By Editorial Staff
May 26, 2026
In the book of Deuteronomy, the ancient directive is clear: "Choose life." For centuries, this has served as a spiritual and ethical mandate. But in the modern era, particularly for those navigating the complexities of a life-altering illness, the definition of "choosing life" has become increasingly multifaceted. It is no longer just about survival; it is about the active, intentional curation of one’s future, even—and perhaps especially—when that future is uncertain.
Rabbi Melanie Levav, BCC, LMSW, Executive Director of the Shomer Collective, suggests that our modern interpretation of choosing life often gets caught up in the mechanics of medicine: researching treatment options, practicing rigorous self-care, and maintaining a relentless focus on remission or "no evidence of disease." While these are vital components of the patient experience, Rabbi Levav argues that they are incomplete without the "hard work" of end-of-life planning.
The Silence Surrounding the Inevitable
There is a profound disconnect between our intentions and our actions regarding mortality. Statistical data highlights a stark reality: approximately 92% of Americans acknowledge the importance of discussing their end-of-life care wishes. Yet, despite this overwhelming consensus, only one-third of the population has actually engaged in these conversations.
This paradox suggests a cultural paralysis. Somewhere along the way, modern society has internalized a mandate to focus exclusively on the positive, often at the expense of addressing the inevitable. We have developed a societal aversion to "the D words"—death and dying—treating them as taboos rather than universal experiences.
This avoidance is not merely a matter of discomfort; it carries significant practical and emotional consequences. When individuals fail to articulate their values, priorities, and medical preferences, the burden of decision-making falls upon loved ones during times of profound crisis. By sidestepping these discussions, we inadvertently trade a measure of future peace for a temporary sense of security.
A Chronology of Care: From Diagnosis to Dialogue
For patients like Meredith L., a beneficiary of support from both Sharsheret and the Shomer Collective, the arrival of a cancer diagnosis acted as a catalyst for a conversation she had already begun.
"My cancer diagnosis was really scary," Meredith recalls. "I was thankful that a lot of basic things like wills and medical decisions were already something that my husband, Ben, and I spoke about, so I didn’t have to include that in my additional planning."
The journey from a diagnosis to a state of preparedness is rarely linear, but it is one that organizations like Sharsheret aim to facilitate. The process generally follows a three-fold progression:
- The Immediate Shock: Following a diagnosis, patients are often overwhelmed by the "medical side" of the illness. During this stage, the priority is survival and information gathering.
- The Integration of Values: As the patient stabilizes, the focus shifts toward aligning medical decisions with personal values. This is where organizations like the Shomer Collective provide a framework for discussing what "living well" means to the individual.
- The Legacy of Preparedness: The final phase involves formalizing wishes, such as advanced directives and estate planning, ensuring that the patient’s voice remains the guiding force, even if they become unable to communicate.
"Sharsheret has been really great because they meet you where you’re at," Meredith notes. "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."
Bridging Ancient Wisdom with Modern Reality
The resistance to discussing death is not unique to the modern era, but Jewish tradition has long offered a counter-narrative. In the Talmud, Rabbi Eliezer offers a teaching that is both provocative and practical: "Repent one day before you die."
When his students asked how one could possibly know which day would be their last, the implication became clear: live every day as if it were your last. This is not meant to be a morbid exercise, but rather a strategy for living with greater intention. By acknowledging the fragility of life, we are empowered to prioritize what truly matters.
"Jewish wisdom reminds us that confronting our mortality can help us live with greater intention and connection," Rabbi Levav explains. "We should live our lives in a state of preparedness, with the awareness that tomorrow is never guaranteed—for any of us, whether or not we have a diagnosis."
The Psychological Implications of Proactive Planning
The psychological burden of the "unknown" is often heavier than the reality of the plan itself. Many fear that by planning for death, they are "giving up" on life. However, clinicians argue that the opposite is true.
Alleviating the Burden
When we express our wishes—about our values, our spiritual needs, and our medical boundaries—we are effectively creating a roadmap for our loved ones. This gift of clarity prevents familial conflict and provides caregivers with the confidence that they are honoring the patient’s true intent, rather than guessing in the dark.
Living More Fully
Engaging with mortality forces us to distill our lives down to their essence. It prompts the difficult but rewarding question: What matters most to me? When we strip away the noise of daily life and focus on the core values that define us, we are often better equipped to spend our remaining time on experiences and relationships that provide genuine meaning.
Normalizing the Conversation
The goal of organizations like the Shomer Collective is to normalize these discussions so that they become a routine part of life, rather than an emergency response to a crisis. By weaving these conversations into the fabric of our relationships—around the dinner table, during family milestones, or in quiet moments—we diminish the fear that surrounds the topic.
Implications for the Future of Healthcare
The shift toward proactive end-of-life planning is beginning to influence broader healthcare policies. Medical institutions are increasingly recognizing that the "patient experience" extends far beyond clinical outcomes.
- Holistic Care Models: Healthcare providers are being encouraged to integrate social workers, chaplains, and counselors into the primary care team earlier in the patient’s journey.
- Cultural Competency: There is a growing appreciation for the role of cultural and religious heritage in end-of-life decision-making. Programs that respect the patient’s background—such as those offered by Sharsheret—are proving to be more effective than "one-size-fits-all" approaches.
- The Digital Shift: The rise of digital tools for advanced directives and legacy planning is making the process more accessible, though experts caution that these tools should never replace the deep, interpersonal conversations that are the heart of the matter.
The Final Question
As we look toward the future, the challenge remains: how do we transition from being a society that fears death to a society that understands it as a natural, if difficult, part of the human journey?
The answer lies in individual action. It starts with a conversation—with a spouse, a parent, or a trusted friend. It requires the courage to ask, "If I were unable to speak for myself, what would I want you to know about what makes my life worth living?"
By talking about the reality of life in the face of death, we open the door to growth, love, and a deeper understanding of our own humanity. We learn more by confronting these realities than we ever could by avoiding them.
The question remains for each of us: What matters most to you, and what are you going to do about it today? By taking care of the "business" of death while we are most alive, we reclaim the agency to focus on what matters most: the living.
About the Author
