Jews: Issues For Jewish Healthcare Staff
working on the Sabbath
In general terms, any member of staff that may work in such a way as to save a live during their working day is permitted to work on the Sabbath. Thus, an ambulance driver or paramedic who has been scheduled to work on Friday evening will know that there are often car accidents on Friday nights, and therefore may be able to save a crash victim during the course of his shift. In this way, he has done more good by saving a life than bad by breaking the rules of the Sabbath.
However, this is only a general guideline. The Sabbath is important not just as a religious ritual, but as a time for the family and the community to be together and confirm their identity. In addition, although Reform and Liberal Jews might happily work on a Sabbath, more Orthodox Jews will adhere more strictly to the letter of the ruling about working on the Sabbath. Thus, if their work is not likely to save lives, they might not wish to work on Friday evening or Saturday.
When drawing up staff rotas, it is always best to talk to staff about their preferences, or to consult a rabbi for advice. The rules about what may or may not be done during the Sabbath are extremely complex and their interpretation varies considerably from group to group.
working on holidays
Many of the Jewish holidays carry the same restrictions on permitted activities as the Sabbath does, and so it is advisable for managers to make themselves aware of when holidays are likely to fall. The Jewish calendar follows a lunar cycle, and so the precise date of any holiday will vary from year to year. Some of these holidays may require staff to undertake fasting or additional prayer, and so even if staff are happy to work on those days, alterations to their normal routine may be needed.
Again, the degree to which working on a holiday is accepted varies enormously from Orthodox to Reform or Liberal Jews and so it is advisable to discuss this with individual staff.
All observant Jews will wish to pray three times a day; once in the morning, once in the afternoon and again at night. These prayers consist of quietly saying verses while concentrating solely on what is being said. The hands are folded over the heart and the supplicant faces towards Jerusalem, bowing slightly at several points during the recitation. Although prayers can be said wherever the person is, peace and quiet help to concentrate the mind and preserve a more spiritual atmosphere. Almost all hospitals will have a quiet area for people of any religion to use for prayer; it is important that time is allowed during a shift for staff to visit these areas.
hastening or delaying death
Jewish law states that nothing may be done to hasten or delay the moment of death in someone who is dying. The interpretation of this ruling is complex, and will depend on the branch of Judaism followed, but for more Orthodox Jews it may encompass life support, resuscitation and withholding of nutrition for patients on life support. It is not likely that many staff will have a problem when faced with issues of life support, but death as a subject may present problems for medical students and other health-related staff in training.
determining the moment of death
Strictly speaking, determining the moment of death of a Jewish patient must be done under halakhic law and not be based simply on brain death. Jewish healthcare staff may have concerns arising from this difference that may need to be discussed – especially if the staff member is involved in dealing with certifying death or with terminal care.
Most Jewish authorities now accept that organ donation either from living patients or after death is a good thing, and saving a life by doing so is seen as a higher priority than preserving the sanctity of a corpse. However, more Orthodox staff may still have reservations about this practice, especially if linked to concerns about determining the moment of death. It is worth speaking to concerned staff members to resolve this conflict, and the advice of a rabbi skilled in medical ethics should be sought.
termination of pregnancy
Although termination is permitted in cases where the mother's life is in danger, the interpretation of that ruling varies greatly amongst the different branches of judaism. Because of this, the circumstances of the termination might be in conflict with the circumstances jewish law considers grounds for proceeding with a termination.
Jewish medical students may have strict views on this subject which should not be ignored; this is a sensitive subject, and it would be wise to talk to the individual student concerned, and where possible, get advice from a rabbi . However, there is nothing that prevents a student from observing the practice of termination even if they do not want to carry out the procedure themselves.
Most Jews now accept that where foul play is suspected that the law of the land requires a post-mortem to be carried out. Provided this post-mortem is carried out with respect, and proper practice is observed, there should be no objection to this. However, there is still a grey area concerning post-mortems that are not required by law, but that may be of vital importance to the furthering of medical knowledge. Some groups consider the good of a post-mortem in these circumstances outweighs the indignity inflicted on the corpse, whereas others would refuse to permit a post-mortem under these conditions. Some medical staff may not wish to be present at post-mortems, especially those of other Jews. Talk these issues through with any concerned staff, and seek the advice of a rabbi if necessary.
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