Saturday, 1 June 2013

Liverpool Care Pathway - EoLC, LCP And The Jewish Religious Perspective

The opinions we hold are always expressed from the standpoint of who we are. That goes without saying. Experience tests us, our beliefs, and what we are.

Rabbi Neuberger is heading up the current LCP Review. The Rabbi supports the negation of life principles of EoLC and the LCP.

The Jewish perspective is renowned for its independence of thought and that is to be respected. It is worthwhile, in that case, to contrast Rabbi Neuberger’s position with that held by others of her faith.

This is Rabbi Julia Neuberger in The Washington Post -

Julia Neuberger

Neuberger is a trustee of the British Council, Jewish Care, and the Booker Prize Foundation, as well as founding trustee of the Walter and Liesel Schwab Charitable Trust

Proposed health-care reform legislation includes a provision that allows Medicare to pay for "end-of-life" counseling for seniors and their families who request it. The provision -- which Sarah Palin erroneously described as "death panels" for seniors --

End of life care in no way rations health care in the United Kingdom.

What it does is to recognise that, at some point, we must die, and that heroic measures become pointless and cruel if they are not working.

Hospice programmes in the United States also recognise that, but the funding under the present system is limited and probably does not allow those who wish to die at home to have sufficient support. The hospice movement is hugely popular in the United Kingdom. It started, in its modern form, as something out of the Christian tradition, founded as it was by Dame Cicely Saunders, who was a devout Anglican. However, people of all faiths support hospices, and the North London Hospice, which provides home care as well as impatient care, is a multi faith hospice (as opposed to non-denominational). It has volunteers of all faiths and patients of all faiths, and it caters to their spiritual needs. End of life care recognises pain that is physical and deals with it. But it also recognises emotional and spiritual suffering, and, at its best, can allow people to die comfortably, alert, having made their peace with family and friends, made their peace with God, and said their goodbyes. I have never understood why this should be regarded as anything other than wonderful, and, having watched both my parents receive end of life care at home, I know I would not wish to die any other way, if I get the choice. So highly regarded is end of life care and the skills that go with it in the UK that it is now- finally- being extended nationwide beyond cancer, AIDS, and Motor Neuron disease to all those who are dying of whatever cause.


This is a Jewish perspective on the Salford City Council website -

End of life care in the Jewish community

Orthodox Jews believe they do not own their body but are invested with guardianship over life and soul including making significant efforts to preserve life despite prognosis. This means that:
  • Nothing may be done to hasten death - including withdrawal of water, nutrition, oxygen or medication
  • Information should be presented to sustain hope and avoid despair leading to the patient giving up
  • Each family is encouraged to consult a competent Rabbi who can assess every risk benefit decision carefully for Halachic implications
A Rabbi will always take account of a patients pain or suffering in decisions to provide palliation or ‘heroic' treatments.
Orthodox Jews may wish to complete an advance directive about medical treatment, which states clearly what they would like to happen in the event that they lack the capacity to make decisions in the future. The Interlink FoundationExternal sitehas developed an advance directive and training material for professionals, both of which are available at the bottom of this page.

Downloadable documents

If you are unable to view documents of these types, our downloads page provides links to viewing software.
This page was last updated on 12 September 2012
Anyone desiring to make an Advance Care Directive or Living Will would do well to adapt that provided above as a guide to their own needs and purposes.

It is most thorough and precludes the arrogant physician stepping in to present an alternative interpretation of intent.

According to DeadSocial on Dying Matters,

Living wills allow you to indicate that you wish to refuse certain types of medical treatment, should you be unable to make or communicate a decision about your treatment in the future.

This appears to contrast markedly with the life-embracing Jewish position.


Frightening, actually.

"DeadSocial" sounds rather like a death cult...

Is this a death cult...? Dying Matters!

These life-embracing differences extend to organ donation. This is BioEdge 

The views of James Leonard Park from the reputable University of Minnesota also stand in stark contrast –

How long will it take before modern medical practice recognizes permanent unconsciousness as death?

If a specific patient and his or her proxies are all in agreement that permanent unconsciousness can be certified as death, then the doctor who is called upon to declare death will merely have to determine scientifically that there is no chance that consciousness will ever return to this body.

This from Interlink Orthodox Jewish Voluntary Action would also appear to confirm that the Pathway does indeed have the intention of making the person 'not live so long' and not prolong life (euphemistically termed 'not prolonging death') -

A woman in her late nineties was hospitalised in a very weak state. The admitting physician immediately issued a DNAR and put her on the ‘pathway’. Her family showed the doctor the signed directive clearly indicating the patient’s wishes to be given fluids, nutrition and to be given life-sustaining care.  The Doctor was legally obliged to take her wishes into account and change his instructions.  He had to admit that he had used his judgement to assume that most patients in her state would wish to die. The patient lived on several weeks enjoying her last days with her family around her.

Had the doctor proceeded, that would have been euthanasia. Euthanasia is unlawful in this land.

By some Jewish opinion at least, the LCP is not a Kosher practice. May we have the Rabbi's opinion on this, please?

It is apparent her opinion is wholly individual and personal, not at all representative and certainly not independent.

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