One life to live. That’s all we have. One life to live with a beginning and an end. At the beginning we had no choice as to whether or not we wanted to be born. At the end we have no choice as to whether or not we will die. But we do have some choices as to when and how. It can be our choice to pass on our life, and it can be our choice to pass on our life.

Pass on life? Yes. We can choose to pass on heroic measures that will maintain some imitation of existence even if we are at death’s door, or beyond. I have directly helped two of my own loved ones die and counseled many others regarding the deaths of theirs.

What does our tradition say about how we are to act towards a person who is dying with no possibility of recovery? But in general, how we treat the terminally ill patient depends on whether we characterize him or her as a terefah or a goses.

You’ve heard the word traif in regard to keeping kosher. Non-kosher meat comes from an animal that has died from being “torn” rather than being ritually slaughtered by a schochet. In regard to end of life issues, a terefah is someone who is torn, who has an irreversible, terminal condition. Some would argue that in this state, feeding tubes, hydration, and/or respirators may be withheld or even withdrawn. Others would argue more stringently that only when we are not maintaining life but are artificially holding off death may such impediments may be removed.

That was the case with my father-in-law. Eighty-eight years old, he was basically healthy and so mentally aware that he was still doing day trading – pretty successfully, by the way – up to the day he died. He stepped out of the shower and had a massive stroke. The doctors assured us that he didn’t feel a thing and that he was probably dead before he hit the floor. There really was no chance of bringing him back to life. He was a terefah, torn from life without the possibility of repair. He was put on a respirator but all the respirator was doing was mechanically holding off death long enough for us to drive from New York to Cincinnati so we could see him one last time.

We stayed with him for a while, and then had the nurses turn off the respirator. It’s what he would have wanted. He would have wanted to pass on a life that was no longer a life. His chest moved up and down for a little while, and then stopped. Quietly, peacefully, he was gone.

My father, on the other hand, was a goses, defined as someone who is on the edge between life and death. At the end he was in agony, unable to do anything but lie in bed and suffer. Mostly, he was unconscious. He tossed and turned and moaned and groaned. Technically, he was still “alive” if you could call that living.

With a Goses nothing is to be removed and nothing is to be withheld as long as it can somehow prolong life. Here there was nothing to treat except the pain. If we gave him a enough morphine to quell the pain it might also depress his breathing enough to cause death. My brothers and I decided to treat the pain. It’s what he would have wanted. He would have wanted to pass on that kind of life. The doctor started the morphine. A few hours later, quietly, peacefully, no longer in agony, he too was gone.

Why did I act this way, and why do I and my family still feel, and always will feel, that we were part of making the right decisions in both cases? Jewish tradition provided some guidance, but just some. What made it so much easier was that we knew what these two men wanted. And because we knew, we could act on their wishes rather than only on our own initiative, no matter how well intentioned. We also were fortunate that there was no disagreement among the family members.

But that’s not always the case. That’s why, if you want things handled the way you want and not left to chance, if you want to spare your family a very difficult and painful decision, decide beforehand. Make a living will. Execute a power of attorney. Consult your lawyer as to how to do this properly. And talk about your wishes with your family. It isn’t macabre to do this. It’s sensible. You might even want to carry something in your wallet that expresses your wishes in case you can’t. Make your wishes for when you die known and put them into black and white.

As much as it can be our choice as to when and how to pass on life, it can also be our choice to pass on our life. It can be our choice to pass on the gift of life with the donation of one or more of our organs. My personal attitude is that when I’m done with my body, if there are any parts at all that can help someone else, they’re welcome to them.

But aren’t we Jews opposed to things like autopsies? Aren’t we opposed to anything that disturbs the body? Don’t we require the body to be buried intact, with all its organs in place? Yes, and no.

Yes, all branches of Judaism are in complete accord the dead are to be treated with the utmost sanctity and respect. Yes, all branches of Judaism are opposed to gratuitous autopsies, but all permit it when there is a great expectation that the procedure will produce knowledge that could directly help others.

Yes, all branches of Judaism want the body buried intact. But all, even the ultra-Orthodox, allow organ transplants. Pikuach nefesh, the saving of life, supersedes everything else. In the Orthodox world, an organ that is transplanted into someone else is considered living tissue, and hence does not require burial! Thus the rest of the body is indeed buried intact!

But there are not enough organs:

The stories… are gut-wrenching.

A 14-year-old girl dies in her father's arms waiting for a lung donation. A 58-year-old singer dies after waiting two years for a kidney that never comes.

Last year alone, more than 6,000 Americans died waiting for a transplant. As of this month, nearly 89,000 people are waiting for a transplant, including 8,500 New Yorkers. Every 20 minutes a new name is added to the list. Yet Americans bury or cremate 20,000 transplantable organs every year. [New York Daily News, July 20, 2005]

Look around you. There may be someone here who can see because someone donated their corneas. There may be someone here who can now avoid the difficulty and danger of dialysis because someone donated a kidney. There may be someone here altogether because someone donated a liver, or a lung, or a heart.

As you know, there’s an organ donor check-off on your driver’s license. Don’t bother. With true bureaucratic genius the cards are laminated, making it impossible to check off anything. Organ donor cards have already been mailed to you, and there are more here today in the back of the room. Please, please, fill out the organ donor card. Have it witnessed. What better mitzvah could you perform at this sacred time of year than seeing to it that someday, very far in the future, of course, you might save the life of another human being?

I want to share with you a very beautiful poem written by a man named Robert Test called “To Remember Me:”

Give my sight to the man who has never seen a sunrise, a baby's face or love in the eyes of a woman.

Give my heart to a person whose own heart has caused nothing but endless days of pain.

Give my blood to the teenager who was pulled from the wreckage of his car, so that he might live to see his grandchildren play.

Give my kidneys to one who depends on a machine to exist from week to week.

Take my bones, every muscle, every fiber and nerve in my body and find a way to make a crippled child walk.

Explore every corner of my brain. Take my cells, if necessary, and let them grow so that, someday, a speechless boy will shout at the crack of a bat and a deaf girl will hear the sound of rain against her window.

If you do all I have asked, I will live forever. [Robert N. Test]

Here are two of the most important Jewish New Year’s resolutions you can make: First thing tomorrow, begin the process of making decisions about how you want to be treated if, God forbid, you’re dying and unable to express your wishes for yourself. First thing tomorrow, arrange to be an organ donor. Do it in memory of the loved ones you’ve come here to remember. Do it in honor of the people you love. Do it for others. Do it for yourself. But do it! Let us all remember and be remembered…