My beloved mother, 97 years old, is in intensive care in Buenos Aires, Argentina, I am in Canada, and also sick with bronchitis. My question is: if she seems to be ready to pass (go to olam habah) and wants me to come see her before that happens, but I am not able to go, what should I do. [What obligations do I have to honor my mother's wishes when it affects my own health?]
Since you cannot bring bronchitis into intensive care, other caring alternatives are needed. How painful to be unable to go to be beside her. The first idea that comes straight to mind is to have a friend or staff person at her facility bring their iPad or computer or phone to her bedside so that you can connect face to face, or certainly voice-to-voice, in this remarkable way. Let her know that you have bronchitis and so this is best way you can come to be with her.
Tell her that you love her and treasure her as your mother.
Ask if she has anything she needs that you might organize to help her be more comfortable, and inquire if there's anything she wants you to know at this point on her journey--she may have unfinished bits to share with you.
Refrain from filling in quiet spaces on the call for her, just make space for her to share as slowly, quickly or haltingly as she might need.
Listen and simply reflect back to her accurately and respectfully what she says, whatever it is, this feels comfortable to all people--to know they have been heard.
There's no point in debating a thing, just tender acceptance at such a time will do.
If nothing comes of this strategy of inviting her to speak, she may just want the gift of hearing your voice. You might share a short memory of a favorite time with her.
If she is able, you might ask for her blessing, a Jewish practice reflected in the Torah. This is very empowering for someone who is dying, to have something so appropriate that they can do--to give a blessing to one's child or grandchildren or other dear ones. The response? Something like. Thank you Momma, that was perfect, I love you. Or if not so perfect then some kindly affirmation to help send her soul on its journey in love into Mystery.
May you, yourself, be blessed with healing from the bronchitis and a gentle, holy and healthy grieving process.
What is really the obligation to honor your parent? To what extent should you sacrifice your personal needs to help a sick parent? Need you jeopardize your personal health to fulfil the last requests of your parent on her death bed?
Honoring parents is an enduring element of the Jewish ethos. The foci of Jewish filial piety are reflected in two Biblical commandments (mitzvot). The first, and arguably the most famous, is stipulated in the Ten Commandments, “Honor your father and your mother” (Exodus 20, 12 and Deuteronomy 5, 16). The second is the obligation of reverence that one needs “to revere his mother and his father” (Leviticus 19:3). The two imperatives are understood in Rabbinic thought to represent two distinct typological categories of honor and reverence. “Honor” entails looking after the needs of your parents (Rambam, mitzvah #210), whereas “reverence” requires respect for their parental status (Rambam, mitzvah #211). The simple rationale would seem to be a strengthening of the family unit by establishing parental position and authority, but in Sefer ha-chinuch these two mitzvot are provided an ethical framework as creating ongoing opportunities to perform actions that can cultivate the character trait of gratitude, thankfulness to those who gave one being and sustenance.
So now to redefine your question. Given that the twin commands of honor and reverence entail a devoted filial relationship based on gratitude what should be done when these values conflict with our own personal needs and interests? Who comes first?
At first glance, this question seems to reflect a dilemma between egoism and altruism. When we exit the womb we begin to differentiate ourselves as individuals, and as we grow up, we gradually assert a sense of emergent independence. We become egoistical beings. Psychological egoism asserts that each person has one ultimate aim: his/her own welfare. We might also develop the trait of altruism, where we sacrifice our self-interests to benefit others. Egoism would seem to be a polar opposite to altruism. I submit however, that the ideal in close family relationships is to blend egoism and altruism by expanding the egoistical conception beyond the physical boundaries of one’s own being to encompass concentric circles of a relationship based on love and appreciation. Egoism and altruism are then united in fulfilling the ideals of honor and respect. What is beneficial for you is also positive for your parent and vice versa.
Returning now to the motivational formulation of Sefer ha-Chinuch, these two mitzvot inculcate and perpetuate the realization that parental attachment is different from other relationships because it is based on two unique features – creation and sustenance, two attributes found only in parents and God.Sefer ha-Chinuch sees this as a unique training ground to facilitate feelings of appreciation and inspire a mode of thankfulness. I would add that this is a way to cultivate a mindset of gratitude that may help bridge the gap between psychological egoism and ethical altruism. By setting a virtue ethic framework of behavior based on appreciation for the gift of life and existence, one can expand the “egoism” to merge with “altruism”. Concern for our personal welfare would then include valuing the filial relationship, and altruistic sacrificing of self-interests becomes a broadening of the self. Of course, this is an ideal that may often be possible only in theory, and as your question demonstrates, there is rarely a simplistic answer to such ethical dilemmas.
There is however a deeper concern in your question and it is found reflected in several stories in tractate Kiddushin, ch. 1, folios 30b-32a where the laudatory descriptions accentuate an ideal piety in relating to one’s parents. They reflect exemplary expressions of outstanding devotion and respect even in dire circumstances, and portray a virtue ethic of filial love and consideration. These anecdotes are held up in Jewish sources as paradigms of a virtue ethic.
