Preparing for our final moments

How can we leave behind a blessing once we are gone?

“Va’yechi” – and he lived. Yaakov has come to the fullness of his life and knows that he will soon die. He calls Yosef to his bedside and broaches a subject that maybe Yosef would have preferred to avoi– – his death, and the burial arrangements that must follow. “I will soon die. Maybe not today or not this week, or not even this year, but it will happen, and most likely sooner rather than later. So I am instructing you to take care of my burial arrangements – promise me that you will take me back to the land of Canaan and bury me there.”

Perhaps at first glance, we are seeing Yaakov taking care of his own needs, making sure that he will be buried with his forefathers. But on another level, what we are witnessing is a tremendous blessing that Yaakov is giving to Yosef. He has given him clear instructions, and when death does finally arrive, Yosef will know what he has to do. Many challenges and much requisite finessing lie ahead for Yosef, but compared to being left in the dark and plagued with self-doubt as to whether he will do the right thing or not, this will be a cakewalk. If we know what we have to do, we can muster the strength and resources to get it done.

[Throughout Tanakh, when someone knows that death is close, they prepare for it. One form of this is what we see at the end of the parsha – they charge those who will be left behind with how to live a proper life, and they give them their blessings – articulating their hopes and aspirations for them. Both Yaakov’s blessings to his children and King David’s charge to Shlomo – “Be strong, and show yourself a man. And keep the charge of the Lord thy God… that you may prosper in all that you do.” (1 Kings 2:2-3) – are powerful examples of such charges and blessings.

These are the earliest examples of an ethical will. A strong Jewish tradition, the ethical will has in the past been primarily the domain of scholars, but in recent years there has been a push to democratize this, and to encourage people to share their life and life’s lesson with the family they are leaving behind. This is one form of preparing for one’s death – strengthening the chain of continuity from one generation to the next.]

But there is another type of preparing, more immediate and concrete. It is about the burial. It is about the estate. And, most significantly, it is about expressing the intervention and end-of-life medical care that one desires, before it becomes too late to let those desires be known.

If we wish to remove not just a burden, but true agony, from our spouse, children, and loved ones, then we will write a living will and assign a health care proxy.

Faced with impossible decisions – to administer CPR or not? to remove the ventilator or not? – without parental guidance, children can be racked with guilt in the moment and for many years after. Did we prematurely end our mother’s life? Did we needlessly postpone her death, extending her pain and suffering without purpose?

We must, following Yaakov’s example, raise this issue with our children. And, if we are the children in this scenario, then we must raise it with our parents. But, of course, we are so often afraid to do so. What will happen if we talk about it? Will it be an ayin hara? Will our parent’s response be, “What, are you waiting for me to die?!”

Whether parent or child, we are quite good at avoiding this discussion. Who wants to think about their own death, or the death of their parents?

So we temporize. We tell ourselves that there is plenty of time, and then before we know it, it is too late. The conversation needs to happen when we begin to think about ours or our parent’s death, even if it still seems far in the distance. When the parsha opens, Yaakov is already planning for his death, but it is only later that he actually falls sick and gives his deathbed blessing. While he blesses his children when his death is imminent, the real blessing he gave them was months or years before, when he planned for this moment.

For all we know, our parents will be greatly relieved that we have opened this conversation. But even if there is avoidance, denial, or anger, we have to love and care about them enough to say, “Mom, Dad, I hope that you live to 120 years, but we are all going to die, and I want to know what your wishes are. How can I ensure that I am doing all I can to care for you? What does proper treatment look like to you?” If we can have those conversations with them, then we will be able to give them what they most want and need, and they, in turn, will be able to give us the peace of mind, and the freedom from angst and suffering, that comes with knowing that we have acted according to their wishes.

And it is not only children and spouses who might be left to shoulder such an agonizing moral burden in the absence of clear directives. In recent months, there have been many cases of people dying from COVID-19 who did not leave end-of-life instructions. In the absence of a DNR, doctors and nurses are supposed to perform CPR. But this has cast upon them a huge, often unmanageable, responsibility. As Jordan Kistner wrote in a recent article in the Atlantic:

Suddenly, performing CPR posed agonizing ethical questions. Chest compressions spewed virus into the air, putting the medical team at extra risk of getting the disease[… and] in most COVID‑19 cases, CPR was useless[…] as low as 3 percent or less—of COVID‑19 patients who receive CPR survive.

What are health-care professionals supposed to do under such circumstances? Administer CPR or not? Absent clear patient directives, there is only guessing, moral grappling, and so often agonizing guilt and moral exhaustion.

We can’t allow ourselves to wait until it’s too late to have these conversations. We have to have them now.

G-d willing, we and our parents will have many more years to live. But, as hard as this might be to confront, we will all eventually die. It is our responsibility to them and theirs to us to prepare for the future. It is a tremendous act of love and chesed that parents can do for children and that children can do for parents.

Such conversations will move us from the beginning of the parsha to its end. They will move us from talk of death and burial, to a blessing for the future. For what greater blessing is there than to know our parents’ wishes and to be able to act on them when the time demands?