Obamacare & Death Counseling

Washington Post Charles Krauthammer

Let's see if we can have a reasoned discussion about end-of-life counseling.

We might start by asking Sarah Palin to leave the room. I've got nothing against her. She's a remarkable political talent. But there are no "death panels" in the Democratic health-care bills, and to say that there are is to debase the debate.

We also have to tell the defenders of the notorious Section 1233 of H.R. 3200 that it is not quite as benign as they pretend. To offer government reimbursement to any doctor who gives end-of-life counseling -- whether or not the patient asked for it -- is to create an incentive for such a chat.

What do you think such a chat would be like? Do you think the doctor will go on and on about the fantastic new million-dollar high-tech gizmo that can prolong the patient's otherwise hopeless condition for another six months? Or do you think he's going to talk about -- as the bill specifically spells out -- hospice care and palliative care and other ways of letting go of life? [...]

EJF - why are they desperate for praise?

R' Tropper's Blog - A strange comment which leaves out the essential point i.e., the Bedatz has severely condemned the EJF
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Question:

Rabbi Tropper, is it true that someone from the Badatz spoke with Hagaon Rav Dovid Feinstein, shlit"a regarding Eternal Jewish Family?

Yitzchok R. Philadelphia, Pa


Rabbi Leib Tropper Responds:

It was reported to me by this Rav from the Badatz that he spoke with Hagaon Rav Dovid, shlit"a and Hagaon Rav Dovid, shlit"a said positive things about Eternal Jewish Family. This same respected Rav from the Badatz spoke with Hagaon Rav Reuven Feinstein, shlit"a. This happened to my recollection, close to 2 years ago.

Another Rav in Flatbush called me who is very close to Rav Dovid, Shlit"a and told me that he also spoke with Rav Dovid, shlit"a and that only nice things were spoken.

This Rav in Flatbush also reported this conversation to Rav Nochum Eisenstein, shlit"a.

Harav Yom Tov Stern also heard the same from this Rav who is from the Badatz.

Doctors who deliver bad news

NYTimes

[...]Most doctors do not excel at delivering bad news, decades of studies show, if only because it goes against their training to save lives, not end them. But Dr. O'Mahony, who works at Montefiore Medical Center in the Bronx, belongs to a class of doctors, known as palliative care specialists, who have made death their life's work. They study how to deliver bad news, and they do it again and again. They know secrets like who, as a rule, takes it better. They know who is more likely to suffer silently, and when is the best time to suggest a do-not-resuscitate order.

Palliative care has become a recognized subspecialty, with fellowships, hospital departments and medical school courses aimed at managing patients' last months. It has also become a focus of attacks on plans to overhaul the nation's medical system, with false but persistent rumors that the government will set up "death panels" to decide who deserves treatment. Many physicians dismiss these complaints as an absurd caricature of what palliative medicine is all about.

Still, as an aging population wrangles with how to gracefully face the certainty of death, the moral and economic questions presented by palliative care are unavoidable: How much do we want, and need, to know about the inevitable? Is the withholding of heroic treatment a blessing, a rationing of medical care or a step toward euthanasia?[...]

Lockerbie Bomber freed for compassion!

NYTimes

The Scottish government announced Thursday that it was freeing the only person convicted in the Lockerbie bombing, permitting Abdel Basset Ali al-Megrahi, a 57-year-old former Libyan intelligence agent, to return home on compassionate grounds after serving 8 years of a 27-year minimum sentence on charges of murdering 270 people in Britain's worst terrorist episode.

The decision to release him early on compassionate grounds was made against strenuous American opposition after Mr. Megrahi's lawyers said he had little time left to live because he is suffering from terminal prostate cancer.

The announcement at a news conference by Scotland's Justice Minister, Kenny MacAskill, came almost 21 years after a bomb smuggled onto Pan Am Flight 103 exploded at 31,000 feet over the Scottish town of Lockerbie on Dec. 21, 1988, killing 259 people on board and 11 on the ground.

Of the dead, 189 were Americans. The Scottish decision was certain to provoke anguished protest from American families of the victims who had demanded that he serve his full sentence. [...]

EJf - June 2009 conference in Jerusalem

EJF Blog

IT WAS BY ALL accounts an unprecedented gathering of leading kiruv rabbanim from around the world, as well as rabbanim in cities and towns throughout Israel. The event took place from June 15–17, 2009 at Jerusalem's Inbal Hotel. The sponsor was the Eternal Jewish Family International, which is in the midst of a major global expansion of its activities to support rabbanim and batei din involved with intermarried couples who genuinely strive for a halachic conversion to Judaism. It also assists kiruv organizations that are on the front lines in the fight against assimilation, such as the co-sponsors of the event: Arachim Ohr Somayach Hidabroot Lev L'achim Shuvu Nefesh Yehudi In the U.S., it also includes the Gateways organization.

