Ethnicity Online

Cultural Awareness in Healthcare

Jews: Death And The Dead

moment of death

Brain death may not be accepted as a definition of the moment of death by more Orthodox Jews. Instead, the correct halakhic definition is that the body has to be without breath or heartbeat for a period which would make resuscitation impossible. Reform and Liberal Jews might accept brain death as an adequate definition of death. Generally, this only becomes an issue if organ donation has been agreed or requested. In such a case, it is worth talking to a rabbi for clarification.

after death

If you happen to be with a Jewish person when they die, then you ought to remain with the body until help arrives. It is considered respectful for a body never to be left alone or in the dark before burial. If possible, light a candle and place it at the head of the body, or turn on a light and leave it turned on.

The eyes and mouth should be gently closed. If necessary, the jaw should be gently strapped to keep the mouth closed. A sheet or other clean cloth should then be drawn up over the face. Try to touch the body as little as possible once you have covered the face, and use gloves when you do so to avoid contaminating it.

Do not cross the arms, but leave them at the side of the body with the palms facing inwards. If possible, move the body so that the feet point towards the door and straighten the legs.

Do not do anything else, just sit quietly with the body until someone from the burial society arrives. It is considered insulting to eat, drink, laugh or talk in front of a corpse, as these are things the body can no longer do.

The relatives must be contacted as quickly as possible; a body should be buried within 24 hours of death wherever possible. For some families, transporting the body home to Israel may add to this time pressure; many older Jews want to be buried in the Holy Land even if they have never lived there.

It is important to leave in place any catheters, drains and tubes as the fluid in them is considered to be part of the body and must be buried with it. Cover them with gauze or bandages. Any wound dressings that have body fluids on them must also be left on the body. Any other open wounds must be covered.

If the patient has died on a Friday, it is likely that the Sabbath will have started before anyone can attend to the body. In this case, the body must be removed to the mortuary until Saturday night, when the burial society will collect it. Do not forget that, if possible, the body must not be left in the dark. This delay in collecting the body may also apply on some Jewish holidays when Sabbath restrictions and rules apply.

If the deceased had no next of kin, then contact a rabbi as soon as possible. The rabbi will probably call the local Jewish burial society (the chevra kaddisha) to come and care for the deceased. Family members usually do not do this, although friends may volunteer to help with the preparation of the body. Until the removal of the body from the hospital, it is likely that someone will want to stay with it if possible.

preparation of the body

Preparation of the body is usually done by the local burial society called the chevra kaddisha, which comprises groups of respected Jewish volunteers. Generally, the body is taken from the hospital to a funeral home, where the preparation can take place in peace and quiet. Female bodies will be attended to by women, and male bodies by men; modesty, even in death, is important. In fact, at the end of the preparation, the attendees will apologise to the dead in case they have unknowingly caused offence by their handling of the body.

The body is washed thoroughly, the hair is combed and then the body is then dressed and wrapped in a clean white cloth before being placed in a plain wooden coffin for burial.

talking to the family

Possibly the best thing that you can do for the family of the deceased is to allow or assist them to call a rabbi to come in with them to be with the body, and allow them space and time for prayers and grieving. If possible, set aside a room for visiting friends and family to congregate in. The family may wish to stay with the body until its removal to the funeral home, and so where possible, this should be catered for. It will also help enormously if the necessary paperwork for the release of the body can be completed as quickly as possible to allow for a speedy burial.

post-mortem

Post-mortems are generally not permitted under Jewish law as they constitute desecration of the body. However, where the local law states that a post-mortem must be carried out, then this obviously overrides any other considerations. Similarly, if the post-mortem of a Jew would provide great benefit to living people and advance the care of similar conditions, then this would also be considered a valid reason to proceed. It is worth talking to a local rabbi and the family about these matters, as Reform, Liberal and Orthodox Jews have very different views about this subject.

Certain procedures need to be followed during the post-mortem of a Jewish person. Healthcare staff must show proper respect and avoid unnecessary damage to the body. The body ought not to be placed face down at any point, and as far as possible it should be kept covered. Gloves must be worn by non-Jewish staff whenever touching the body. Any samples taken from the body must be as small as possible, and incisions must be avoided wherever possible.

