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Jews

Jewish Patients

The British Jewish community identifies with neither a specific country of origin nor ethnic group.

There is a wide variety of beliefs and attitudes and even of languages spoken. However, observant Jews have specific dietary and other religious requirements and may hold cultural beliefs about health and illness, life and death.

Certain genetic illnesses, such as Tay Sachs disease occur more commonly among Jews of European origin than in the general population.

This paper will endeavour to talk about normative Judaism, as a description of the various religious strands (Chassidic, Ultra-Orthodox, Orthodox, Masorti, Conservative, Progressive, Reform, Liberal) may be more confusing than helpful. Reference to different practices is made therefore only when essential for guidance.

Daily Prayer and Worship

It is recognised that in a crisis situation and in a hospital environment, where lack of privacy and loneliness often exist, the patient's mind often turns to God, through prayer, ritual and observance.

Therefore it is unwise to make any assumption as regards the grade of observance or non-observance by a Jewish patient. Observations sometimes heard: "He/she is not very observant" or "He is not really very orthodox" might be totally wrong and only by creating an atmosphere of trust will the patient feel uninhibited to reveal his or her religious or spiritual requirements.

It is only natural that a religious and particularly an ailing person will wish to thank God when he/she wakes up in the morning, when he/she is at the height of day (in the afternoon), and in the evening before sleep. He/she will probably find time and space for the latter two occasions, but at the morning prayer, a male over 13 may wish to put on his tallit or prayer shawl.

This may need to be facilitated by staff willing to give the patient a longer time of privacy. During weekday morning services some Jewish men also wear tephillin, two leather boxes containing tiny scrolls from the Torah. One is tied to the forehead and the other bound round the left arm and hand with a leather strap.

A Jew may pray at any time, in any language and any posture, but the discipline of the three timebound prayers in Hebrew are hallowed by tradition and therefore a comfort.

A Jewish prayer book is available on each ward.

Holy Book

The Torah (or Pentateuch) is the most important Jewish Holy Book. Synagogues keep copies handwritten in Hebrew on a parchment scroll and covered by a mantle when not in use. The patient may bring a printed version, which may be an English translation, into hospital for personal use.

Holy Days and Festivals

The Sabbath Day (Shabat, the 7th Day of the week): The concept of the Sabbath Day is contained in Exodus 20:8, known as the 4th commandment.

It contains the command to abstain from work on the 7th day of the week, Saturday, and celebrates the creation of the world by God in 6 days and His subsequent rest on the seventh: thus declaring it as a day of holiness, social freedom, but also of joy, where sadness is banned and mourning suspended.

The interpretation of "work" is creative acts, or acts which change one condition into another.

A fully observant Jew is therefore not allowed to switch on or extinguish a light, or even to ask anybody else to do so on Shabat. If therefore he/she accepts some help it should not be interpreted as laziness.

The fully observant Jew is also not allowed to travel on that day and will not wish to be discharged from hospital on a Saturday. Sabbath restrictions also prohibit the carrying of money or gifts, or the purchase of any articles or refreshments. But any religious law may be transgressed if life is in danger.

Shabat begins on Friday before nightfall with a short ceremony of candle lighting and blessing of wine and bread, and ends with the first sighting of three stars on Saturday evening by a farewell ceremony. Hence, it begins and ends at different times over the year. Privacy will be appreciated by any Jewish patient wishing to conduct these ceremonies on a hospital ward.

Jewish Holy Days

Passover or the Festival of Unleavened Bread: celebrates the Exodus from Egypt by the Children of Israel. The message is national and personal freedom. The diet during the 8 days of the festival is strictly "unleavened" and the kosher hospital meals will be accordingly. No bread must be consumed.

The Jewish patient may prefer to have food brought from home, at least on the first night, when a family meal is consumed. The festival is about Easter time.

Shavuoth or the Festival of Weeks, Pentecost: 2 days in the summer. Also called the Season of the Giving of the Torah (Jewish teaching), when God committed the Jewish religion to Moses on 2 tablets of stone on Mount Sinai.

The High Holidays follow in the autumn: The 10 Days of Awe or repentance for our sins. The first 2 days is the Jewish New Year, and the 10th day is the Day of Atonement (Yom Kippur), a solemn 25 hour fast.

If a religious Jew has to be in hospital on that day he/she must consult the doctor if a full or limited fast is medically permitted. Jewish patients may (wrongly) seek to fast even against medical advice: assistance from a Jewish Rabbi may be necessary.

The Festival of Succot, Tabernacles: this festival begins five days after Yom Kippur. It cannot be properly celebrated in a hospital. Meals are held in temporary structures out of doors in memory of the protection by God during the wanderings of the Children of Israel in the desert, but symbolising also our temporary dwelling on this earth. It is also a festival of the final harvest.

On all these festivals the prohibition of work is almost the same as on Shabat.

