How to Recite the End-of-Life Confession (Shabbos 32)

Pioneer nurse, Florence Nightingale, was a deeply spiritual individual, who encouraged her nurses to attend religious services. She once encountered a patient on her deathbed who was convinced that she was destined for eternal punishment for her sins. She assured the young lady, “God is far more merciful than any human creature ever was or can ever imagine.”

During the coronavirus crisis, more and more nurses are finding themselves maintaining, not only the physical, but also the spiritual legacy of Florence Nightingale. At this point, it has become nearly impossible for rabbis to recite viduy, the confessional prayer, with dying patients in the final moments of their lives. Nurses are now finding themselves acting ‘in loco rabbinus.’ They are reciting the Shema and offering words of comfort and hope to those requiring spiritual assistance at their most desperate hour.

What is the viduy and why do we recite it at the end of life?

תָּנוּ רַבָּנַן: מִי שֶׁחָלָה וְנָטָה לָמוּת, אוֹמְרִים לוֹ: הִתְוַדֵּה, שֶׁכֵּן כׇּל הַמּוּמָתִין מִתְוַדִּין. אָדָם יוֹצֵא לַשּׁוּק, יְהִי דּוֹמֶה בְּעֵינָיו כְּמִי שֶׁנִּמְסַר לְסַרְדְּיוֹט. חָשׁ בְּרֹאשׁוֹ — יְהִי דּוֹמֶה בְּעֵינָיו כְּמִי שֶׁנְּתָנוּהוּ בְּקוֹלָר. עָלָה לַמִּטָּה וְנָפַל — יְהִי דּוֹמֶה בְּעֵינָיו כְּמִי שֶׁהֶעְלוּהוּ לַגַּרְדּוֹם לִידּוֹן, שֶׁכָּל הָעוֹלֶה לַגַּרְדּוֹם לִידּוֹן אִם יֵשׁ לוֹ פְּרַקְלִיטִין גְּדוֹלִיים — נִיצּוֹל, וְאִם לָאו — אֵינוֹ נִיצּוֹל. וְאֵלּוּ הֵן פְּרַקְלִיטִין שֶׁל אָדָם: תְּשׁוּבָה וּמַעֲשִׂים טוֹבִים. וַאֲפִילּוּ תְּשַׁע מֵאוֹת וְתִשְׁעִים וְתִשְׁעָה מְלַמְּדִים עָלָיו חוֹבָה וְאֶחָד מְלַמֵּד עָלָיו זְכוּת — נִיצּוֹל, שֶׁנֶּאֱמַר: ״אִם יֵשׁ עָלָיו מַלְאָךְ מֵלִיץ אֶחָד מִנִּי אָלֶף לְהַגִּיד לְאָדָם יׇשְׁרוֹ. וַיְחֻנֶּנּוּ וַיֹּאמֶר פְּדָעֵהוּ מֵרֶדֶת שָׁחַת וְגוֹ׳״. רַבִּי אֱלִיעֶזֶר בְּנוֹ שֶׁל רַבִּי יוֹסֵי הַגְּלִילִי אוֹמֵר: אֲפִילּוּ תְּשַׁע מֵאוֹת וְתִששְׁעִים וְתִשְׁעָה בְּאוֹתוֹ מַלְאָךְ לְחוֹבָה וְאֶחָד לִזְכוּת — נִיצּוֹל, שֶׁנֶּאֱמַר: ״מֵלִיץ אֶחָד מִנִּי אָלֶף״

One who became ill and tended toward death, they say to him: Confess, as all those who are decreed death must confess. And these are a person’s advocates: Repentance and good deeds. And even if there are nine hundred ninety-nine (angels) calling for his account and only one asserting his merit, he is spared, as it is stated (Job 33): “If there be for him an angel, an advocate, one among a thousand, to vouch for a man’s uprightness; then He is gracious unto him, and says: Deliver him from going down to the pit, (I have found a ransom).” Rabbi Eliezer, son of Rabbi Yossi HaGelili, says: Even if there are nine hundred ninety-nine portions within that same angel accusing him, and one portion advocating that he emerge meritorious, he is save, as it stated: “An advocate, even one among a thousand.”

