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Toronto rabbinic council urges power of attorney on health care

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Document aims to ensure patients can influence their fates according to Halachah.
Document aims to ensure patients can influence their fates according to Halachah.

The Vaad Harabonim of Toronto – the city’s Orthodox rabbinic council – is urging members of the community to obtain and sign a power of attorney for personal care and statutory declaration to be used in case they become incapacitated and can’t make decisions about their medical care.

The Vaad is distributing a sample document in synagogues and public places frequented by the Orthodox, and is distributing it digitally as well. The council is taking the step because of developments in Canadian law on the issue of assisted suicide and to ensure that Orthodox patients and their families can influence their fates in accordance with Jewish law, said Rabbi Dovid Schochet, a spokesperson for the Vaad.

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“There is a change in the law now on assisted suicide,” Rabbi Schochet said. “The government needs empty beds in hospitals, and when a person is on life support or critically ill, and there is little chance of surviving, there is pressure to hasten the process.”
Rabbi Schochet said the document was distributed recently as a public service to inform the community about their options in cases of severe illness. With the document in hand, families have the right to influence health care providers so that medical treatment does not violate Jewish law.

In addition to containing a blank power of attorney for personal care and statutory declaration, which would give people the right to make medical decisions on behalf of incapacitated family members, it includes a cover letter containing an “urgent message.”

The message cites a two-year-old Supreme Court of Canada decision in which the head of critical care at Sunnybrook Hospital in Toronto wanted to disconnect a critically ill patient from life support.

The court ruled the doctors should have applied for permission to do so from the Consent and Capacity Board, a provincial panel appointed under the Health Consent Act.

The board is empowered to “determine what the patient would have chosen themselves, in their present condition, given quality of life, pain, etc.,” the Vaad quotes the court as saying.
“Based on the stated desire of some doctors to go ahead and terminate the life of a number of patients in the past few months, the power of attorney…form was prepared.”

Rabbi Kalman Ochs of Torah Emeth Jewish Centre said the document was prepared after consulting with doctors, lawyers and others close to the issue. “The document began because there’s been a trend in the medical system, in almost all hospitals, that once people are over 80 or are deathly ill, they don’t have quality of life, and living is about quality of life, so there’s no point prolonging their lives,” Rabbi Ochs said.

The document, he continued, “addresses the view of Judaism that life is an eternal, intrinsic value. In Judaism, we value life itself. This [document] conveys to doctors the wish of the Jewish person to preserve their lives.”

Besides including a power of attorney form, it includes a blank form allowing the user to appoint a consulting rabbi to assist in the determination of the pertinent Jewish law.

It also includes a statutory declaration in which the individual asserts their “desire that all health care decisions be made for me in accordance with Jewish religious law and custom as determined in accordance with strict Orthodox Jewish interpretation and tradition should any uncertainty arise as to my wishes. I fully subscribe to the values and beliefs of Judaism that every moment of life is of infinite value. I therefore direct that, unless determined by my rabbinic advisor that such actions would be contrary to Jewish law, my life be prolonged for as long as possible by any means medically available.”

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In its message to the community, the Vaad notes that even if the document is completed, it “brings no guarantees. It must be stressed that the Supreme Court decision is dangerous to our principle of preserving life and has taken you and your families’ right to decide on end of life issues out of your hands. This document, even at its best, can only serve as a means of influencing the Consent and Capacity Board to understand how you would decide, if you could, with regard to termination of your life. As such, it cannot guarantee the result you would want to see, but it is the best that can be done in this onerous environment.”

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