Jewish Beliefs and Practices Affecting Health Care
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Overview of Health/Illness: Jewish approaches to health, medical practice, and ethics places the life of the person above all else. This means that any law in Judaism can be transcended (with a few exceptions like murder, because they pertain to life as well) if the life of a person is at risk. This can also apply to mental well-being, although a rabbi should be consulted. That being said, the expertise of the health-care professional is extremely important in caring for a person who is ill. They are seen as instruments of God who is the ultimate giver and taker of life. This then creates a relationship of partnership between the patient, family, health practitioner, and God (and the rabbi/chaplain as a facilitator). Through the efforts of all of these partners, the patient has the optimum conditions for recovery, for which we pray, if it’s God’s will. The issue of suffering is therefore not seen as a judgment from God, since all of us are mortal. Rather it is a by-product of the illness and anything that can be done to ease the suffering of the patient is highly recommended. [back to top] Birth: The birth of a child is a celebratory event and a rite of passage into Judaism. This means that after all considerations are taken for the life of the mother and the newborn, the child is then brought into the Jewish people through a naming ceremony and the rite of circumcision (if it is a boy). The circumcision may be done eight days after the birth of the boy. It is generally done by a trained and ritually knowledgeable person in the Jewish community, known as a mohel. The rabbi/Hillel director in town knows how to contact one and make him/her available to the family. The rabbi/Hillel director will also make arrangements for a naming ceremony. [back to top] Abortion/Birth Control: In keeping with the principle of the importance and holiness of the life of a person above all else, an abortion can be done in all cases if the woman’s life is physically at risk. The principle is that the fetus is a life-threatening danger to the woman and she must be saved. In liberal Jewish denominations this also applies to the mental well-being of the woman. When in doubt a rabbi should be consulted. Birth control is considered to be a private affair between a man, a woman, and the teachings of the particular branch of Judaism they are in. If the issue is one of at-risk sexual practice, Judaism highly recommends the use of a condom. [back to top] Death: When a person is near-death they should be encouraged to relieve themselves of their worries, fears, sense of guilt, sense of wrong-doings—in other words, unburden themselves. They should receive as much attention from family, friends, community, and the rabbi/chaplain as they can bear, on the principle that one should not go into death alone. This attention is considered one of the highest commandments to be practiced by a Jew. Any spiritual texts can be chosen to read to comfort the patient, but Psalms is highly recommended and can be found in any Jewish prayer book. The prayer for the well-being of the sick can also be found in any Jewish prayer book and is said at regular prayer services, which can be held at the hospital or if that is not possible in the patient’s room. It is recommended that a quorum (minyan) of ten people (men, if the patient is Orthodox) be present. The rabbi/Hillel director can help arrange these. When a person is about to die they are encouraged to read a confessional and say the Shema, which is the creed of faith of Judaism. If they cannot talk then it can be said for them, whether they can hear it or not. We assume they can hear it. (On no conditions should a belief in Jesus be professed or encouraged by an attending chaplain. This is an anathema to the Jewish religion.) Questions about keeping a patient on life support vary among different Jewish denominations. The principle revolves around the importance and holiness of life, whether the person ceases to be a functioning human being, and how life can be ended. These questions are best resolved between the families and their rabbis. The Reform Movement generally supports the wishes of the family with their doctor. The Conservative Movement generally does the same but would like to be consulted. The Orthodox and Chasidic movements need to be consulted by the families and the health professionals. [back to top] After Death: A rabbi should be consulted immediately upon death to help with the very detailed preparations for the body and the care of the family. On the principle of respect for the body in death, as in life, and in preparing the family for grieving, the body must be buried as soon as possible. Generally cremation is discouraged. Autopsies are permitted if necessary, but all body parts must be buried. Organ donations are permissible in most branches of Judaism, if it is the will of the patient. In the case of Orthodox families a rabbi is extremely necessary in all decisions regarding the body. [back to top] Bereavement: Bereavement cannot formally begin until the body is buried. Clearly, the family should be consoled, prayers are said—usually Psalms and texts such as the Book of Job can be read. Yet all attention on the burial of the body should be maximized. Then there is a grieving period of seven days in the home of the family. After this, there are varying amounts of time over the course of a year of mourning, depending on the branch of Judaism the family is part. In the case of Orthodox families a