After the soul passes from this world to the afterlife, the heavenly tribunal decides its fate. In order to ensure the best possible outcome, we endeavour to enter into the next world sin-free. Very few people go through life with a perfect track record. Nevertheless, repentance can wipe the slate clean. Consequently, our Sages advise “Repent one day before you die.” Since, however, nobody knows their final day on Earth, we repent every day, as part of our daily services. The intense confession takes place during the tachanun prayer. But even on days when tachanun is not recited, we include prayers of confession and atonement in our Amidah, including the blessings of “Selach lanu avinu ki chatanu,” and “Baruch harotzeh biTeshuvah.” Thus, the utterance of a confessional prayer on one’s deathbed should never be construed as a declaration of despair. It’s a vital prayer that we recite regularly, to ensure we are always prepared for the worst, as we maintain our faith and hope for a best-case scenario.

In fact, our Sages tell us that the end-of-life viduy is not only important in case the individual should pass on, but if it is decreed from on High that the patient should recover, then the recitation of viduy is a segulah (good omen) for the healing. Thus, the formula for the bedside confessional is:

I acknowledge before You, Lord my God and the God of my fathers, that my recovery and my death are in Your hands. May it be Your will that You heal me with total recovery, but, if I die, may my death be an atonement for all the errors, iniquities, and wilful sins that I have erred, sinned and transgressed before You, and may You grant my share in the Garden of Eden, and grant me the merit to abide in the World to Come which is vouchsafed for the righteous.

I have led the bedside viduy hundreds of times over the course of my rabbinic career. And I have personally witnessed dozens of patients – whose families and the doctors believed that there was no hope – recover and leave their ‘deathbeds’ to be blessed with healing and a new lease on life.

Sometimes a family will call me to do the viduy with their loved one. Other times, I will sense from them that they feel it’s the end, and they’re looking to the rabbi for comfort and guidance. At that point, I will ask them to join me for a family conversation outside the room. I will then explain to them the purpose and segulah of viduy, but make it clear to them that it is completely their decision whether to proceed. And I will emphasize how many recoveries I have witnessed personally.

And that’s why immediately following the instructions to confess at the end-of-life, the Gemara proceeds to demonstrate the spiritual statistics of recovery. Even if one angel calls for merit in the face of a thousand or even one portion of such an optimistic angel says recovery is possible, then there’s hope. Sadly, most people focus on the negative side of the equation. When the doctors say there’s 90% chance the patient won’t survive, they conclude that they’re doomed. But what she actually said was that one in ten people survive! In the face of such a prognosis, we must maintain our hope and faith that we can be the lucky one. And the viduy might be just what this individual needs to build up sufficient merit to draw down God’s healing Hand.

Returning to the viduy conversation, once the family agrees, we will return to the room and I will repeat the conversation to the patient, regardless of whether they appear to be lucid. We often do not know how much they can hear, even whilst in a semi-conscious state. In addition, I will explain to them that, in Judaism, the individual is not confessing to the rabbi. My role is simply to help them perform the task. Ideally, they should be reciting the prayer on their own. If they are unable to do so, I will recite it for them and they should answer Amen. That might be a mental Amen.

Why do I share all these details now? As I began this piece, at our present juncture, rabbis are not permitted to visit people who are reaching end-of-life. And so it is imperative that we are all equipped to deal with such situations as they arise, whether you may be a close relative or a medical professional. If Hashem places you into the situation, it probably won’t be an easy conversation to initiate, but you must be prepared to take that leap of faith and believe that He has entrusted you with this special mission.

We are living in terrifying times. The Almighty has entrusted many of us with missions that we never dreamed we’d be tasked with. May you gird your loins and have the courage to carry out your Divine mission wherever it leads you!