Jewish Medical Culture: Case Studies in End-of-Life Decision Making A Dissertation Presented to The Faculty of the Graduate School of Arts and Sciences Brandeis University Department of Near Eastern and Judaic Studies Sylvia Barack Fishman, Advisor In Partial Fulfillment of the Requirements for the Degree Doctor of Philosophy by Joshua N. Cypess August 2015 The signed version of this form is on file in the Graduate School of Arts and Sciences. This dissertation, directed and approved by Joshua N. Cypess’s Committee, has been accepted and approved by the Faculty of Brandeis University in partial fulfillment of the requirements of the degree of: DOCTOR OF PHILOSOPHY Eric Chasalow, Dean Graduate School of Arts and Sciences Dissertation Committee: Sylvia Barack Fishman, Department of Near Eastern and Judaic Studies Jonathan D. Sarna, Department of Near Eastern and Judaic Studies Yehudah Mirsky, Department of Near Eastern and Judaic Studies Lisa Fishbayn Joffe, Hadassah-Brandeis Institute Copyright by Joshua N. Cypess 2015 Acknowledgements This dissertation could not have been written without assistance of numerous individuals and institutions. I have benefited first and foremost from the love and support of my family: my wife, Rebecca, and our three children, Benjamin, Joseph, and Sarah. I thank them for providing an environment in which we can discuss ideas freely and take pride in each other’s accomplishments. Rebecca, with the acumen and brio of a world-class scholar and the superhuman hessed and patience of a Biblical heroine, has provided invaluable help throughout the long years and wide-ranging travels of my graduate-school odyssey. I would not have been able to realize the vision of this project without her peerless aid. These words are not enough to thank her, but in a dissertation, words are all I can give. My brother, Aaron Cypess, is a doctor, a molecular biologist, and a ben Torah. He has been a close friend and keen havruta for all of my life. He has always been there to listen to his younger brother, whose perpendicular perception often felt intellectually isolated in a world where what was obvious to everyone was not to him, and vice versa. Since early in our post- Princeton years, while he embarked on his arduous path for an M.D.-Ph.D. and I was in rabbinical school, he has shared with me his views on medicine and science. I could not have undertaken a project such as this without his expert guidance, his earnest wish to help, and his good sense of humor. My mother- and father-in-law are both political scientists who have dedicated their lives to using ideas in the service of the public good. Their daughter carries that mission with pride and I am happy they have been part of my life. I know that they share my interests in social science, policy, and philosophy beyond the dusty page. iv My advisers and professors in the Department of Near Eastern and Judaic Studies at Brandeis University have provided mentorship, guidance, encouragement and patience. In searching for a scholarly home in which to pursue my doctorate, I was proud to be accepted by an institution with such a distinguished legacy, and I carry that pride forward as a responsibility to uphold that legacy. My advisor, Sylvia Barack Fishman, welcomed me to the department when I embarked on my graduate studies, and I have benefited immeasurably from her teaching and her scholarship. Jonathan D. Sarna has encouraged me at every turn, providing valuable feedback and advice, both formally and informally. The field of Jewish Sociology is small, and I am fortunate to be mentored by two recipients of the Marshall Sklare award from the Association for the Social Scientific Study of Jewry, in the institution built by Professor Sklare himself. Together, Prof. Fishman and Prof. Sarna have shaped my thinking in lasting ways, and I hope I will be able to contribute to their fields in ways that reflect well on all they have given me; with my family, I have come to see them as personal as well as professional mentors. I am grateful for the guidance of Yehudah Mirsky, who applied his remarkable breadth of knowledge to enriching this project. He arrived in Brandeis at the time I was leaving Massachusetts for New Jersey; although I wish I had been able to spend more time learning from him and sharing ideas as a student, I look forward to doing so in future years. Lisa Fishbayn Joffe of the Hadassah-Brandeis Institute served as outside reader, bringing her expertise in legal studies to bear on our discussions as I sought to refine my work. In addition, I thank the professors with whom I worked in seminars and as teaching assistants: Marc Brettler, ChaeRan Freeze, Reuven Kimelman, Jonathan Levisohn, Antony Polonsky, and Eugene Sheppard. Len Saxe, Ted Sasson, and Ben Phillips of the Cohen Center