Sermon by Rabbi Denise L. Eger, April 22, 2005

Shabbat Shalom and A Sweet and Happy Passover to everyone.

For the last several weeks—one would think that the whole world was Roman Catholic. The death of John Paul II and the election of Benedict XVI has consumed the media day and night. Indeed who shall head the largest Church in the world is news—but the speculation and the excessive detail has been sensory overload for many of us.

This fall Jews and Catholics will celebrate forty years since the Vatican II Councils breakthrough document—Nostra Aetate came into being. Nostra Aetate—begun under the term of John XXIII and came to full fruition under Pope Paul VI. This groundbreaking document changed forever the way Roman Catholic teaching related to the Jews. For centuries, since the founding of the Church—Jews had been blamed, indeed cursed for causing the death of Jesus. A part of the Gospel, reinforced in Catechism and the dogma of Church teachings, expounded from Pulpits throughout the decades—the accusation against Jews became the justification for virulent Anti-Semitism and according to some analyses, led to the ultimate murder of Jews during the Shoa.

Certainly as we Jews begin to celebrate the Passover holiday—the memories of Pesachs past—when blood libels against Jews were the justification for pogrom after pogrom are not far behind. These church teaching that blamed Jews for the death of their Savior, under gird the violence perpetrated against shtetls in East Europe as well as the annihilation of Jews in towns and villages across Europe as the Crusaders marched to liberate the Holy Land from infidels.

But Nostrae Aetate, which came out in October of 1965—repudiated these teachings, and forever changed the relationship of Jews and Roman Catholics.

Thus when John Paul II, visited Auschwitz in 1979, visited Israel in 2000 as well as being the only Pope to ever visit inside a synagogue –as he did in 1986 in Rome, he gave further strength to this teaching of reconciliation between Jews and Roman Catholics. John Paul II reached out to the Jewish community, apologizing on behalf of the entire Church for the sin of Anti-Semitism. This was historic and unprecedented in Church history—reinforcing the II Vatican Councils words.

But what do we make of this new pope- The Former Cardinal Joseph Ratzinger—now Pope Benedict XVI? A German Pope, who was once a member of the Hitler Youth—has risen to this most powerful position. In truth Ratzinger was forced to join the Hitler Youth as many in his day and time and his family had a strong anti-Nazi bent. But it remains to be seen whether this New Pope will continue to reach out to the Jewish community and to Israel.

For the last 20 years, Ratzinger’s position in the Church has been to as head of the Congregation for the Doctrine of the Faith in 1981, where he was responsible for enforcing Catholic orthodoxy and was one of the key men in the drive to shore up the faith of the world's Roman Catholics. Formerly he had been the bishop and then cardinal of Munich (the place where Hitler and Nazism got its start) and then a theologian who taught at the University of Regensberg in.

As head of the Congregation for the Doctrine of Faith (which in another time was called the Holy Office and before that the Holy Inquisition)—Ratzinger’s right ward and orthodox thinking reigned supreme—influencing greatly John Paul II pronouncements and teachings. Ratzinger even as recently as John Paul’s funeral—renounced relativism and secularism as the scourge of Europe and a threat to the Church.

Ratzinger’s writings of which there are many—are as fundamentalist in their views as any.

Many people believe Ratzinger will be remembered as the architect of John Paul’s internal Kulturkampf, intimidating and punishing thinkers in order to restore a model of church -- clerical, dogmatic and rule-bound -- many hoped had been swept away by the Second Vatican Council, the 1962-65 assembly of bishops that sought to renew Catholicism and open it to the world – of which Nostra Aetate document was a primary example. Ratzinger’s campaign bears comparison to the anti-modernist drive in the early part of the century or Pius XII’s crackdown in the 1950s, critics say, but is even more disheartening because it followed a moment of such optimism and new life. He has silenced Catholic theologians who dare to think beyond the boundaries of the Church be it Liberation theologians which uplifts the poor and condemns capitalism or the spirituality, creation ideas of Father Mathew Fox. He has been virulent in his condemnation of gay life and gay marriage—but silent in the face of the evil pedophilia scandals that has rocked the Catholic Church. He is clear that women cannot and never will be priests. This new pope has a long record of enforcing doctrinal purism and does not see change as part of the vocabulary of the church.

In 1986 Ratzinger wrote document (which has the force of a memo) to the Church—called "On The Pastoral Care of Homosexual Persons." The letter warns of "deceitful propaganda" from pro-homosexual groups. It instructs bishops not to accept groups that "seek to undermine the teaching of the church, which are ambiguous about it, or which neglect it entirely." The letter refers to homosexual orientation as an "intrinsic moral evil." In the wake of the letter, many Catholic bishops bar Dignity from using church facilities.

