Sacred Decisions: Human Stories at the Heart of Medicine & Halacha

Choosing Joy in Uncertainty

Guest: Shana Alayev

Shana Alayev is a wife, mother of four, friend, daughter, speech therapist, and someone living with metastatic breast cancer. In this episode, she joins Rabbi Dr. Shlomo Brody for an honest conversation about continuing to live fully when illness and uncertainty are always present.

Shana shares how she moved from waiting for cancer to be “over” to recognizing that this is something she is living with, but it does not have to define her. She reflects on parenting, the strength she draws from her family and friends, and how her understanding of hope and emunah has evolved. She also talks about humor and her conscious decision to look for joy, even while making space for fear, sadness, and difficult days.

Together, they explore what it means to live with uncertainty, how serious illness changes our relationship with time, and the internal decisions we make about how we want to live when so much remains outside our control.

About the Guest:

Shana Alayev is a wife, mother, speech therapist and friend who living with metastatic breast cancer. She shares her experiences navigating illness, family life, and finding emunah and joy on Instagram at @shana.alayev.

Resources mentioned:

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Shaar HaBitachon (the fourth gate from Chovot HaLevavot) - Rabbi Bachya ibn Pekuda

Learn more and access Ematai’s resources at ematai.org.

Questions or feedback about Sacred Decisions? Contact us at office@ematai.org.

What Do We Owe Our Parents?

Guest: Rabbi Dr. Jason Weiner

What do we owe our parents as they age? How do we honor them when their needs increase, their independence changes, or their wishes conflict with what we think is best?

Rabbi Dr. Shlomo Brody speaks with Rabbi Dr. Jason Weiner about the complicated transition from being cared for by our parents to becoming their caregivers.

Drawing on his experience working with patients and families in the hospital, Rabbi Weiner explores the halachic and emotional challenges of caring for aging parents, balancing family responsibilities, making difficult medical decisions, and navigating the guilt that can accompany caregiving.

Key Topics:

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How Kibbud Av V'em changes as parents age and children become caregivers

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Balancing honoring parents with responsibilities to one's own family

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When to say no to a parent's requests and recognizing the limits of caregiving

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Making medical decisions for parents who can no longer speak for themselves

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Navigating caregiver guilt and difficult end-of-life decisions

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Having meaningful conversations with parents before it's too late

About the guest:

Rabbi Dr. Jason Weiner is the Senior Chaplain and Director of the Spiritual Care Department at Cedars-Sinai Medical Center, Senior Consultant at Ematai, and Rabbi at Knesset Israel Congregation in Beverlywood. He is the author of Bedside Halacha: Practical Guide for Healthcare Professionals, CARE and COVENANT: A Jewish Bioethic of Responsibility, Jewish Guide to Practical Medical Decision-Making, andGuide to Observance of Jewish Law in a Hospital. Resources and sources mentioned in the conversation:

Nishmat Avraham — Rabbi Dr. Avraham S. Abraham

Sefer Chasidim — Rabbi Yehuda HaChasid

Robert M. Beren Healthcare Directive & Conversation Guide — Ematai

Kuntrus HaRofe L’Shvurei Lev - Rabbi Yitzchok Schechter (based on the teachings of Rabbi Dovid Cohen)

Story of Rav Asi - Kiddushin 31b

Learn more and access Ematai’s resources at http://ematai.org.

Questions or feedback about Sacred Decisions? Contact us at office@ematai.org.

In this episode of Refuah & Psak, Rabbi Brody speaks with Chaya Lasson, Director of Jewish Hospice and Palliative Care for Bridging Life in Baltimore, about clarifying misconceptions around hospice and integrating it with Jewish values. Chaya distinguishes hospice from palliative care, outlines the collaborative hospice team model, and dispels myths about hospice.

They discuss aligning care with halachic guidance, involving rabbis and clinicians in real-time decision-making, and recognizing patient preferences within Jewish law. Chaya stresses the importance of early education for families, rabbis, and communities to avoid crisis-driven decisions, and shares moving stories of patients who lived longer and more meaningfully under hospice. The conversation urges building relationships with culturally sensitive providers and viewing hospice not as giving up, but as “doing everything” to maximize dignity, comfort, and meaningful living until the final breath.

In this episode of Refuah & Psak, Rabbi Brody speaks with Dr. Beth Popp, a palliative-care physician, about the medical, emotional, and halachic complexities of artificial nutrition and hydration (ANH). They review why ANH may be needed, the methods used, and the risks that may be involved. The conversation highlights how decisions differ at various stages of illness, especially near the end of life. Together they stress the importance of case-by-case evaluation, patient comfort, sensitive guidance for families, and review some of the key information needed for providing halachic guidance about ANH.

In this episode of Refuah & Psak, Ematai’s associate director and physician assistant Rachel Secunda speaks with Ematai’s director of community outreach, Bassie Taubes, an oncology nurse, health coach, and rebbetzin, about how rabbis and communities can better support those who often feel unseen. They highlight the elderly who quietly withdraw due to physical challenges, caregivers who sacrifice silently and need recognition and respite, mourners who grieve long after shiva or outside traditional halachic categories and the ill themselves.

The discussion also covers the importance of sensitive bikur cholim, remembering caregivers after a loved one’s passing, and empowering rabbis to ask questions of the healthcare team when answering shailot. Ultimately, they stress that rabbis cannot and should not do everything alone; rather, they should do what they can to make congregants feel acknowledged and educate the broader community to notice, listen, and care so that no one feels forgotten.