Your visit to your 97-year old mother in the intensive care unit is not merely a technical fulfilment of a mitzvah, it is an essential part of palliative care, namely to help reduce your mother’s suffering and pain. Furthermore, you may be arriving at a crucial time of life passage where emotional needs and spiritual concerns are of paramount importance. Therefore, from both the halachic and ethical perspectives, you should try your utmost to arrive and fulfill your filial obligations. This is not merely a matter of honor and respect, it is doing what is virtuous and best for both you and your parent. It is both egotistical and altruistic to visit your parent. But just so, if your own health is really in grave danger, it is again both egotistically and altruistically correct not to visit.
 One of the best discussions in English can be found in the book by Prof. Gerald Blidstein, Honor Thy Father And Mother: Filial Responsibility in Jewish Law And Ethics, Jersey City, New York, Ktav Publishing, 1976 (augmented edition 2005). See chapter IV on Responsibility and Conflict, pp. 75 ff. On the dilemmas in caring for a sick parent see there, pp. 116-121. The book is downloadable for free at www.PDFEBookDS.com.
 It is the only one of the Ten Commandments to establish a positive obligation of one person to another. For a plea to use this commandment for legal understanding and legislation see Charlotte K. Goldberg, "The Normative Influence of the Fifth Commandment on Filial Responsibility," Marquette Elder's Advisor, vol. 10, issue 2, 2009. Available at: http://scholarship.law.marquette.edu/elders/vol10/iss2/3
 See Yerushalmi Peah, 1, 1, Kiddushin 1, 7, Mechilta, Kedoshim, ch. 1. Rambam, hilchot mamrim, ch. 6, Shulchan Arukh, Yoreh Deah, Laws of Honoring Father and Mother, 240.
 See Sefer ha-Chinuch, mitzvot 27 and 212, where the twin commands of honor and reverence are interpreted as a practical training ground to learn how to experience gratitude and to constantly be aware that it is our parents who were instrumental in the miracle of our personal existence. This quality can then facilitate a heightened appreciation of the Divine Benevolence that actualizes and sustains all life and existence. Sefer HaHinuch’s explanation is in line with his general rationale of mitzvot as a behavioristic way of inner emotional training and moral improvement. This is capsulized in his pithy rationale: The inner heart (feelings and attitudes) are fashioned by external actions.
 Ethical egoism is the position that a moral agent ought to do what is in their own self-interest. It differs from psychological egoism which claims that people can only act in their self-interest and from rational egoism, which holds that it is rational to act in one's self-interest. For a good overview of these three types of “egoism” see Robert Shaver, "Egoism", The Stanford Encyclopedia of Philosophy (Winter 2010 Edition), Edward N. Zalta (ed.), URL = <http://plato.stanford.edu/archives/win2010/entries/egoism/>.
 For further reading see for example, Joshua May, “Altruism and Psychological Egoism,”
 Parents, by definition, give birth and raise their children. So also a tenant of Jewish belief is that God creates the world and sustains it. The juxtaposition of these two concepts implies that parents are partners with God in the acts of creation and sustenance. See Sifra (Weiss ed., 86d), Mekhitla (Horowitz ed. pg. 232), Kiddushin 30b, Niddah 31a, Kohelet Rabbah 5,10, Yerushalmi Pe’ah 1,1, 15c, Yerushalmi Kil’ayim 8,4, 31c.
Yours is a serious and subtle question that needs to be considered on a variety of levels. First is the halachic. That is, what is the minumum requirement according to Jewish law in honoring one's parents. The Talmud in Ketubot defines pretty clearly the limits of what it means to honor parents. It means to refrain from publicly contradicting them, it means to leave them a place, and it means to financially assure that they are cared for in times of infirmity. It does not require one to obey them, or even to be physically present for them. The Talmud recognizes that there are a variety of family relationships and that in some cases being physically present for a parent can be toxic to someone or hurtful in other ways. So from a purely Jewish law perspective, no, you do not have to travel.
The second level is the emotional. Our tradition is one that honors generational connections. There is a reason the Talmud always offers teachings with a web of history connecting the original thought to its current tradent. It is critical for us as human beings to find ways of honoring our relationships with our parents. To fail to do so is to harm ourselves on a deep level from which it is difficult to recover. This level requires a more personal calculus on your part. You are not required to visit your mother, but the question of whether you should is more complex. Certainly, if travelling will cause you harm you may not travel. However, you need to then think long and hard of other ways in which you can honor and care for your Mother will she is still living. That might include phone or skype calls, letters, hiring some help in Buenos Aires, sending her flowers, etc. She may remain disappointed that you havent come, but you will then know you made the effort to honor your connection and love of her.
The final level is spiritual. I am big believer in the power of prayer. The connection with a parent is one key path by which we access the Most Holy. Prayer and contemplation at this challenging time may well provide you with comfort, but also with some direction in how to lovingly and compassionately respond to your Mother in a way that leaves her feeling loved and respect, but also cared for you and for your needs.
This is a difficult and painful situation. While the mitzvah to honor one's parents (kibbud av ve eim) is a very important mitzvah, the mitzvah of pikuach nefesh (the preservation of life) takes precedence. If you own health is at risk, then you would not be obligated to travel to Argentina. In fact you would be prohibted from travelling.Your own health takes precedence over your obligation to honor your mother's desire to see you. Perhaps because of the advances in technology you could arrange to visit your mother by Skype or Facetime. While this is not a totally adequate substitute for your being there in person, it is one way to care for your own health and at the same time perform the mitzvah of kibbud av ve eim (honoring one's parents). In this case you would be able to perform both mitzvot.
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