The rabbanim deliberated on such topics as "Worldwide Assimilation: Today's Spiritual Holocaust", "Building Barriers Against Fictitious Conversions to Judaism," Anti-Semitism and Assimilation: Cause or Effect?", and "Determining the Status of Certain 'Jews' in the Community". The rabbanim, who represented numerous cities around the globe, expressed their deepest concern over the grave issue of world-wide assimilation. In addition, they addressed a growing problem in Israel where many young people return from study abroad with non-Jewish spouses. Kiruv experts spoke of the dangers facing Israeli youth in Israel. They resolved to step up the educational efforts to hopefully thwart this growing trend. The tone of the historic conference was set by Eternal Jewish Family's chairman, Menachem Yitzchak (Tom) Kaplan who noted that "in my wildest dreams I could not imagine such a rapid and broad acceptance by rabbanim all over the world of the vision we laid out with the help of the leading Torah authorities". Kaplan said that he was "committed to do whatever it takes to take on assimilation and problematic conversions to Judaism wherever the problem exists". Rabbi Leib Tropper, the organization's chairman of the Halachic Committee, spoke of the successes of Eternal Jewish Family in "raising the bar on conversions to Judaism and successfully uniting rabbanim and dayanim from disparate backgrounds in preserving kedushas yisroel". The theme of kedushas yisrael was also addressed by some of the notable gedolei yisrael and leading rabbanim who participated in the conference. [...]

When cancer changes your appearance

NYTimes

I have survived over 40 years of ill health. Even so I have learned to live a life of chronic patienthood where I am not dominated by illness. I have managed to focus on goals that have nothing to do with illness. Living life for me is learning to surf above the uneven terrain of my health.

My health history is so involved I have created a Google document to keep track of it. I've had three kidney transplants, a pancreas transplant, 27 years of Type 1 diabetes, and four-plus years of metastasizing cancer. I've broken my leg, elbow, wrist, both feet, hands, skull and ribs (yes, I might be accident prone from time to time). Plus, I've coped with all the secondary illnesses that waltz along with these problems, including osteoporosis, gastroparesis, cataracts, gallbladder failure, impacted bowel and chronic bleeding.

Today, my most obvious issue, a side effect of treatment for head and neck cancer, is chronic facial swelling, also known as moon face. The removal of several lymph nodes from my neck and subsequent radiation treatments have rendered my lymphatic system unable to drain fluids from my head. I get up each morning and remind myself that I'm going to be swollen, tired and nauseous. So if I get something done, like epoxy the hatches of the kayak I'm building, it's a great day. Or if I get through all my (liquid) food, it's a great day. Or if one of our cats comes up to say hello, rubs itself on my leg and settles down for a nap near me … yep: great day! [...]

Is child abuse pikuach nefesh?

Roni commented to a previous post - I am making it a separate post & moved other comments

Shalom!

Lean"d regarding 2 (and then 3), it is clear lefu, rihatoh that at best the C is applicable:

I have to check all M"M; but lefm ruhatoh it is barur, that there are two cases of refuah. a) where there is no sakanah whatsoever, b) where there is chashash sakonoh, especially if it is a safek or sfek sakanah.

It would appear clearly, that whereever there is a sakanah or safek sakanah, that we have an issue of pikuach nefesh! where it is much more than avedat gufoy!

The m"m that you cite are mostly for a) cases where there is no sakanat nefashot. A proof for that is: that at the beggining of YD 336 it says (after it states that it is reshut, it adds that it is ) Mitzvah "ubichlal pikuach nefesh!". It seems pashut that pikuach nefesh does not require the parsha and obligation of of "hashvat aveda"; it is a chiyuv on it's own.

It would appear that the reference that are cited later in the posskim (or the rishonim) refer to a situation where there is clearly no sakanat nefashot; there it is under the parsha of "hashavat gufoy"; but if it is akin to "roeh chaveroy toveah bayam..." or nochrim having a bad thought on a Jew (CM 426) then it falls under "loy taamod al dam reecho" and if it is a case of sakanat nefashot it falls under pikuach nefesh.

Wrt to three: It seems clear that there is an additional obligation of "atrichoy veoygureh" (to add tircha and hire experts) that is not under the general obgliation of a regular "hashavat gufoy".

the question will have to be analyzed what is the geder of molestation: "pikuach nefesh" sakanat nefesh or just "hashvat gufoy" (I would tend to a go with the former. But let's hear the discussion on it).

Regarding Chemdat Shlomoh. I don't have the mareh mekomot in my mind now, but I remember a LOT OF ACHRONIM MATMIHA ON THIS PATICULAR CHEMDAT SHLOMOH and disagreeing harshly with him.

Bechavod uvrachah,

Cognitive therapy and the army

NYTimes

The Army plans to require that all 1.1 million of its soldiers take intensive training in emotional resiliency, military officials say.