The body ought to be placed on a clean white cloth during the examination to soak up any blood or fluids. After completion, all of the organs must be put back into the body in their natural location. Instruments must be wiped clean and the cloth the body lay on must be packed back into the body cavity before closing up. If in any doubt about how to proceed with a post-mortem under these conditions, talk to a rabbi or the Jewish burial association, either of whom may wish to be present at the post-mortem to observe.

organ donation

Modern medical procedures, undreamed of during the time of the Patriarchs, have caused intense debate among Jewish scholars during the past few decades. The questions surrounding organ donation were some of the most hotly contested as they bring two lines of law into direct conflict; the overwhelming necessity of preserving life is finely balanced against the perceived desecration of the body of someone who has only just been pronounced dead.

Eventually, a general resolution was reached that states that in cases where a transplant is vital to save a life, an organ may be taken from a body for immediate transplantation into another patient.

However, great sensitivity must still be shown about the timing of pronouncing life extinct. This is because it is only permissible to harvest organs from a body that has been pronounced dead under Jewish law (see 'moment of death' above). It is not permissible to harvest organs for storage; if the organ cannot be used for immediate transplant, then it must be buried with the body. This precludes the removal of organs for medical research or for storage in an organ bank.

Finally, it is permissible to remove organs from a living person only if the organs are to be used immediately, and the removal of them does not affect the future health of the donor (thus, taking bone marrow, blood or even a kidney would be allowable).

cremation and burial

Cremation is technically forbidden under Jewish law, although it may be permitted under certain circumstances and is accepted practice in some Progressive/Liberal Jewish communities across the world. The dissolution of the body is meant to be a gradual process, giving the soul time to leave its fleshy home and the body time to return to the earth.

Generally, burial is the preferred choice for commitment of a body. The family usually call upon the services of Jewish undertakers to prepare the body for burial; dead bodies are considered 'unclean' not because they are in any way evil, but because they are no longer part of the living world.

After being washed and dressed, the body is wrapped in a clean white shroud and a prayer shawl wrapped around it. In some countries, the body is then laid straight into the ground; in others, it may first be placed in a simple wooden coffin. The coffin will have many holes drilled through it to facilitate the rapid decomposition of both the body and the coffin. The idea is to return the matter tied up in the body back to the universe as quickly as possible.

donation of body to science

For many Jews, this would be perceived as a desecration of the body and so would be forbidden. Liberal and Reform Jews might consider it if they had a condition that affects many other people; in this case, donation of the body or organs might benefit many other people, and so outweigh the desecration. Organs should not be retained unless specific authority has been given by the patient or their family.

suicide

The life you have is a gift from G-d, and so is not yours to dispose of. Deliberately taking your own life is considered to be self-murder, and this is not just forbidden but roundly condemned.

In very Orthodox societies, the deceased will be buried as normal, but no eulogy will be read over the grave, and no kadish sung. The family will obviously mourn, but no formal period of shiva will be recognised. Many Orthodox rabbis refuse to officiate at the funerals of those who have committed suicide.

In less-strict communities, the actual fact that a suicide has taken place would need to be established before any extreme treatment was authorised. Generally, unless someone states that they are about to kill themself, and then does so in front of witnesses, the evidence for suicide is considered debatable. The funeral will go ahead as normal, although the eulogy may be shortened or even missed. The family are allowed to go through their period of shiva and the kadish is sung over the grave.

amputated limbs, removed organs

Any limb that is removed from a living Jew or any organ that is taken out and is not to be used in transplantation must be handled as though it were a dead body. It must be treated with respect, wrapped in a white sheet and given to the patient or their family for burial. Do not cremate the organ or limb. However, it may be worth talking to the patient or a rabbi as opinions about the disposal of limbs and organs vary greatly among different groups of Jews.

miscarriage

If a woman miscarries her unborn child after 30 days of gestation, then it is considered to have had a 'breath of life' and to have human form, and should be treated accordingly. The body will be washed and prepared by the burial society and buried as an adult would be.

termination of pregnancy

If a baby is terminated before 30 days of gestation, then the unborn child is generally not regarded as having had life, and no special treatment of the remains is required under Jewish law. If the unborn child has 'human form' (usually this is taken as being 40 days of gestation and over), then it must be treated as though it were alive but miscarried. The foetal tissue must be collected and buried, although a full ceremony is not necessarily obligatory unless the parents want one. The non-foetal tissues may be disposed of by cremation. If in doubt, ask a rabbi about this very sensitive issue.

 

 

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