Thus I believe we must greet this new pope with grave caution. For the gay community this Pope has a long track record of hatred. For women, this new pope has written extensively and believes in the infallibility of the position that the non-ordination of women is part of "the written word of God." This new pope has written that feminists within the church are to blame for the woes of the world and that womens grab for power within the church has “lethal effects on the structure of the family."

And of course Ratzinger continues to support and promote a policy of the Catholic Church against birth control and particulalry the use of condoms as a moral evil—which simply increases the spread of HIV and AIDS. This is a terrible Irony since Catholic priests have an unusally high rate of AIDS and HIV infection—higher than the average for men of a similar age.

And so we must as this new Pope begins his term—keep our eyes and ears open. We must continue to speak up for our beliefs and values—which are often 100 percent diametrically opposed to those Ratzinger takes. And even though we have a distates for all he promotes—we must remain in dialogue with Catholics—because although he heads the Church—the millions of parishoners around the world—do not always agree with those teachings. And it is there that we can share our lives, our values and our beliefs. We must not ever be intimidated for what we believe or how we love.

As we gather at our seder tables tomorrow and Sunday night we shall come to a portion of the traditional seder –that was said as the door is opened for Elijah. The door was opened in history not only for Elijah—but to check that no villagers were coming to attack the Jewish home. This prayer recited at the open door is one whose history stems from the virulent Anti-semitism often promulagated by the Church in medieval times.

This prayer known as Shefoch Chamatcha—based on Psalm 79:6-7 and Lamentations 3:66- asks God to “Pour out Your fury on those peoples who do not know You—And over realms which do not even call You by Your proper name. For such nations have eaten Jacob alive, Wiping out the places where we peaceably lived.”

This is hardly a text of dialogue with our neighbors—but one can understand that pain and suffering inflicted by the dogma of church hatred of Jews might inspire our own people toward revenge.

Thus as we gather tomorrow night—and open doors – let us not ask for Anger and destruction be the mode with which we come to the end of our seder meal. Let us pray instead—that God’s wrath be turned to love for all people and that love infect the world leading us to peace and dialogue even with those with whom we differ. Pour out your Divine love –even upon this new Pope—so that he will turn his hardened heart and hardened faith into a wellspring of hope and reconcilation with our Jewish people, with women in his church, and yes with the Gay and lesbian community as well.

Sermon by Rabbi Denise L. Eger, April 8, 2005

Shabbat Shalom.

They say famous deaths come in threes. First was Teri Schaivo—made famous by the circus surrounding her life and death, then the Pope—buried this morning and Prince Rainier—longest reigning monarch in Europe. With all the talk of funerals and legacy, end of life issues we cannot help but reflect on these topics in relationship to our own lives.

And given also that this week’s Torah Portion Tazria—is focused on illness and healing, plague and impurity—the Understanding from a Jewish perspective on death and dying issues and particularly end of life issues is very important.

By now we are all at least familiar with the issues surrounding the death of Teri Schaivo. Her husband Michael decided after 15 years of trying to provide her with every hope, every possible treatment, to accept the opinions and medical advice of her doctors that –that nothing they could do would a) make Terri recover and b) that she was in a persistent vegetative state and that she had no real consciousness given the state of decay of her brain.

Her parents, the Schindlers, fought him tooth and nail, taking their case through the State courts, and by act of Congress—through the federal system several times trying to prevent him from removing the feeding tubes that kept Terri “alive.”

Tonight I won’t try to address the sheer audacity, imprudence and unethical and politicizing tactics of Tom DeLay, Sen. Bill Frist, the Congress, the President and his governor brother—Jeb of Florida. They should be ashamed of the way they comported themselves, interfered in a private matter of a marriage, fished for activist judges, and subverted the legal system.

Many of us have been in the very difficult and painful decision making shoes of Michael Schaivo. We have had to decide for a loved one—a partner, a parent, or close friend whether to withhold medical treatment, and or even have to make the decision to disconnect a feeding tube or respirator. We have had to struggle with questions about what our loved one wanted, what their wishes were, as well as our own moral perspective.

But Judaism and specifically Reform Judaism do offer us guidance in this regard. So tonight I want to talk to you about the Jewish perspective on the Teri Schaivo case. For much is written about this very topic in Jewish tradition and in Reform Jewish tradition.

Even though medical technologies have progressed extending life beyond sometimes-sheer imagination—our Jewish sacred texts envisioned many different situation not dissimilar from the decision Michael Schiavo had to make.

