Every Catholic (LeHavdil) knows of the need for last rites. However, even many observant Jews overlook what the Aruch HaShulchan (Y.D. 338:1 and 3) refers to as an “Ikkar Gadol,” a major pillar of Torah life, that being the Vidui (confession) a Jew should make before he or she leaves this world. In fact, the Shulchan Aruch devotes an entire chapter (Y.D. 338) to this issue, which demonstrates the importance of this practice.
In this essay, we shall outline some of the issues and challenges involved with implementing this practice effectively. While we hope that Mashiach speedily arrives and, in the words of Yeshayahu, “eliminates death forever and wipes off tears from every face” (25:8), in the meantime we hope that our discussion will help raise awareness of the need to implement this rule at the necessary time.
Timing is crucial. In determining when a relative or a Rav should introduce the need for Vidui to a patient, the Shulchan Aruch (Y.D. 338:1) cites from the Gemara (Shabbat 32a) that we introduce the Vidui to a patient when “he is close to death.” One should not introduce the Vidui earlier, as it may crush the spirit of the patient, for he may perceive this as being told that he is about to die. On the other hand, since it is important not to squander the opportunity to perform the Vidui, one cannot delay too long in introducing the need to recite it.
One cannot underestimate the importance of maintaining the patient’s good cheer. It is well-known that a patient’s will to fight illness is critical to facilitating his recovery. Those who lose hope are far less successful at recuperating than those who maintain a positive attitude. It is for this reason that the Shulchan Aruch (ad. loc.) states that the Vidui should not be conducted in the presence of those who cannot control their emotions and will cry, thereby disheartening the patient.
Concern for a sick individual’s spirit is so great that the Shulchan Aruch (Y.D. 337:1) rules that we do not inform a seriously ill individual about the death of close relative for whom he is obligated to observe Shivah. The Aruch HaShulchan (Y.D. 337:2) adds:
We are not concerned with the Kaddish that he must recite, as Pikuach Nefesh enjoys priority over all else. From this, we may learn that it is forbidden to cause any undue pain to an ill individual and that all efforts should be made to strengthen his spirits as much as possible.
Indeed, it is wise to refrain from informing elderly and frail relatives of the death of a second or even a first cousin, as this might unduly weaken and possibly endanger them. Elderly people understandably are highly distressed by a perception that so many of their friends and relatives are dying. Hence, one should be very careful about revealing distressing information to sick and/or elderly individuals. If one chooses to reveal the information, one should do so with intelligence and sensitivity so as to not endanger them. Recall that Rashi (Bereishit 23:2 s.v. LiSpod) explains that Sarah Imeinu died from the shock of hearing about Akeidat Yitzchak.
Moreover, the Shulchan Aruch (Y.D. 339:1) rules that one should not prepare for a funeral until a relative has died. This rule also seems to stem from concern of distressing a near-death patient. We should add that this Halacha applies even if the patient is comatose and appears unable to understand what we are saying. We do not truly know what such individuals are capable of perceiving.
Strategies for Introducing the Vidui
The Torah teaches us to be sensitive to the needs of a very sick person and to present the Vidui in the gentlest manner possible. The Shulchan Aruch (Y.D. 338:1) instructs us to say:
Many individuals have recited the Vidui and have not died, and many who did not say the Vidui have died. In the merit of your reciting the Vidui, you will live, and whoever recites the Vidui enjoys a portion in the World to Come.
We should note that the text of the Vidui (Shulchan Aruch Y.D. 338:2 and printed in many Siddurim, including the Artscroll edition) itself contains an optimistic element, as it begins with a plea to Hashem for a Refuah Sheleimah (full recovery). In this manner, the Vidui also teaches the patient never to relinquish hope for a miracle that (by Hashem’s grace) will cure him completely. Thus, the patient’s spirit is bolstered by the Vidui’s injection of an element of hope.
The Chochmat Adam (151:11), writing in the early-nineteenth century, records the custom of the Berlin Jewish community. Whenever someone would be ill for more than three days, a community leader would visit him and lead him in reciting the Vidui. The Chochmat Adam writes, “Since in this community this is the common practice, the ill individual is not distressed at all by the call to Vidui. It is proper to establish this practice in all Kehillot.”
