Orthodox Jewish Chamber of Commerce Spearheads Battle to Preserve Pro-Life Values for End of Life Care
It occurs in doctor’s offices, hospitals, nursing homes, and rehabilitation centers every day - away from the eyes of the public: Life-and-death medical decisions are forced, or subtly encouraged, against the wishes and values of patients and their loved ones. Decisions over whether to provide lifesaving treatment to the elderly or chronically ill are made solely on the grounds of saving money and/or the secular liberal value that some lives are less worthy of saving than others.
This battle isn’t new; there are many families of all stripes who have endured it firsthand. However, the battle is continuously getting more difficult and contentious.
The world watched in horror as 1 year old Alfie Evans was forced off life support against the wishes of his parents, as decided by UK bureaucrats and judges. On one level or another, similar events occur countless times a day across the United States. Recently, a prestigious NYC hospital worked to limit access to Jewish community volunteers who assisted their patients, in part due to the fact that volunteers would sometimes advise on behalf of prolonging life against the will of hospital hierarchy.
“As an organization representing a cross section of families and corporations, including many in the healthcare field, the Orthodox Jewish Chamber of Commerce and our partners are working tirelessly to protect the integrity of medical providers and institutions, and improve relationships with patients, families and communities,” says Duvi Honig, Founder and CEO of the Orthodox Jewish Chamber of Commerce.
Among the Chamber’s partners in this endeavor are the Friends of Zion organization, which has a close relationship with the Trump White House, particularly on issues of religious liberty; and veteran Jewish community activists, including Tzvi Gross, a New Jersey healthcare executive. “We will take our message to all levels of government and the medical community,” says Mr. Gross. “We will not rest until we are confident that the law and medical community culture fully respect the lives and religious values of their patients, and prioritize their needs over any financial or political concerns.”
“The key issue is religious liberty and freedom,” explains Rabbi Mendy Mirocznik, Executive Committee member, Orthodox Jewish Chamber of Commerce; and Executive Vice President, Rabbinical Alliance of America/Igud HaRabbonim, “permitting a patient to consult with his or religious authority to help ascertain what steps should be taken to preserve life. Sadly, the religious and medical definitions of end of life often collide; and an institution cannot deprive patients the ability to make a proper determination based upon their religious values.”
The Root Challenges
What would encourage an otherwise sincere medical professional to encourage decisions that hasten death?
There are many factors at play, including these two very powerful, yet little known, ones:
Conversation Protocol: Unfortunately, physicians and other medical providers have financial incentive to working against the prolonging of life. When they have discussions with patients and families, the discussions are oftentimes slanted.
The devil is in the details: What kind of conversation are doctors required to have? Is the POLST (Provider Orders for Life-Sustaining Treatment) form too complex and slanted in a way to encourage the “you don’t have to suffer” mentality? The POLST form talks about all the horrifying ways to die and then asks someone if they want that. What about asking if they want the wondrous treatments innovated by our amazing medical system?
To the objective observer, this process seems to skew toward “ending it” and in fact the data bores this out clearly. Add paying doctors to do this and you have a potent cocktail that would scare any anti-Death Penalty advocate.
Financial Penalty: To the average America, “readmission penalty” sounds like the fact that you need to buy another ticket to a baseball game once you’ve exited the stadium.
In truth, this is a provision in US healthcare law that ostensibly requires hospitals to reduce unnecessary readmissions to the hospital. However, for practical purposes, it basically considers all readmissions unnecessary. The penalties are extremely severe. Penalties can be as high as 3% (and rising each year) of Net Medicare revenue for “unnecessary” readmissions. For a hospital with a 10% profit margin, that means that as much as 30% of profits are penalized if fragile patients are encouraged to remain alive and then take up the hospital’s bed capacity in the long term.
Hospital CEOs across the nation begin their business meetings with this topic. Whether consciously or unconsciously, it weighs on every medical decision made, at every level.