Knowledge is Love: The Importance of Advanced Directives for End of Life
This past summer, my grandmother, the beloved matriarch of my family, died. She was able to communicate and make known to my mother and uncles when she wanted to stop eating and drinking. Her children then had the chance to show her the ultimate kindness: that of respecting her wishes.
Last week’s Torah portion, Vayehi, begins and ends with scenes of patriarchs of the Jewish people on their deathbeds. The beginning paints a vivid scene of Jacob’s deathbed, his beloved son Joseph and grandchildren Ephraim and Menashe by his side. Yaakov makes Joseph swear that after he dies, Joseph will carry his body back to the land of his fathers, and bury him there. The parsha and with it, the Book of Genesis, ends with the death of Joseph. Joseph makes his brothers swear that they will one day carry Joseph’s bones back to the Promised Land whenever they, as a people, finally leave Egypt and return home to Canaan.
Each of us has had close relatives – people we love and care for – die. In some cases, parents, certainly grandparents, in some cases siblings, spouses and even children & grandchildren. How often do we make sure to have critical conversations with our loved ones about their wishes at the end of life and after their death? In last week’s parsha, both Jacob and Joseph have the luxury of calling their children around their deathbeds to make their wishes known. But we all know, this is not always the situation as we or our loved ones approach the end of their lives. Thus, we need to make our advanced directives known. There is a medical advanced directive that asks questions within Five Categories. The Five Categories to make known are:
- Who do you empower to make care decisions for you when you cannot.
- The kind of medical treatment you want or don’t want at the end of life.
- How comfortable you want to be.
- How you want people to treat you.
- What you want your loved ones to know when you leave this Earth.
Several weeks ago, Temple Sinai ordered a guide called “Five Wishes,” which are available for free at the back of the sanctuary. The short booklet guides you through these five questions, giving you room to write in your answers, and it ensures that your loved ones will know what your wishes are, when your own time comes. The last question, “What you want your loved ones to know,” begins to enter spiritual and ethical dimensions of who you are and what you want to communicate to future generations. But only in a very general way. Another tradition in Judaism is to create your own ethical will. Like a regular will, the ethical will is meant to pass down an inheritance to your loved ones. But instead of things, it is meant to communicate the life lessons and values you want to pass on as a legacy to your loved ones and future generations of Jews in your family. If you would like to work on an ethical will in addition to the Five Wishes form, make an appointment with me. I would love to help guide you in this process.
Parshat Shemot, this week’s Torah portion which begins the Book of Exodus, quickly gets to the part we chanted out loud tonight: “There a rose a king of Egypt that did not know Joseph.” Rashi suggests that this is not a new pharaoh, different from the one Joseph worked with; but rather Pharaoh came to know Joseph differently. He feels threatened by the success and vigor of the Israelites in Egypt’s midst, and Pharaoh thus engages in a process of un-knowing Joseph. He does this because, in order to oppress anyone, you have to either not know them in a true, empathic sense, or pretend not to know them. Pharaoh, it seems, willfully tries to forget his sympathetic relationship with Joseph in order to justify enslaving Joseph’s people.
If we go with the simple meaning of this sentence, that there was an entirely new pharaoh who arose in Egypt, than clearly the new pharaoh’s father, the pharaoh that did know Joseph, did not write an ethical will for his son. He did not make his wishes for this Israelite people living in their Egyptian midst, known.
Each of us will one day die. We each have a legacy and a set of ethics that make us who we are and infuse our lives with meaning. We owe it to future generations of our families to pass down our life-lessons, wisdom and ethics to generations that will not know us directly. We also owe it to ourselves and our loved ones, to gather their wishes for the end of life. If you have an aging parent, or siblings, or even young and healthy children—take an extra brochure to give to them to fill out with you. This can include wishes for health care at the end of life and for their funerals.
We may not need our bones to be flown into Israel (although we might request that!), but surely each of us has preferences for the end, and we ought to make them known. We will not all have the luxury of clearly saying in the moment, “no more food and no more water” as my grandmother had last summer. Filling out Five Wishes for yourself is a favor to your surviving loved ones, who may not otherwise be able to guess what you would have wanted if they cannot ask you directly. Please take a Five Wishes form, complete it with your spouse or loved one, and send copies of it to your next of kin as well. No one should be left guessing when the time comes for decisions about care and burial at the end of life.
And may we all merit a life of knowing. Knowing ourselves, coming genuinely to know others, and thereby offering all our relatives the respect, love and care that comes with truly knowing. Shabbat shalom.