Rav Yechiel Michel Tukachinsky, in his classic mid-twentieth-century work Gesher HaChaim (1:5:3), records a similar practice:
There was an excellent practice in years past at the Bikkur Cholim hospital in Yerushalayim. A well-known, God-fearing individual would come every morning to Bikkur Cholim and would recite the Vidui aloud, and all of the patients responded and recited it along with him. Since they knew that this was the practice, they said the Vidui without being alarmed, and it alerted those who truly needed the Vidui.
Although these approaches are most likely inappropriate for our communities at this point, we can learn from these practices to utilize strategies that are appropriate to the individual and his milieu. For instance, my father-in-law, Rav Dr. Shmuel Tokayer, a psychotherapist who has led the West Orange, New Jersey Chevra Kadisha for decades, told me that he once introduced the Vidui by saying that it was “something that will make it easier for you.” He reports that the family informed him that the patient was very appreciative to have been introduced to the Vidui, as he felt empowered and relieved. The patient felt that it gave him an opportunity to take some control of a situation in which his life was being taken from him and to account and repent for some of his missteps.
The problem also can be avoided by being aware of the Vidui throughout one’s life so that one is prepared to recite it at its appropriate time. This avoids the shock of the Vidui being introduced at a very vulnerable moment. Indeed, Rav Tukachinsky writes that an individual should habituate himself to recite the Vidui any time he is ill. In fact, Rav Hershel Schachter stated in a public Shiur in February 2006 that his father, Rav Melech Schachter (who was still alive at that time), already had recited Vidui no less than nine times, as he recited it each time he entered a somewhat dangerous surgery.
The Extent of the Vidui
The Vidui recorded in the Shulchan Aruch is relatively brief, and the Rama offers an even shorter version if necessary. The Aruch HaShulchan (Y.D. 338:4) writes: “It is obvious that if he wishes to recite a longer Vidui, even as long as the Yom Kippur Vidui, that he may do so.” The Gesher HaChaim (1:5:1) adds that if the patient recognizes a specific sin he has committed, he should mention it quietly. He cautions, however, that if an excessive amount of Vidui will unduly distress and weaken the patient, he must refrain from doing so.
Vidui for a Comatose Patient
The Aruch HaShulchan (Y.D. 338:3) writes: “It is of paramount importance to insure that the Vidui be recited while the patient is still competent, because if the patient is not mentally competent, the Vidui is meaningless.” This poses a huge challenge for leading comatose patients in Vidui. We should note, though, that the Beit Lechem Yehudah (commentary to Shulchan Aruch Y.D. 338) also stresses the need to recite Vidui when one is still alert but does not add that at a later point the Vidui is meaningless. Perhaps he believes that there is value in reciting the Vidui even when the patient is unconscious, even if it is not the ideal manner in which to conduct the Vidui.
In practice, I have heard that Rabbanim do lead a comatose patient in Vidui. Indeed, the Shulchan Aruch states that if one cannot recite the Vidui, he should think it “in his heart.” Comatose patients, for all we know, might follow the Rav’s lead and recite it in their hearts.
In fact, Rav Elchanan Zohn, the head of the Chevra Kadisha for the Vaad HaRabbanim of Queens and a leading expert in Halachic matters relating to death, relates how once he was tending to a congregant who was comatose for weeks before his death. The family discussed discouraging matters before him, and when Rav Zohn tried to convince them to avoid such talk, they replied, “He is already dead.” Nonetheless, Rav Zohn visited him at a time when the family was not present and it looked like the end was near. He told the patient that he would begin to lead him in the Vidui. At that point, the patient grabbed Rav Zohn’s hand in an incredibly tight grip, letting go only when the Vidui was completed.
It is incredible to hear about Jews who recite the Vidui only because a Catholic nurse has urged them to do so. It is time for the final Vidui to be restored to its rightful and fitting place in Jewish life. We nonetheless continue to yearn for the day of the arrival of the Mashiach, when such concerns will be reserved for theoretical discussion.