By Editorial Staff
May 26, 2026
In the book of Deuteronomy, the ancient imperative is clear: "Choose life." For centuries, this has been interpreted as a call to action—to pursue justice, to sustain community, and to foster growth. But in the modern clinical landscape, the definition of "choosing life" has evolved. Today, for many, it involves the clinical rigor of researching treatment options, adhering to complex self-care protocols, and maintaining a steadfast focus on remission.
Yet, as Rabbi Melanie Levav, Executive Director of the Shomer Collective, argues in a recent commentary, there is a missing piece in our modern approach to wellness. True life-affirming behavior, she suggests, requires us to do the unthinkable: to speak openly about death.
The Paradox of Planning: Data and Disconnect
The tension between our intentions and our actions regarding end-of-life planning is one of the most significant gaps in modern healthcare. According to national health surveys, 92% of Americans agree that discussing end-of-life wishes is a critical component of personal responsibility, regardless of one’s current health status.
However, the reality is starkly different: only one-third of the U.S. population has actually engaged in these conversations or formalized their directives. This massive statistical chasm suggests that while we intellectually grasp the importance of preparation, we are paralyzed by a cultural aversion to the "D-words"—death and dying.
Chronology of a Crisis: The Shift from Denial to Preparation
The journey toward end-of-life planning often begins at a point of trauma, particularly following a life-altering diagnosis. For many, the timeline of preparation is reactive rather than proactive:
- The Pre-Diagnosis Phase: Characterized by a societal "focus on the positive." During this period, mortality is treated as a distant, abstract concept. The cultural mandate is to avoid morbidity, leading many to defer the "hard work" of legal and medical planning.
- The Point of Diagnosis: The moment of impact. Patients are suddenly thrust into a whirlwind of clinical decision-making. As Meredith L., a beneficiary of support from Sharsheret and the Shomer Collective, notes, "My cancer diagnosis was really scary. I was thankful that a lot of basic things like wills and medical decisions were already something that Ben and I spoke about, so I didn’t have to include that in my additional planning."
- The Integration Phase: Utilizing support systems like Sharsheret, individuals move from the initial shock to a state of empowered agency. In this phase, patients align their medical treatment with their personal values, ensuring their legacy and wishes are protected by documentation.
The Wisdom of Preparedness: Bridging Heritage and Modernity
The Shomer Collective and Sharsheret emphasize that confronting mortality is not an act of surrender, but an ancient strategy for living with intention. Drawing from the Talmud, Rabbi Levav highlights the teachings of Rabbi Eliezer, who instructed his students to repent one day before they die. When his students asked how one could possibly know the day of their death, the lesson revealed itself: one must live in a perpetual state of readiness.
This philosophy suggests that tomorrow is never guaranteed—not for the healthy, and not for the chronically ill. By normalizing the conversation around mortality, we strip away the paralyzing fear associated with the inevitable and transform it into a framework for a more meaningful life.
Perspectives from the Field: The Role of Support Organizations
Support organizations play a pivotal role in normalizing these discussions. Sharsheret, known for its focus on Jewish women facing breast and ovarian cancer, acts as a bridge between clinical requirements and personal heritage.
"Sharsheret has been really great because they meet you where you’re at," Meredith L. explains. "If you don’t have some of those longer-term needs in place, they can guide you. It feels so reassuring to know that there’s a place that not only understands the medical side of it but the Jewish heritage side as well."
For these organizations, the goal is to alleviate the burden on loved ones. By making decisions today—designating power of attorney, detailing preferences for care, and having difficult, honest conversations—patients can focus their remaining energy on the act of living rather than the logistics of transition.
Implications: Changing the Cultural Narrative
The implications of failing to plan are far-reaching. When families are forced to make decisions during a medical crisis without having had prior conversations, they often face "decision fatigue" and internal conflict. This adds an unnecessary layer of trauma to an already grief-stricken experience.
Conversely, those who engage in proactive planning report a sense of relief. By "taking care of the business of death while we are most alive," individuals grant their families the gift of clarity. This shift has several key implications:
- Reduced Emotional Burden: Survivors who know their loved one’s wishes are spared the guilt and second-guessing that often accompany end-of-life care.
- Increased Autonomy: The patient retains control over their personal narrative, ensuring that their values—rather than a medical protocol—dictate their final days.
- Enhanced Intentionality: Confronting the reality of a finite life encourages individuals to prioritize what truly matters, fostering deeper connections and more meaningful daily experiences.
The Call to Action: What Matters Most?
The overarching question posed by the Shomer Collective is both simple and profound: What matters most to you, and what are you going to do about it today?
This is not a prompt for gloom, but a catalyst for vitality. To talk about death is to affirm the value of the time we have. It is an acknowledgment that our lives are defined not just by how we endure challenges, but by how we prepare for the inevitable conclusion of our journey.
In a world that encourages us to look away from the horizon of mortality, choosing to engage in these conversations is an act of profound courage. It is, ultimately, the most authentic way to "choose life." Whether facing a diagnosis or navigating the complexities of everyday existence, the invitation remains the same: step into the conversation, alleviate the future burden, and live with the clarity that only an honest confrontation with reality can provide.
By integrating this wisdom, we move away from viewing death as a failure of our medical system or our personal optimism, and instead view it as a final, vital chapter of the human experience—one that we have the power to write with our own hand.
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