Let us begin with traditional texts:

First let us look at the actual Jewish sources—from the Shulchan Aruch— A dying person is considered as a living being in all matters. It is forbidden to touch him lest death be hastened. Whoever touches him is considered like one who sheds blood. This is compared to a flickering candle, which becomes extinguished as soon as touched. (Shulchan Aruch, Yoreh Deah, 339:1)

We believe that life is sacred. Life is a gift from God and in our tradition we adhere to the concept of Pikuah Nefesh—preserving a life—and protecting life. This principal is illustrated by these comments in the Shulchan Aruch. In fact we can even violate Shabbat, or Yom Kippur rules to get someone the medical attention they need if the case is life threatening.

Now let us look at another case from the Shulchan Aruch:

Even if a patient has agonized for a long time, and he and his family are in great distress, it is forbidden to hasten his death by for instance, closing his eyes, or removing a pillow from under his head or placing an object such as feathers or a synagogue key under his head (Yoreh Deah 339:1)

In the second comment from the Shulchan Aruch we see that we are not to hasten the death—it seems that certain actions that change the nature of the person—like removing a pillow—and therefore the way they breathe—might quicken their death. This might be compared to the concept of Active Euthanasia. The tradition speaks clearly here – Active Euthanasia is not provided for by our tradition. Thus we cannot give an injection to end a life.

But now read Rabbi Moses Isserles comment to this section—

However, if there is an obstacle which prevents the departure of the soul (death), such as noise outside or salt present on the dying person’s tongue we may stop the noise or remove the salt so as not to hinder death. (Commentary of Rabbi Moses Isserles to Shulchan Aruch, Yoreh Deah, 339:1)

There is a recognition that the soul –the true seat of life—might have difficulty in passing from this world to the next—and we can get rid of the obstacles that keep the soul chained to this earth—and yes, to that body. This is more a description of passive euthanasia, which the tradition seems to support.

Rabbi Moshe Feinstein , a leading a halachic authority from the previous generation of Orthodox scholars, clearly allows the terminally ill patient in intractable pain to refuse life-prolonging treatment that will neither cure him nor relieve his pain. According to Rabbi Feinstein a patient may refuse resuscitation or intubation if he so chooses. A non-terminally ill patient may refuse treatment if the proposed therapy is sufficiently dangerous or unproven.

This is radically different from the Schaivo case because Terri was not capable –given the amount of brain damage, to make such a decision.

However, The general consensus in most of the halachic literature has been that certain treatments, such as oxygen, nutrition, and hydration are obligatory for all patients, regardless of the severity of their medical condition. This obligation is predicated upon the assumption that there are certain bodily needs that all people share, regardless of their prognosis, and that failing to provide for these needs constitutes a breach in the obligation to care for one's fellow human being.

Now let’s read the section form the Talmud, Ketubot 104 a.

Rabbi Judah the Prince was very ill. Seeing this, his maidservant went up to the roof and prayed for his death, since the prayers from the Rabbis below (in the synagogue) were keeping him alive. As the rabbis continued their prayers for heavenly mercy, the maidservant took up a jar and threw it down from the roof to the ground. In doing so, she caused such a noise that the Rabbis below were distracted and ceased their prayers. In that moment of silence, Rabbi Judah died.

The maid, mindful that the prayers of the students of Rabbi Judah were the “Medicine” that was keeping Rabbi Judah alive—stopped the medicine, or in this case the prayers—from being delivered. You might state that this is akin to the withdrawal of needs to the patient.

And if we further read at the top of the page—

Rabbenu Nissim of Gerondi was a prominent 13th century Spanish Rabbi. He used the story of Rabbi Judah’s maidservant as proof that there are times when one should ask God’ mercy that a sick person whose recovery is impossible and whose agony is great be allowed to die.

“Moreover, the Shulchan Aruch also explains that there is a prohibition of touching a moribund patient (goses) who is estimated to have less than three days to live. Resuscitation of a goses is not required, and in fact may be prohibited as a forbidden intrusion on the natural dying process. The underlying assumption in Judaism is that one should NOT resuscitate a gravely ill patient, but only a patient for whom there is a reasonable expectation of reversing the underlying cause of physiologic collapse the is impossible and whose agony is great be allowed to die.”

Dr Daniel Eisenberg, writes, “In Igros Moshe (the responsa of Rabbi Moshe Feinstein), Rabbi Feinstein was asked the question: "Should intravenous feeding be provided to a terminally ill patient for whom there is no method of relieving his pain, and should this be done even against the will of the patient?"