rabbi must be consulted. [back to top] Dietary Regulations: Judaism’s system of Kashrut (keeping Kosher) is practiced by Jews on many levels. Some only refrain from eating pork, others will refrain from a variety of foods and food mixtures. Still others will not be able to eat any hospital food unless it is certified Strictly Kosher and cooked in a Kosher Kitchen. The family should identify their level of Kashrut and help the hospital staff with their needs. Families from out-of-town should contact the synagogue to find what arrangements are possible in Charlottesville. [back to top] Personal Devotions: Personal practices vary and contacting the rabbi/Hillel director would be a place to start if the family/patient would like regular Jewish prayer services. Providing the patient with a Jewish/Hebrew prayer book known as Siddur would be helpful. Most Jews look to pray on the Sabbath (Shabbat) which is Friday night when the sun goes down and continues through Saturday when it gets dark. [back to top] Religious Objects: On the Sabbath (Shabbat) and holidays it is common to light two candles in candleholders. It is also usual for those who have the custom of sanctifying Shabbat or the holidays to have a glass/cup of wine to make the blessing. The wine should be any Kosher grape wine or grape juice, if wine is not wanted or available, and can be found at Giant Food on Route 29 or Market Street Wine Store as well as some other places in Charlottesville. When praying, many Jewish men and some women wear kipot or yarmulkes (small head coverings) and prayer shawls, tallit. These can be borrowed from the synagogue or Hillel. Other than that, most Jews will only require a Jewish prayer book (siddur) of their particular denomination for their needs. [back to top] Special Care of Women: There are no differences of care except in the cases of Orthodox and Chasidic women. They will be the determiners of their needs and should be asked. Generally Orthodox and Chasidic women are more sensitive to needs of modesty, would like a woman doctor if possible, and require special attention after childbirth. Please consult an Orthodox rabbi. [back to top] Holiday Observances: Holidays are celebrations of great joy and family. While in the hospital it is important for the Jewish community to be aware that patients are there so that they can include them during these seasons of joy. With the patient and family’s permission, please call the rabbi/Hillel director to let them know. On Jewish holidays, Jews should be encouraged to seek out the rabbi/Hillel director. They may not realize that there is a very active Jewish community and Hillel in Charlottesville. Important holidays are: Rosh Hashana, Yom Kippur, Sukkot, Simchat Torah, Chanukkah, Purim, Passover, and Shavuot. Friday night Shabbat services at the synagogue, Congregation Beth Israel, are Reform and Saturday they are Conservative. At the Hillel Jewish Center at the University of Virginia on Friday nights they have Conservative services, with Reform services every other week. On High Holidays (Rosh Hashana and Yom Kippur) Hillel has Conservative and Reform services. [back to top] Bioethical Decision-Making: As mentioned above, the preeminence of life is the principle that health care revolves around. That being said, the time to leave this world must also be done with dignity and respect for the living. Therefore there are varying views on relinquishing life-supports and organ donations. These decisions should be done in consultation with a bioethical team including the family, health professionals, patient (if possible—they may have left a living will), and a Jewish chaplain (rabbi, cantor, Hillel director, etc.) It must also include a religious professional from the Jewish denomination of the family, if that is their wish (Orthodox, Chasidic, Conservative, Reform, or Reconstructionist.) The rabbi/Hillel director in Charlottesville will know how to reach these people if they are requested. [back to top] Visitors/Community: It is considered to be one of the highest commandments for the community to tend the sick. This can be difficult if the patient is not aware that a Jewish community exists in Charlottesville. They may also feel ill-at-ease to ask for a strange community to tend them. They should be encouraged, because the community is warm, caring, and eclectically religious. Even though the synagogue is Reform affiliated, there are Jews from Orthodox, Conservative, Reform, and Reconstructionist backgrounds. There is even a Chavurah/Progressive group. Friday night services at the synagogue are Reform and Saturday they are Conservative. At Hillel they generally have Conservative with some Reform services. On High Holidays, Hillel has Conservative and Reform services. [back to top] Ethnic (Language) and Cultural Sensitivity: •It is highly recommended to greet Jews with “Happy New Year” on Rosh Hashana and Yom Kippur, which is in the fall. •Happy Chanukkah can be appropriate, since Chanukkah is in December. Yet is should be noted, Chanukkah is not the “Jewish Christmas nor is Passover the Jewish Easter.” They are separate historical/cultural/religious holidays unto themselves. •It is generally poor taste to wish Jews a “Merry/Happy Christmas.” Although some Jews do celebrate Christmas as a secular event, Judaism discourages it and many Jews find Christmas greetings offensive. •Israeli Jews do not have to be religious, yet they still appreciate a Jewish presence and Hebrew speakers. The synagogue or Hillel can supply people who speak Hebrew and are familiar with Israeli culture. [back to top] |
