By Editorial Staff
May 26, 2026
In the ancient book of Deuteronomy, the mandate is clear: "Choose life." But in the modern era, particularly in the shadow of a life-altering medical diagnosis, the definition of "choosing life" has become increasingly multifaceted. For many, it encompasses a rigorous regimen of treatment options, self-care, and the relentless pursuit of remission or a "no evidence of disease" (NED) status. Yet, according to experts, there is a missing, often overlooked component to this mandate: the courage to plan for the inevitable.
As we navigate an era of unprecedented medical advancement, the taboo surrounding mortality remains a stubborn barrier. Rabbi Melanie Levav, BCC, LMSW, Executive Director of the Shomer Collective, argues that confronting our mortality is not a morbid exercise, but a profound way to live with greater intention and connection.
The Disconnect: Intentions vs. Actions in End-of-Life Planning
The tension between our desire for control and our avoidance of the "D words"—death and dying—is supported by sobering data. Recent research indicates that while 92% of Americans believe it is vital to discuss their end-of-life wishes, only one-third of the population has actually engaged in these conversations.
This statistical gap reveals a deep-seated cultural discomfort. We are taught, from a young age, to focus on the positive, to look forward, and to prioritize the vibrancy of the present. While this mindset is often a survival mechanism, it frequently comes at the expense of necessary logistical and emotional planning.
"My cancer diagnosis was, naturally, really scary," says Meredith L., a beneficiary of Sharsheret and the Shomer Collective. "However, I felt a sense of profound relief that fundamental aspects of my life—like wills and medical directives—had already been discussed with my partner, Ben. It meant that during the crisis of my diagnosis, I didn’t have to scramble to add these complex decisions to my plate."
Meredith’s experience highlights a crucial reality: planning is not an admission of defeat; it is an act of preservation. By tackling the administrative and emotional burdens of the future while one is "most alive," individuals can liberate themselves to focus on the present moment.
Chronology of a Shifting Perspective
To understand why this conversation is gaining momentum, one must look at the evolution of patient advocacy.
- Pre-Diagnosis: Individuals often exist in a state of "mortality denial," assuming that end-of-life planning is reserved for the elderly or the terminally ill.
- The Diagnosis: When a life-altering illness strikes, the landscape shifts instantly. The "business of death"—legal documents, medical proxies, and value-based goal setting—becomes an urgent, often overwhelming necessity.
- The Integration Phase: Organizations like Sharsheret and the Shomer Collective bridge this gap by providing a framework that integrates clinical support with cultural and spiritual guidance. By meeting patients where they are, these organizations transform what could be a traumatic process into a manageable, empowering experience.
"Sharsheret has been vital because they don’t just provide medical guidance; they understand the intersection of medical necessity and Jewish heritage," notes Meredith. "Knowing there is a place that respects both the clinical reality and the spiritual journey provides a sense of reassurance that is hard to quantify."
The Wisdom of Preparedness: Bridging Tradition and Modernity
Jewish tradition has long emphasized the value of contemplating mortality as a tool for living. In the Talmud, Rabbi Eliezer offers a teaching that is as relevant today as it was centuries ago: "Repent one day before you die."
When his students asked, "How can one know the day of their death?" the answer provided a foundational philosophy: Live every day as if it were your last. This is not meant to incite anxiety, but to foster a state of preparedness. It suggests that if we live with the awareness that tomorrow is not guaranteed, we are more likely to prioritize what truly matters—our relationships, our values, and our personal legacies.
This ancient wisdom aligns perfectly with modern psychosocial support. The Shomer Collective emphasizes that "choosing life" in the 21st century involves:
- Open Communication: Initiating honest, perhaps uncomfortable, conversations with loved ones about values and priorities.
- Normalization: Breaking the silence around mortality so that it ceases to be a source of shame or fear.
- Active Engagement: Taking concrete steps to codify wishes, ensuring that the burden of decision-making does not fall solely on family members during a time of grief.
Implications for the Healthcare Ecosystem
The implications of this movement toward open communication are significant for the healthcare system, families, and the individuals themselves.
For Patients and Families
The primary implication is the reduction of "decision-making distress." When a patient has clearly articulated their wishes, family members are spared the agony of guessing what their loved one would have wanted during a crisis. This gift of clarity allows families to focus on care, comfort, and companionship rather than navigating legal or ethical dilemmas.
For the Healthcare System
Increased rates of advance care planning lead to better alignment between patient goals and clinical interventions. When doctors know exactly what a patient values—whether it is quality of life, longevity, or specific spiritual requirements—they can provide more personalized, compassionate, and efficient care.
The Psychological Shift
Perhaps the most profound implication is the psychological growth afforded by this process. Confronting the reality of our mortality forces us to distill our lives to their essence. It encourages individuals to identify what matters most and, crucially, to take action on those priorities today.
Moving Forward: From Fear to Empowerment
The fear of death is a universal human experience. It is perhaps the most fundamental fear we face. However, as Rabbi Levav suggests, avoiding the subject does not make it less real; it only makes it more isolating.
By integrating the "business of death" into the everyday, we are not dwelling on the end; we are affirming the value of the journey. Planning is a gift of agency. It is a way to ensure that, regardless of the diagnosis or the prognosis, the individual retains their voice, their dignity, and their values.
"What matters most to you?" this is the question posed by the Shomer Collective. It is a question that serves as a compass. Whether you are currently facing a health challenge or living in the fullness of health, the invitation is the same: start the conversation.
The work of planning for the end of life is, ironically, the most effective way to ensure we are fully present for the life we are living right now. By clearing the path of future administrative and emotional debris, we create the space to love more deeply, learn more freely, and live with the kind of intention that only comes from knowing—and accepting—our own humanity.
As we look toward the future, the goal is a culture where talking about the end of life is as natural as talking about our plans for the next week. It is a transition from fear-based silence to a life-affirming transparency. It is, in the truest sense, choosing life.
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