for Modern Jewish v Studies offered me training in statistics and hands-on experience in sociology, for which I am most thankful. My work would have been dramatically different without the guidance of the faculty of Sociology at Brandeis, from which department I received a master’s degree in 2012. It was Shulamit Reinharz who created the joint degree in NEJS and Sociology and encouraged me in my application to Brandeis; I am grateful that she saw the potential in me to join this venerable community. My studies with Peter Conrad have shaped my thinking in the Sociology of Health—a field he has developed and nurtured, much as he has nurtured students like me; he is a lively and friendly scholar who lived up to my image (I guess it came from Tuesdays with Morrie) of the Brandeis sociologist. Wendy Cadge, who advised my master’s thesis, has been a living example of an adept thinker in my fields the Sociologies of Religion and of Health. Her knowledge in this complex area is matched only by her abilities as a teacher. Sociology is a well-regarded field at Brandeis with leaders on and off campus, and I am happy to be able to be associated with such a storied and able legacy. I came to the department thinking like a rabbi, philosopher, and anthropologist and it was their task to craft me into a sociologist whom they would be proud of, one committed to social science and to public service. I hope to continue that unending task. I offer my thanks to David Cunningham, Karen V. Hansen, Gila Hayim, Laura J. Miller, Chandler Rosenberger, and Sara Shostak. The other members of the graduate community at Brandeis were of great importance in my experience as a student. I am grateful to Meredith Bergey, Rachel Bernstein, Casey vi Clevenger, Zev Eleff, Brian Fair, Nicole Fox, Allyson Gonzalez, Alexandra Herzog, Vanessa Lopes Munoz, Shay Rabineau, Emily Sigalow, Jill Smith, and Ken Sun. The librarians at Brandeis provided essential support, and it was also a pleasure for me to discuss ideas with them; I mention in particular Jim Rosenbloom and Nancy Zibman. I am grateful to Joanne Arnish and Jean Mannion, department administrators in NEJS, who acted as safety nets at every step. My studies at Brandeis were made possible by a Mildred and Abe S. Bloomberg Endowed Fellowship in Judaic Studies and a Fein, Pinanski, Sain Fellowship of the Hebrew Free Loan Society from the Boston Area Combined Jewish Philanthropies. I acknowledge these fellowships with the deepest gratitude. The Halachic Organ Donor Society has made an enormous amount of material on Jewish approaches to end-of-life medical issues available freely on-line. My work has been aided greatly by this resource. In addition, I acknowledge the materials provided by the Dr. Falk Schlesinger Institute for Medical-Halachic Research. I am grateful to the many scholars outside of Brandeis whom I consulted and who offered advice and guidance on my work. These include friends from Newton—Jay Berkovitz, Ruth Langer, Benjamin Samuels—as well as David Biale and Michael Broyde, who answered questions from afar, and old friends Zvi Novak, Don Seeman and Yuri Simon who have been able to provide guidance and models of expertise in social science and philosophy. The alumni of the Wexner Graduate Fellowship provide fellowship in the truest sense of the term, offering intellectual and professional support across the world of Jewish leadership, across all denominations, and in many academic fields touching on Jewish Studies. I am grateful for the consistently lively and enriching discussions that I have with my Wexner colleagues, with vii special mention for those who survived graduate school: Sarah Bunin Benor Yossi Chajes, Beth Cousins, Jonathan Crane, Danna Livstone, Michael Miller, Yossel Kanofsky, Moshe Simon Shoshan and Shaul Kelner, whose strong work in sociology I hope to emulate. The Foundation leadership is renowned for helping develop and nurture emerging scholars, and I learned how deep that help could be; I owe my gratitude to Bob Chazan, Larry Moses, and to Maurice Corson. In their dedication to both Torah and Madda, Rabbi David Ebner and Rabbi Aharon Lichtenstein of blessed memory embody the values that I aspire to most highly. I am humbled and thankful to have had the opportunity to study with them. I undertook my studies at Brandeis because of the mentorship of numerous professors and rabbis at Yeshiva University; I was fortunate to study with Rabbis-Professors David Berger, Yossi Blau, J. David Bleich, Yaakov Elman, Arthur Hyman, Ephraim Kanarfogel, Sid Z. Leiman, Michael Rosensweig, David Shatz, Haym Soloveitchik, and Moshe David Tendler. My approach to the study of culture was shaped during my undergraduate years at Princeton University, the rigor of which was revealed over my many years of education in many places.