Book review: Jewish Guide to Practical Medical Decision-Making

Originally published in The Times of Israel on September 7, 2017

by Ben RothkeMedical Decisions web 1


It may be a stretch, but I’d propose that Ludwig Wittgenstein would really like Rabbi Jason Weiner. Wittgenstein explored the relationship between language and reality. While not a book on language and reality per se; in Jewish Guide to Practical Medical Decision-Making (Urim Publications 978-9655242782), Weiner notes that many of the disconnections between clergy and medical professionals are often in the language they use.

Weiner writes that when seeking to clarify on issues related to medical ethics; effective communication is essential. Little progress can be made if the religious and medical communities are unable to communicate.

To that, Weiner delineates the many critical terms needed to make those effective medical decisions. Some of them include value vs. sanctityinfinite vs. relative value, pain vs. suffering, and more.

An important nuanced point he makes is that pain is usually addressed medically, while suffering can be addressed though spiritual care. It is at those times specifically where the medical teams and religious patients may be most susceptible to different languages.

The book is a valuable resource that provides valuable insight into the process of contemporary medical decision-making. For many people, they may assume halacha operates in one way when it comes to medical decisions; when in fact it is the opposite. Weiner provides the general answers and their sources, providing the reader with a method to provide a level of spiritual care that matches the medical care.

He notes that when chaplains or rabbis find themselves helping to advocate for treatment of patients who may be experiencing a great deal of pain, it is most effective if their arguments are couched in the language that clearly explains some of Judaism’s teaching about the preciousness of life, and the distinction between pain and suffering.

The obstacle the book attempts to address is that healthcare professionals and spiritual leaders often talk right past each other, as if they were speaking different languages. By working on a common language, or at least using terms that all parties can agree on; the patient is better served, both medically and spiritually.

As a full-time chaplain in a large metropolitan hospital, Weiner is able to stay up to date with advances in the medical field. But for those whose understanding is not as deep, the book provides a vital reference to both the medical concepts, and their halachic implications.

While there is a plethora of similar Hebrew books (Nishmas AvrahamEncyclopedia Hilkatit Refu’it and more), this serves the English reader. In addition. Weiner quotes extensively from the eminent and sophisticated posek Rabbi Asher Weiss. Weiss’ ability to answer the most complex questions, combined with Weiner’s personal interaction and annotation of them, make this a unique reference.

Weiner notes that many of the existing books on the topic are simply obsolete. One example he gives is of a rabbi who was asked to render an end of life question; but answered it based on a method of oxygen delivery that hadn’t been used in decades. When faced with the new reality, the rabbi was left in a quandary.

The book covers a wide range of topics across the entire patient lifecycle. From surrogacy and egg donation at the start of life; to assisted suicide and organ donation at the end.

For anyone looking to understand the current state of medical technology and how they intersect with Jewish law, this is an excellent reference.

This is a must read for rabbis, medical ethicists or anyone involved in medical and end of life decisions. When it comes to the inevitable end of life decisions. it’s irresponsible for the parties to wait until the inevitable occurs. For the responsible caregiver, Jewish Guide to Practical Medical Decision-Making should be on their reading list.


Originally published in The Times of Israel on September 7, 2017


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