In this episode of Refuah & Psak, Rabbi Brody speaks with Dr. Moshe Ornstein, a genito-urinary oncologist and author of Cancer in Halakha, about cancer and its treatments. Dr. Ornstein explains what cancer is, clarifies the difference between localized and metastatic disease, and reviews treatment options from surgery and radiation to immunotherapy and targeted therapies.

Dr. Ornstein highlights the importance of distinguishing between curative and palliative goals, noting that “palliative” often means long-term management rather than giving up hope. The conversation also delves into how rabbis and families can support patients with both medical realities as well as spiritual and emotional support.

In this episode of Refuah & Psak, Rabbi Brody speaks with Dr. Ernest Mandel, member of the Ematai medical advisory board and nephrologist about the halachic and medical nuances of cyclical treatments, with a focus on dialysis and vasopressors. They discuss how treatments that naturally start and stop differ from continuous interventions, and why this distinction matters for both halacha and patient decision-making.

The discussion covers the use of time-limited trials, potential risks and side effects, and how “pause points” allow for reassessment. They also explore the importance of aligning medical care with a patient’s goals and halacha, especially in end-of-life contexts.

In this episode of Refuah & Psak, Rabbi Brody speaks with Rabbi Dr. Jason Weiner, senior consultant at Ematai as well as the executive director of the Spiritual Care Department at Cedars – Sinai in Los Angeles, about the halachic and ethical distinction between withholding and withdrawing life-sustaining treatments.

They explore how Jewish law, secular bioethics, and Israeli law approach these decisions; practical examples like stopping chemotherapy or ventilator withdrawal; and touch upon how this impacts nutrition, hydration, and other interventions. The conversation highlights moral, emotional, and pastoral considerations, and includes a moving real-life story that illustrates both halachic nuance and compassionate care.

In this episode of Refuah & Psak, Rabbi Shlomo Brody speaks with Dr. Jonah (Yonah) Rubin, Ematai medical advisory board member and pulmonary and critical care physician at Mass General Hospital, about the medical and halachic complexities surrounding DNI (“do not intubate”) orders. Dr. Rubin explains the full spectrum of oxygen support, from nasal cannula and high-flow systems to BiPAP and, when necessary, invasive mechanical ventilation, highlighting how intubation serves as a bridge to recovery rather than a cure.

They discuss scenarios where intubation may be futile (“a bridge to nowhere”), the potential need for tracheostomy in prolonged cases, and the factors that determine whether and when to extubate, including the distinction between clinical and palliative extubation.

Rabbi Brody outlines key halachic perspectives and together they offer practical guidance for families and rabbis, such as asking whether the patient is likely to be successfully extubated, understanding prognosis and possible outcomes, and keeping the decision-making process dynamic, recognizing that new crossroads for choice often emerge during a patient’s course of care.

In this episode of Refuah v’Psak, Rabbi Brody is joined by Ematai medical advisory board member and palliative care physician Dr. Moshe Cohen to demystify the halachic and medical concerns around pain management at the end-of-life. From addiction fears to end-of-life sedation, they explore how pain management at the end-of-life is not only possible but may even be halachically mandated.

In this episode of Refuah & Psak, Rabbi Shlomo Brody speaks with speaks with Dr. Jonah (Yonah) Rubin, Ematai medical advisory board member and pulmonary and critical care physician at Mass General Hospital, about the medical and halachic considerations surrounding DNR (“Do Not Resuscitate”) orders. Dr. Rubin explains what CPR includes and that success should be measured not only by restarting the heart but by the chance of meaningful recovery.

They address the confusion and tension DNR orders often cause, including misconceptions that DNR means “do not treat.” Both emphasize the importance of clear, proactive communication among rabbis, families, and clinicians, ideally through structured “goals of care” meetings, to clarify what the patient wants, distinguish between resuscitation and other treatments, and align medical decisions with the patient’s prognosis, values, and halachic guidance.

In this episode of Refuah & Psak, Rabbi Brody speaks with Rabbi Dr. Aaron Glatt, Ematai rabbinic advisory board member and Chairman of Medicine and Chief of Infectious Diseases at Mount Sinai South Nassau, and a medical halacha authority—about how rabbis can most effectively communicate with physicians to guide families through complex medical situations.

Rabbi Glatt emphasizes the rabbi’s multifaceted role: providing comfort and pastoral support, helping families navigate halachic decisions, and ensuring unity by clarifying in advance which rav should be consulted to avoid conflict. They explore strategies for involving all stakeholders, addressing differing religious orientations, obtaining accurate medical facts directly from doctors, and knowing when to consult more specialized poskim. From both rabbinic and medical perspectives, they stress respectful collaboration with healthcare teams, understanding hospital protocols, and advocating firmly yet diplomatically when halachic guidance differs from medical norms. The conversation blends practical scenarios, halachic principles, and relationship-building tips to help rabbis protect patient dignity, maintain shalom bayis, and achieve the best outcomes for congregants.

Welcome to Refuah & Psak, Ematai’s podcast for rabbis who support their congregants through life’s most sensitive moments.In this special introductory episode, Ematai associate director, Rachel Secunda PA-C, takes listeners on an imagined tour of the ICU with Dr. Jonah (Yonah) Rubin, Ematai medical advisory board member and pulmonary and critical care physician at Mass General Hospital.

Together they demystify common but often misunderstood medical terms and scenarios to give rabbis an understanding of what they might encounter when answering shailot about medical dilemmas. Ultimately though, the best tip is to ask for a clear explanation or clarification!