Joseph about 4,000 years ago. Our practices have changed a great deal as well in the decades since contemporary Jewish advance healthcare directives were first 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.

Because of this need, my colleagues and I here at Cedars-Sinai have developed an innovative new healthcare advance directive, as well as a specifically Jewish version of the document we hope will be embraced by our Jewish patients and by diverse Jewish communities around the world.

To understand the nuances of this new advance directive, it is helpful to appreciate why a document like this is so essential.

Medical technology grows more sophisticated with each day, and with that comes the ability to intervene, cure disease, mend bodies and prolong life. Advance directives allow our patients to convey to their families and healthcare providers how they feel about their medical care if they are unable to actively participate in decisionmaking.

So why a Jewish version of the advance healthcare directive? The more the document can be formulated in a culturally and religiously sensitive manner, the better chance it has of actually being utilized and of accurately expressing patients’ goals, values and preferences.

There have been previous advance healthcare directives that catered to the Jewish community, including two by Orthodox organizations and one written by conservative rabbis. These documents have value, but our new advance healthcare directive takes an entirely different approach.

We cater to a diverse community, and our aim has been to craft language in a way that is sensitive to the religious views of the patient. And because the Cedars-Sinai version gives patients an opportunity to describe their values, it tells us about who our patients are, what is important to them and what is not important to them, not just which interventions they do or do not desire.

The Cedars-Sinai Jewish Advance Healthcare Directive provides a range of options. For example, individuals can appoint their own rabbi or a Jewish institution to assist with decisionmaking; patients also can indicate whether they want to donate their organs. 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.

My hope is that the user-friendly healthcare advance directive will resonate with any Jewish patient who needs it, regardless of affiliation or persuasion.

This work is the start to a larger undertaking. Because Cedars-Sinai serves a broad and diverse community, it is our goal to produce more culturally sensitive and religiously appropriate directives for other groups so that all patients can express their values as they work through some of the most profound decisions in their lives.