Two minor festivals: Purim in early spring and Chanukah, (the festival of lights about Christmas time) are very happy occasions. Work is permitted. Candles are lit during the week of Chanukah, and permission may be sought to light and display them on the ward.

Diet and Hygiene

A quick reference guide can be found in the Guide to Diets page. In addition to the restrictions listed, meat-eaters will refrain from milk or cheese dishes at or after meat meals. Meals permitted by Jewish law (kosher) are available.

They should arrive with disposable cutlery and should not be removed from their containers or unsealed by staff nor be put on hospital plates. There should also be no probing for temperature checking of the meal. In case of special diets a word with the dietitian or catering manager should be encouraged, as also with meals brought in from home, if medically permitted.

As an alternative, meatless or fish (not shellfish) might be suggested. It is important that Jewish patients are informed of the availability of kosher meals, but not be made to feel embarassed if they don't wish to take them. Some may find vegetarian meals an acceptable alternative: others may wish to simply refrain from pork or shellfish.

Gender Issues

Although Jewish patients have no specific requirements concerning gender issues, like the majority of patients they prefer the sexes to be segregated.

Orthodox Jewish patients may object to women rabbis. Orthodox Jewish women may express a preference for women medical staff examining them, for reasons of modesty. Ultra-Orthodox Jews consider it immodest to touch women other than their wives, and care needs to be given to what contact is necessary between nurse and patient.

Visiting

It is considered an important religious duty to visit those who are unwell, and many Jewish patients therefore receive large numbers of visitors. On the Sabbath (Friday night and Saturday) and on festivals, visits by relatives, even if the patient is dangerously ill or has died, might not take place unless the relative lives within walking distance of the hospital.

Jewish relatives or friends visiting a patient on Shabat may have walked long distances in order to do so. Even so, they will refrain from purchasing refreshments when they arrive.

Members of the Jewish community are also willing and able to visit any Jewish patients who do not have family and friends in the area. In the event of a Jewish patient requiring but not receiving visitors, please contact the duty chaplain and request a visit from one of our visitors. It is considered a particularly important duty to sit with a dying patient, and every facility should be extended to allow this.

Birth

Baby boys are circumcised on the 8th day after birth. The operation is postponed in the event of infantile jaundice, premature birth, or any other contra-indication. The ceremony itself is usually performed at home, although it can take place in hospital. The birth of a daughter simply calls for the giving of a name.

Amongst Orthodox Jews, baby girls are given their name on the Sabbath after the birth whereas boys are named after the circumcision ceremony. Amongst Reform and Progressive Jews, both boys and girls have baby blessing ceremonies, normally held during the Sabbath morning services in the synagogue.

Death

Jewish law prohibits any active intervention which would hasten the death of a terminal patient. Where a question arises relating to any such intervention, a Rabbi should be consulted.

When a patient is in the process of dying, it is not even permitted, in Orthodox Jewish law, to move or touch the patient in any manner, as this may hasten death. Obviously, it is permitted to give pain killing drugs or otherwise improve the comfort of the patient.

Judaism does not have a special ceremony of "last rites", but a patient may wish to recite the "Shema", or special psalms, particularly Psalm 23 (The Lord is my Shepherd) as well as a death-bed confession known as "vidui". They may appreciate being able to hold the page on which it is written. Most patients will want to see a Rabbi, and arrangements for this can be made through their local synagogue.

Traditionally, the body should be left for about eight minutes while a feather is placed over the mouth and nostrils and watched for signs of breathing.

The family may ask that a Rabbi is contacted or the local synagogue so that the "chevra Kaddisha", the holy assembly might carry out the last attentions to the dead. Preferably they or the family, or, if that is not possible, staff with gloves on, should remove any tubes etc. Traditional prayers are said as this happens.

Post-mortem examinations are not permitted in Orthodox Jewish law except in cases of emergency, or where civil law absolutely requires an autopsy. Progressive Jews permit autopsies.

Orthodox Jews may object to organ transplants.

Jewish law requires burial to take place as soon as possible after death, and any unnecessary delay must be avoided. Cremation is not permitted by Orthodox Jewish law. Some Progressive Jews permit cremation.

A non-Jew should not touch the body.

If there are no signs of life the Son or nearest relative does the following:

  1. The eyes and mouth of the deceased should be gently closed
  2. The jaw tied up
  3. The hands and feet placed in their usual position, the hands at the side of the body
  4. Fingers should be opened (not fist-clenched)
  5. The body should then be covered with a white sheet and, where possible, should then be left untouched after death
  6. Traditionally the body is placed on the floor with the feet towards the door, covered with a plain sheet and a lighted candle is placed just above the head.

Some families may ask to keep vigil and pray by the body. A Rabbi should be contacted as soon as possible.

Chaplains

In case of difficulty, contact the duty chaplain for guidance on 01274 542200.