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FORWARD Newspaper on Betancourt

Posted Oct 02 2009 10:01pm

Rebecca Dube has a new article in FORWARD, the Jewish Daily Newspaper, linking the ongoing Betancourt litiigation to the health care reform debate.

While the health-care reform bills attract loud debate and close scrutiny, a case that’s quietly making its way through the New Jersey court system may end up having just as much impact on end-of-life medical decisions, and Jewish groups are weighing in on it.

The case concerns the fate of Ruben Betancourt, a 73-year-old man who was admitted to Trinitas Hospital in Elizabeth, N.J., last year with kidney failure. He had been in and out of several treatment centers and a nursing home after suffering complications from cancer surgery, and he was dependent on a ventilator, dialysis and a feeding tube.

Trinitas Hospital wanted to take Betancourt off the ventilator, and his family wanted to keep him alive. A New Jersey superior court judge ruled that Betancourt’s daughter, Jacqueline, had the right to make decisions for her father and that the hospital shouldn’t be allowed to overrule her. The hospital appealed; in the meantime, Betancourt has died (while on the ventilator), but the appeal may still go forward because the issues raised could potentially set a precedent for other end-of-life cases.

The case is drawing national attention because it’s being framed as a conflict between patients’ rights to determine their own care versus doctors’ rights to refuse treatment that they believe is inappropriate or even inhumane. In Betancourt’s case, the hospital contended that Betancourt was “actively dying,” suffering from bed sores and infections. But his family members reported that he responded to their voices, and said that he had always been a fighter and would want to keep living for as long as he could. The question for the court was, essentially, who should decide when to pull the plug, the family or the doctors? New Jersey courts so far have sided with the family, but because the case has potential to set precedent on appeal, legal experts are following it closely. . . .

Two Orthodox groups, Agudath Israel and the Rabbinical Council of America, recently filed friend-of-the-court briefs to support the family’s position.

“It really comes down to patient autonomy versus medical authority, and who makes these decisions,” Agudath spokesman Rabbi Avi Shafran explained. His organization distributes and encourages its ultra-Orthodox members to complete halachic living wills, specifying the sort of medical care they want and designating a rabbi as their representative if they’re incapacitated. The halachic answer isn’t always to continue life support or pursue extreme measures to keep someone alive, Shafran said, but the important thing is that patients’ wishes are respected. So far, the public debate around end-of-life care has spurred only a slight uptick in demand for halachic living wills, he said.

But end-of-life care is something that both politicians and ordinary individuals should think more about, Shafran said, especially as it relates to religious convictions.

“There should be a respect of deeply held religious beliefs with regard to life and death,” Shafran said. “This is a very fundamental religious right, the right to stay alive.”

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