By Editorial Staff
May 26, 2026
In the book of Deuteronomy, the ancient directive is clear: "Choose life." For centuries, this has been interpreted as a call to action, a mandate to pursue vitality, righteousness, and engagement with the world. But in the modern era, particularly for those navigating the complexities of a life-altering illness, the definition of "choosing life" has become nuanced. It now encompasses everything from rigorous medical research and treatment protocols to the intentional practice of self-care and the pursuit of remission.
However, as Rabbi Melanie Levav, Executive Director of the Shomer Collective, argues, there is a missing piece to this modern puzzle: the courage to engage with the reality of our own mortality. By confronting the "D-words"—death and dying—before they are forced upon us by circumstance, we don’t just prepare for the end; we fundamentally enrich the way we live.
The Great Silence: Why We Avoid the Inevitable
The statistics regarding end-of-life planning in the United States paint a stark picture of cultural avoidance. According to national health surveys, approximately 92% of Americans agree that it is critically important to discuss their end-of-life wishes with their loved ones. Yet, despite this overwhelming consensus, only about one-third of the population has actually initiated these conversations.
This disconnect suggests a profound psychological barrier. We live in a society that often prioritizes the "positive," a cultural reflex that views death as a failure to be avoided rather than a natural, inevitable chapter of the human story. By labeling mortality as a taboo subject, we inadvertently leave ourselves and our families vulnerable to crisis-driven decision-making.
"We’re all born mortal," says Rabbi Levav. "And yet, somewhere along the way, so many of us learned not to talk about death. We focus on the good and the light, but we do so at the expense of doing the hard work of planning for the future."
A Case Study in Proactive Planning
For many, the catalyst for this difficult work is a diagnosis. Meredith L., a beneficiary of support from Sharsheret and the Shomer Collective, found that her cancer diagnosis brought the necessity of planning into sharp focus.
"My cancer diagnosis was really scary," Meredith recalls. "However, I was thankful that a lot of the basic things—like wills and medical directives—were already things that my partner, Ben, and I had spoken about. Because we had those conversations early on, I didn’t have to include that heavy administrative burden in my additional planning."
Meredith’s experience highlights a critical, often overlooked benefit of end-of-life planning: the reduction of emotional labor for loved ones. When wishes are articulated in advance, the burden of "guessing" what a patient would have wanted is lifted from family members, allowing them to focus on caregiving and presence rather than legal and ethical crises.
Chronology of Awareness: From Taboo to Empowerment
The journey toward normalizing end-of-life planning has moved through several distinct phases:
- The Era of Avoidance: Historically, death was discussed in private, often behind closed doors, with final wishes left to chance or verbal assumption.
- The Rise of Advance Directives: The late 20th century saw the codification of "Living Wills" and "Durable Power of Attorney." While these documents became standard, they were often treated as legal hurdles to be cleared rather than relational conversations to be held.
- The Integrated Approach: Today, organizations like Sharsheret and the Shomer Collective are shifting the narrative. By combining medical support with spiritual and emotional guidance, they are framing advance care planning not as a legal necessity, but as a "gift" to survivors.
- The Modern Integration: We are now entering an era where mortality is being re-integrated into the concept of "living well." This involves a holistic view where psychological readiness is considered as vital as physical health.
The Wisdom of Preparedness
The intersection of Jewish tradition and modern palliative care offers a unique perspective on this topic. Rabbi Eliezer, a sage cited in the Talmud, famously taught that one should "repent one day before you die." When his students asked how anyone could know the date of their death, the answer became a guiding principle for life: because we do not know when our end will come, we must live every day in a state of preparedness.
This is not a morbid obsession with death; it is a profound strategy for intentionality. If we accept that tomorrow is never guaranteed, the way we prioritize our time, our relationships, and our values changes.
"Sharsheret has been really great because they meet you where you’re at," Meredith adds. "It feels so reassuring to know that there’s a place that not only understands the medical side of cancer but the heritage side as well. Knowing that there is guidance for the long-term, not just the acute, makes a world of difference."
Implications: Why Conversations Matter
The implications of failing to discuss end-of-life wishes are significant. Without clear guidance, families often find themselves in courtrooms or hospitals, paralyzed by indecision and conflict during the most vulnerable moments of their lives.
Conversely, the implications of proactive planning include:
- Alleviating Future Burden: By settling the "business of death" while we are in the fullness of life, we grant our families the freedom to mourn without the distraction of administrative chaos.
- Clarifying Values: The act of discussing our wishes forces us to articulate what we value most. Do we prioritize comfort? Length of life? The ability to communicate? These are essential questions that define our legacy.
- Enhancing Connection: Paradoxically, talking about death can bring people closer together. It creates an atmosphere of radical honesty and vulnerability that is rarely found in the mundane conversations of daily life.
Moving Forward: Taking Action Today
The question for the reader remains: What matters most to you, and what are you going to do about it today?
Planning for the end of life does not require a formal document or a lawyer on day one. It begins with a conversation. It starts by asking your spouse, your parents, or your children, "If something were to happen to me, here is what I would want you to know."
As Rabbi Levav emphasizes, this process is an act of love. By expressing our wishes, we ensure that our final chapter is written in our own voice. We move away from a culture of silence and toward a culture of connection.
In the face of a world that is inherently uncertain, the most radical way to "choose life" is to live it with eyes wide open—aware of our limits, grateful for our time, and prepared to handle the inevitable with dignity and peace. Whether you are facing a medical diagnosis or simply reflecting on the passage of time, the time to start these conversations is now. The future—and your loved ones—will thank you for it.
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