Death & Taxes: Four Questions to Ask This Passover

The day after Tax Day* is National Healthcare Decisions Day, a nod toward Benjamin Franklin’s famous saying, “In this world, nothing is certain except death and taxes.” Designed to promote Americans’ conversations about and planning for end of life, the day is meant to get more people to consider their mortality at the time that we are required to consider our livelihood. Never heard of National Healthcare Decisions Day? You’re not alone. Much needed change around end-of-life care and conversations is under way in the United States, thanks to the efforts of pioneers in the “positive death movement,” including The Conversation Project, and others. And yet more attention to the vital work of planning for end of life is needed, especially in Jewish communities. This year, as is often the case, Passover and Tax Day intersect. On Passover, we read in the Haggadah, “chayav adam lirot et atzmo ke-ilu hu yatza mi-mitzrayim,” a reminder that each of us is obligated to see ourselves as if we’d actually left Egypt in the the Exodus. How might the holiday of our liberation relate to the surety of death and taxes? 

Here in New York, the Marlene Meyerson Jewish Community Center in Manhattan, in partnership with Plaza Jewish Community Chapel, the Center for Pastoral Education at the Jewish Theological Seminary, and UJA Federation of New York, created an innovative, community based, Jewishly-infused advance care planning project, called What Matters: Caring Conversations About End of Life. Now operating in more than 20 local synagogues and partner agencies, this initiative builds upon Respecting Choices, an advance care planning program with proven success nationwide. According to Respecting Choices’ research, while 92 percent of Americans say it’s important to discuss their wishes for end-of-life care, only 32% have had such a conversation. What if Jewish communities in the US could move the needle and double or triple the number who have discussed their wishes for end-of-life care?

Advance care planning empowers us to identify what matters most in our lives, to consider how we want to live, knowing that death is inevitable. Sometimes, starting the conversation may lead to more questions than answers. On this holiday of asking questions, we offer four questions to help you get the conversation started:

1. What does a good day look like as you approach end of life?

Where are you? Who is with you? What can you see? Hear? Smell? Touch?

2. What Jewish, cultural, and/or spiritual beliefs or practices provide you comfort and may influence your health care decisions?

Would you like kosher food? Do you want traditional prayers for healing? A spiritual guide by your side?

3. What quality of life would be unacceptable to you as you approach end of life?

Some people are willing to live through a lot for a chance to live longer. Other people know that certain situations would seriously impair their quality of life and would choose to focus on comfort measures. 

4. Who would you want to speak for you if you were unable to speak for yourself? 

Is there someone you trust to serve as your healthcare proxy, to make decisions on your behalf? Have you had a conversation with this person and documented this information on an advance directive?

Our answers to these questions often change as we age or as conditions such as the COVID pandemic befall us. Just as we ask the same traditional 4 questions of the Passover seder each year, so too should we consider these questions of how we want to live as we approach end of life at regular intervals. Your answers should be shared with your healthcare proxy and other important people in your life. Experts in advance care planning recommend revisiting one’s plans at key liminal moments in life, known as “the 5 D’s”: Diagnosis (of a serious illness), Decline (in health), Decade (reaching the next one), Divorce, and Death (of a loved one.) 

Beyond these 4 questions, there are many ways to consider integrating conversations about what matters most as we retell the story of our collective liberation on Passover. What Matters created these seder supplements to help enrich your conversations around the seder table.  

Based upon its success in New York, What Matters will transition this summer to become a signature national program of Shomer Collective, offering advance care planning , to individuals and Jewish communities throughout the United States. 

Founded in 2020 by members of Natan, Shomer Collective is committed to the work of inspiring end-of-life conversations and experiences grounded in Jewish wisdom, values and practices. Shomer envisions a world where end-of-life matters are spoken about openly, thoughtfully, and frequently, thus creating opportunities for transformational impact on the individual, the family and the larger community systems.

Talking about and planning for end of life has the potential to liberate us from the fear, the uncertainty, and the crises that too often surround death and dying. The Jewish calendar provides us with regular reminders of our mortality. This year, as Tax Day, National Healthcare Decisions Day, and Passover intersect, as you envision yourself leaving Egypt and tell the story of our collective liberation, we urge you to consider how you want to live in your freedom, identifying what matters most to you and who needs to know that. 

*While Tax Day typically falls on April 15, this year it has been pushed to April 18 to avoid conflicting with the observance of Emancipation Day, a holiday celebrated in Washington, DC commemorating the end of slavery in the District in 1862.

This article was co-authored by Sally Kaplan. She is the Program Director of What Matters: Caring Conversations About End of Life. Previously she was Planning Manager of UJA-Federation’s Caring Commission. She has served as a trustee of Congregation Rodeph Sholom and the Dalton School, and as a member of the Advisory Committee of the Center for Pastoral Education at the Jewish Theological Seminary, HUC-JIR Pastoral Education Advisory Committee, and the Advance Care Planning Committee of NYU Langone Health System.