Rabbi Feinstein reiterates the requirement to provide oxygen to a suffering patient, regardless of the inability to cure the patient, because of oxygen's palliative benefits. He then responds to the question of providing intravenous nutrition to a terminally ill patient with the intent to

"Extend [the patient's] life span [although] prolonging his suffering, when we feel that [the patient] has no pain from abstaining from food . . . Clearly, we must feed him food that will do him no harm, for food surely strengthens him somewhat, despite the fact that neither the patient nor his attendants are aware of this effect."

Rabbi Feinstein distinguishes this case from the medical treatment of a terminally ill patient when he writes:

"Our ruling in this matter is not to be compared with the question of giving medicine to a terminally ill patient. The distinction is obvious: Food is a natural substance which must be consumed to insure survival."

Rabbi Feinstein's position suggests that the necessity of feeding (and hydrating) terminally ill patients is predicated upon there being benefit to the patient and the absence of anticipated harm from the providing of nutrition as opposed to an objective obligation to feed per se.

But what if the physician feels that nutrition or hydration is not only non-indicated, but actually contra-indicated in a particular patient? This may undermine our first assumption -- benefit to the patient. What if the vehicle used to provide the nutrition has potential for severe complications? This would undermine our second assumption -- lack of harm to the patient.”

In the Reform Jewish Responsa –written by the Responsa Committee of the CCAR they mention yet, a different approach which is provided by R. Yehoshua Boaz b. Barukh, the 16th-century author of the Shiltey Giborim commentary to Alfasi. “ He notes that while it is forbidden to hasten the death of the goses it is likewise forbidden to take any action that unnecessarily impedes it. Salt, which cannot bring healing but only impede the patient's death, should never have been put on his tongue. Whoever put it there has acted improperly; thus, its removal, even though it involves physical contact, is permitted as the restoration of the correct status quo ante.

The advantage of the Shiltey Giborim's analysis is that it turns our attention away from blurry distinctions between "active" and "passive" measures and toward the nature and purpose of those actions. The essential issue is the medical efficacy of the factor we seek to remove. Certain measures must never be applied to the goses because they lack any trace of therapeutic value. Offering no hope of cure or successful treatment, they serve only to delay his or her otherwise imminent death. Since it is forbidden to do this, to unnecessarily prolong the death of the dying person, these measures may be discontinued even if we must touch the patient's body in order to do so.”

As the Responsa Committee continues, “This theory helps to translate the medieval language of the texts into a usable contemporary vernacular. Does there not come a point in a patient's condition when, despite their obvious life-saving powers, the sophisticated technologies of modern medicine--the mechanical respirator, for example, or the heart-lung machine (or in the case of Terry Schaivo-the feeding tube)--become nothing more than mere "salt on the tongue," mechanisms which maintain the patient's vital signs long after all hope of recovery has vanished? Answering, "yes" to this question, some contemporary poskim allow the respirator to be disconnected when a patient is clearly and irrevocably unable to sustain independent heartbeat and respiration. Even though the machine is considered part of routine medical therapy (for patients are as a matter of course connected to it during emergency-room and surgical procedures), it has at this juncture ceased to serve any therapeutic function. They can no longer aid in the preservation or prolongation of life. Once their therapeutic function is exhausted, the machines "merely prolong in an artificial way the process of dying. We must disconnect the patient from the machines, leaving him in his natural state until the soul departs."

Thus Jewish tradition—although erring on the side of life—recognizes at times—that there are occasions that keep the soul from departing naturally.

But at the heart of the Terri Schiavo case is one final consideration—and that is the critical issues of making sure your wishes—your instructions are followed. Terri’s problem at the core was that there were no written wishes—only the report of her husband what her wishes were.

For each of us—we should have learned from this example that we must as responsible adults—whether in relationship or not—take a few moments to think through these issues for ourselves. God forbid –if something happened tomorrow to you—and you had a massive stroke from which there would be no recovery- would you want to be resuscitated? Who would make those decisions for you if you can’t? If you are not legally married—are you comfortable with a parent or sibling making those decisions for you? Who would you trust with your life? What are your boundaries for life and death?

We might have been spared the circus that was made of Terri Schaivo’s life and death if only she had documented her wishes. I have several copies of an Advance Health Care Directive Form here—take one—fill it out. File it with your doctor—give it to your mate and/or family.
Don’t leave this life or death decision to others to agonize over in the event you can’t communicate.

No one likes to talk about death, dying or illness and few of us are willing to do what it takes to prepare for that day—but if Terri Schaivo left us a legacy of anything—then this is it—As the book of Ecclesiastes Teaches—There is a time for every experience under heaven-a time to be born and a time to die. The question is will you be prepared.

Shabbat Shalom.