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Take Him Home, There’s Nothing We Can Do

Eytan Kobre

Hospitals and doctors are in the business of saving lives — until they’re not. Our new health care reality means both professionals and institutions are taking a different view of terminally ill patients, one in which those tottering on the edge of life are costly liabilities.

Sunday, November 09, 2014

If ever someone was qualified for the title of living legend, it was Mrs. Miriam Lubling, the diminutive powerhouse whose advocacy for patients in New York’s hospitals benefited thousands over decades. Hers was a ubiquitous, almost revered presence in hospital wards, where, dressed as if on her way to a wedding, she spent countless hours every day raising the spirits and ensuring the first-rate care of the innumerable patients she called her “cousins.”  The stories of how her selfless resolve and firm but winning demeanor produced impossible-to-get appointments for consultations and operations for people she’d never met are legion. This is the lady who once raced to the airport to confront a leading pediatric neurosurgeon heading off to vacation: “You can go on vacation, but if you don’t operate on this child’s brain tumor immediately, he never will.” And as Rabbi Israel Rosman, NYU Hospital’s Jewish patient advocate, relates, “She stuck so clearly to halachah. She spent 30 years on the floor with doctors and she never shook hands with any men, no matter what. If a phone call came in while she was bentshing, she didn’t rush.” Less than a year ago, the woman whom Rabbi Moshe Sherer called “Klal Yisrael’s angel of mercy” entered the hospital with an infection at age 96. The level of care she received from both doctors and nurses was second to none; after all, she was in the hospital she touted to be world-class. But when her infection did not respond to antibiotics, and she lost consciousness and required intubation, the Lubling family found themselves at the mercy of the ominous new reality in American health care: The doctors balked at continuing treating her infection aggressively, advising her children instead — in what has become an oft-heard euphemism for ending all life-prolonging efforts — to “let her be… make her comfortable and let nature take its course.” The family consulted their posek, who, despite the doctor’s assessment of a less than ten percent chance of recovery, ruled that in the absence of mitigating factors like excessive pain, aggressive treatment should be continued. Ultimately, says her son, attorney and communal askanChanochLubling, “the doctors who said that her staph infection would not subside were wrong — it did abate and she died from something else. After being unconscious for weeks, my mother regained some awareness, and on Purim day, when some of her grandsons sang and danced around her bed, she acknowledged them and squeezed their hands. Two days later, she left the world.” Welcome to the grave new world of American medicine, in which “quality of life” reigns supreme as the yardstick doctors use to determine what “quantity of life” will be allotted to the elderly and chronically ill. And, for these arbiters of life and death, a life of limited function and mobility inherently lacks sufficient “quality” for money and effort to be spent to prolong it. Undergirding this approach is a secular worldview that doesn’t allow for the existence of an eternal soul or a view of life that sees every additional day in this world as precious and worth fighting for.

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