From the Guidelines
Caring for Orthodox Jewish patients in the emergency department requires a sensitive and respectful approach to their religious beliefs and practices, prioritizing their physical and emotional well-being while navigating complex medical decisions. When interacting with Orthodox Jewish patients, it is essential to consider their unique needs and preferences, such as assigning same-gender physicians and staff when possible, as many Orthodox Jews observe modesty laws that restrict physical contact between genders 1.
During Shabbat (from Friday sunset to Saturday nightfall) and religious holidays, Orthodox patients may avoid activities like writing, using electronic devices, or pressing buttons, so staff should offer assistance with forms, call buttons, and electronic beds. Dietary restrictions are also crucial; kosher food should be provided, with sealed kosher meals being preferable.
In terms of medical decision-making, it is vital to involve family members and respect the patient's wishes regarding life-sustaining treatments, as the preservation of life is a high-priority value in the Jewish faith, and withholding or withdrawing life-prolonging treatment is subject to specific guidelines and restrictions 1. For medication administration, gelatin-free alternatives should be offered when available, as some medications contain animal-derived ingredients that may not be kosher.
Effective communication is key to providing respectful and effective care; healthcare providers should ask open-ended questions regarding the impact of a patient's culture and spirituality on their medical decision making, and consider using standardized tools to assess a patient's spiritual or religious beliefs 1. By taking a sensitive and respectful approach to the care of Orthodox Jewish patients in the emergency department, healthcare providers can balance respect for religious beliefs with the provision of timely, effective medical care.
Some key considerations for healthcare providers include:
- Assigning same-gender physicians and staff when possible
- Providing kosher food and gelatin-free medication alternatives
- Involving family members in medical decision-making
- Respecting patients' wishes regarding life-sustaining treatments
- Using open-ended questions and standardized tools to assess spiritual or religious beliefs
- Offering assistance with activities that may be restricted during Shabbat or religious holidays.
From the Research
Care Considerations for Orthodox Jewish Patients
- Orthodox Jewish patients have unique cultural and religious needs that must be considered in the emergency department 2
- Their entire lives revolve around the teaching of the Torah, and their religious beliefs are reflected in all aspects of their lives, including health and illness 2
- Care for Orthodox Jewish patients at the end of life can be complex, with religious perspectives on advance directives, comfort care, and pain control often unfamiliar to the medical community 3
End-of-Life Care
- End-of-life decision-making for Orthodox Jewish patients may conflict with traditional Western medical ethics 4
- A casuistic deontological approach can help clinicians understand the ethical framework used by Orthodox Jewish patients and their families 4
- Cultural sensitivity and humility are essential when approaching end-of-life care for Orthodox Jewish patients, allowing for compassionate and comprehensive care that respects their religious perspectives 4, 5
Specific Considerations
- Definition of death, organ donation, and caring for the patient at life's end are profound issues that must be addressed from a religious perspective 3
- Withholding and withdrawing treatment can pose potential conflicts with some aspects of current religious practice 6
- Clinicians must be aware of the relevant principles of Jewish law to provide appropriate care for their Orthodox Jewish patients 6
Hospital Practices
- Hospitals serving an Orthodox Jewish population can benefit from guidelines for the care of dying Orthodox Jewish patients, which can help balance religious obligations, medical procedures, and personal preferences 3
- Modifying common patient care practices to meet the needs of Orthodox Jewish patients can help ensure culturally competent care 2