Orthodox Jews are considered the most traditional members of the Jewish community. They live their lives by the Torah, which are the first 5 books of the Jewish Bible. Orthodox Judaism has made a point not to change its observances and has kept close practices such as daily worship, dietary laws, traditional prayers and ceremonies, regular study of the Torah, and separation of men and women in the synagogue. It also preaches strict observance of the Sabbath and religious festivals and does not permit instrumental music during communal services. Orthodox Jews often consult a rabbi before making major life decisions, including matters of health care, to ensure adherence to Jewish law. Saving or preserving life, is a fundamental principal for Orthodox Jews when considering decisions about health care. Life is viewed as a divine gift, and should be treasured and protected. This principal creates an imperative, such that most other religious obligations are permitted or required to be set aside if doing so will result in saving or prolonging someone’s life. Orthodox Jews value being able to be in their homes, surrounded by familiar and caring people, when their needs can be met there. There is support for patients, whether children who have complex medical needs or the elderly who are nearing the end of their lives, is of the upmost importance in the Orthodox Jewish community. This care may be provided informally by individuals or through community organizations.
The familial structure of the Orthodox Jewish is the central unit of life. Orthodox Jews have very tight knit families and are very involved in caring for each other. It is how traditions are passed along to each generation and is of upmost importance. It is forbidden to judge or contradict your parents and parents are bound by Judaism and God’s laws, so there can be a dichotomy to the unit if the parental opinions differ from religious teachings. In Judaism, parents are seen as partners with God in a child’s creation, and they should receive deference similar to that given to God. Some people might respond by deferring to more observant relatives in situations where healthcare concerns arise. Hassidic groups are led by a ‘Rebbe’ (teacher) who holds a most important place in the lives of his parishioners. His authority in all matters, be they religious, personal, social or even political, is beyond dispute. Non-Hassidic communities also defer greatly to their leader (Rav) even though he is given enormous respect, his authority is deliberately restricted to legal or ritual matters. His role is much more as a teacher than a life leader. The Rav generally does not intrude on personal choices, where the Rebbe is centrally involved in personal life decisions.
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So how do we as EMS providers, care for our patients and understand the cultural needs they have? Ask the family what their wishes and concerns are culturally, as every patient and patient’s family is different. Be prepared to work with the Rabbi or elders in the family, answering questions and respecting their input as allowed by the patient. Some Jewish families will be much more concerned with Jewish law than others. Some patients will have specific requests about modesty, or ways to celebrate Jewish holidays. Be willing to have a provider of the same sex with the patient if possible, be understanding, and willing to work within the confines of their beliefs as long as it does not interfere with their health care. In the Jewish religion, preservation of life is of upmost importance, and with explanation of why procedures need to be completed, you will most likely find acceptance.
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