JEWISH CHAPLAINCY OF THE UPSTATE
Thursday, October 16, 2003
JEWISH ISSUES IN PASTORAL CARE
Cultural/Ethnic
The vast majority of American Jews is highly acculturated and upwardly mobile, thus reflecting the lifestyle and mores of the societal mainstream.
Elderly Jews patients may speak Yiddish (Judeo-German) or Ladino (Judeo-Spanish), and may be Holocaust survivors, with related apprehensions and emotional scars.
Younger and middle-aged Jewish patients may be immigrants, speakers of Hebrew, Russian, or Farsi, not yet fully attuned to mainstream culture and “American-style” health care, particularly Russians, who have an entirely different concept of “navigating the system.”
Ritual Concerns
Many Jews observe kosher laws to some extent (specially slaughtered meat and poultry, separation of milk and meat, including dishes and utensils, abstinence from pork and shellfish).
Majority is not particularly strict with all aspects of kosher laws, but may prefer to avoid pork, shellfish, and mixing milk and meat at same meal.
Many Jews abstain from bread and other leavened items on Passover. With physician’s permission, may wish to fast on Yom Kippur and Ninth of Av.
Jews who strictly observe Sabbath and Holy Days prefer to postpone all but the most necessary medical procedures from those days.
Whenever possible, provisions should be made (within constraints of safety) to kindle candles on Sabbath eve and on the nights of Hanukkah.
Pastoral Visitation
Judaism believes primarily in the “ministry of presence,” the act of simply “being there,” listening and responding with empathy, allowing the patient or family member the latitude to set the tone and content of the conversation.
Judaism does not believe in surrendering to illness as “God’s will,” or that keeping “a stiff upper lip” is necessarily the most helpful therapeutic approach to patient and family wellbeing. Permission to grieve, act out, or remain silent is the essence of therapeutic processes. The ancient Jewish sages recognized the necessity of these processes, much in the way that Dr. Kubler-Ross did in our own day.
Note, please, that most Jews are hypersensitive to the notion of having “someone else’s religion” forced on them, and this will chafe at a prayer offered in Jesus’ name. The pastoral visit, however, should include a prayer and/or Psalm (particularly 20, 27 and/or 91), for which the chaplain might underscore the Jewish origin. The traditional Mi She-Berakh prayer states:
May God who has blessed us now bring blessings of healing on. May s/he know no more sadness, no more sorrow, no more pain, no more suffering. Rather, may s/he be at one with the Lord her/his God, walking in God’s ways and pursuing God’s teachings. May s/he be restored to good health, a restoration of body and spirit, that s/he might soon be privileged to offer thanksgiving for the gift of her/his healing. Amen.
Only the largest cities have established Jewish communal chaplaincy programs. Otherwise, the local rabbis eagerly pitch in. If the patient is affiliated with one of the local congregations, his/her rabbi should be alerted as soon as possible. If the patient is unaffiliated or lives in another city, one of the rabbis (or, in the case of Upstate South Carolina, Jewish Chaplaincy of the Upstate) should likewise be alerted.
Ethical Issues
Judaism’s posture on most bio-ethical issues is in relative conformity with most mainstream liberal faith communities. Patient and family should thus be encouraged to draw their rabbi into contemplating a bio-ethical decision.
Note that orthodox and most conservative Jews:
Sanction abortion only under life-threatening circumstances.
Define death as cessation of spontaneous respiration and heartbeat, not “brain death.”
Typically expect a “full court press,” including resuscitation of patients in extremis, withholding life-sustaining treatment in instances in which the patient is irreversibly moribund. Then, only omissive, but never comissive, euthanasia is allowed, treading the thin (imaginary?) line between extending life and prolonging the inevitability of death.
Object to post-mortem examination except under potentially life-saving circumstances. Autopsy is considered a mutilation of the body, and the body must be buried intact.
Judaism does not see illness and death as punishment. Rather, they are time for reconciliation and making peace. Nor does Judaism subscribe to the idea of “God needed another angel in heaven.” Death is part of life’s inevitability. God judges us lovingly and mercifully on the quality of our deeds. Our very finitude and mortality should be the greatest stimulants to living our lives to the fullest today, for tomorrow is always an unknown.
