When Choosing Hospice Means Choosing Life


The leader of Philadelphia’s Jewish Hospice Network offers her belief that opting for hospice care is a conscious decision to enjoy a higher quality of life toward the end. 

Of all the quotable phrases in the Tanach, the one I hear the most is “Choose Life.” Why these words? Perhaps because I am a hospice chaplain and rabbi, and every day I meet people who are wrestling with life and death.

Choose life: Who would dismiss such an imperative? We all value life so dearly, but do we really understand what these words imply — or the context in which they are given?  

The quote comes from Devarim: Nitzavim, 30:19-20: “…I have placed life and death before you, blessing and curse; and you shall choose life, so that you will live, you and your offspring, to love Adonai your God, to listen to God’s voice and to cleave to God, for God is your life and the length of your days…”  

The people are being called to choose life and blessing for themselves and their offspring — not just to avoid death, but to live in a way that makes their lives truly filled with blessings.

So what does this have to do with hospice? Isn’t hospice about choosing death, about giving up? Isn’t hospice the antithesis of “choose life”?  

Picture this scenario, a composite of my various experiences: It is erev Shabbat and Miriam’s family has gathered by her bedside to say goodbye. She may never get to be with all of her family again to hear them express their love and appreciation for her. She may never have the opportunity to tell them, “I’m sorry,” “I forgive you,” “I am not afraid,” “I am ready to die,” “Take care of each other,” “Thank you” or “I love you.”  

This gathering came about because several weeks ago, Miriam chose to have hospice care rather than continue with the cancer treatments that were causing her terrible suffering. She did not want to die, but her body wasn’t recovering. She wanted to have as much quality time with her family and friends as possible, so she chose hospice care in an effort to preserve the qualities she valued during the time she had remaining.  

This erev Shabbat, along with the traditional brachah over the candles, each person offers their personal blessing of appreciation for Miriam — some silently, some whispered. The kiddush cup is passed around, and each person shares a particularly sweet memory. As they take their share of challah, they kvell over their mazel to be part of such a family, whether in the best or the most challenging of times. And, despite some past disagreements and disappointments, they promise Miriam that they will always be there for each other.  

Miriam wanted as much quality time with her family and friends as possible — time to share feelings, thoughts, hopes and love. So she chose hospice care.  

It is not the right choice for everyone, but when the burden of treatment is too great to bear, hospice care provides a path of comfort and peacefulness that allows us to live our final days with dignity and in accordance with our values and preferences. It is a way to choose life and to make our final days a blessing. 

Rabbi Tsurah August is the hospice rabbi for Jewish Family & Children’s Service of Greater Philadelphia’s Jewish Hospice Network (JHN). JHN ensures that all Jewish hospice patients and their families have access to an experienced, clinically trained rabbi and are embraced by the greater Jewish community while they face this challenging time of life.  

On Saturday, Feb. 15, Congregation Adath Jeshurun in Elkins Park will host the first Hospice Awareness Shabbat in cooperation with Rabbi Seymour Rosenbloom. Family members who experienced hospice care will share their stories and Rabbi August will answer questions.


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