The training, the first of its kind in the military, is meant to improve performance in combat and head off the mental health problems, including depression, post-traumatic stress disorder and suicide, that plague about one-fifth of troops returning from Afghanistan and Iraq.

Active-duty soldiers, reservists and members of the National Guard will receive the training, which will also be available to their family members and to civilian employees.

The new program is to be introduced at two bases in October and phased in gradually throughout the service, starting in basic training. It is modeled on techniques that have been tested mainly in middle schools.

Usually taught in weekly 90-minute classes, the methods seek to defuse or expose common habits of thinking and flawed beliefs that can lead to anger and frustration — for example, the tendency to assume the worst. ("My wife didn't answer the phone; she must be with someone else.") [...]

Segregating women on buses

YNET

NA'AMAT women's organization chairwoman pushes for limit against segregation on public transport. 'It's unthinkable that women in a democratic country are violently pushed to the back of a bus,' says Women's Lobby chairwoman

A Transport Ministry's committee convened Tuesday to discuss whether to legalize segregation between men and women on public transportation lines. Meanwhile women's organizations are joining the struggle against the separation.

Since the petition on the matter was filed to the High Court of Justice in 2007 by the Israel Religious Action Center and author Naomi Ragen, a wide front has been formed for battling the matter. Dozens of leading public figures have signed the petition calling on Transportation Minister Yisrael Katz to come out against the phenomenon, including Israel Prize Laureates A. B. Yehoshua and Haim Guri. [...]

Changing entrenched attitudes

Yirmiahu wrote:

Recently, Rabbi Daniel Eidensohn mentioned that he was interesting in exploring "how to actually change entrenched attitudes which have no halachic basis." As it turns out I had recently been skimming a book from fifty or sixty years ago on Public Relations, called "Public Relations"* which addressed this issue (albeit without direct reference to ideas without halachic basis).

Public Opinion is not a mere collection of individual opinions. It has its own dynamic which should be taken into account if one hopes to be an influence. While we are interested in how these principles are applicable to a specific sociological group, we should bear in mind that they apply generally as well. Indeed as individuals these principles likely factor into our opinion making more than we would like to imagine, and almost certainly factor into how many who share our opinions reached their conclusion. Hopefully such a recognition will help us consider the role of these principles in Public Opinion without developing a spirit of condescension.

Initially we need to consider what we mean by "public", "A public is comprised of people who are engaged in a common enterprise with similar interests and are conscious of their mutual dependence" (page 26). Public Opinion is the position taken on a controversial issue by the public. In any given public there are members of various education, aptitude, and temperament. At times Public Opinion is driven by the higher, more reasoned opinions of the knowledgeable and educated. But even the knowledgeable and educated can be swayed by emotion or otherwise make poor judgments, and as a result direct Public Opinion, or allow it to be directed by those less equipped to make such decisions, in a less well thought out direction.

Now people display certain patterns of thought and behavior with respect to the "public" they identify with which influences how "Public Opinion" is developed: For the rest of the post click on this link

Abuse - reporting exempts from responsiblity?

R' Pinchos Yehoshua HaKohain wrote:

Dear Rabbi Eidensohn,

I would like to follow up on some Shakla v'Tarya from 13 July. (It is copied below). I would like to present 3 points:

1) Shomer SheMosar L'Shomer is not applicable here.

2) It is a case of Hashovas Aveida

3) What are the parameters of Hashovas Aveida and how they would apply in our context.

1) Shomer SheMosar LeShomer would not seem to be applicable here.

Either according to Abaye, that the reasoning is because "Ain Reztoni SheYehe Pikdoni b'Yad Acher" or whether according to Rovo that it is because of "At M'Hemnis Li b'Shevuoh, v'Haich Lo M'Hemnis Li", b oth reasons see that the underlying principle is a contractual agreement (a shibud) that binds the shomer, because of the contract undertaken, with the owner of the property. In our situation there has occurred no contractual arrangement between the victim and his erstwhile rescuer/interventionist.

Whether there is an Isur aspect of "Osur L'Shomer Limsor l'Shomer" is discussed in the Acharonim - please see Aruch haShulchon 291:45,46 and Pischei Choshen vol 2, 4:1:1). B ut even if there is an Isur aspect, it flows from being "Maavir Al Daas Baalim" - a Gezel/Gneiva parameter which would not be applicable in our scenario in a strictly Halocho legal sense. (Musar/ethical/moral considerations need to be considered separately)

The following sources and analysis, I believe,support this position: Click on this link for the rest of the posting

EJF - universally accepted conversions?

Anonymous comment on your post "EJF's Enhanced Web site":

I am converting through EFJ (monsey, NY) and I would like to know whether those beit dins are kosher and my conversion will be kosher. Thanks