End-of-life care for the devout Jewish patient

Area of Science:

• Medical Ethics
• Cultural Competence in Healthcare
• Religious Studies

Background:

• The Joint Commission highlights cultural competence and communication in quality medical care, especially during end-of-life (EOL) decisions.
• Orthodox Jewish end-of-life (EOL) decision-making frameworks may conflict with Western medical ethics.
• Diverse cultural and religious backgrounds significantly influence EOL care preferences.

Purpose of the Study:

• To familiarize clinicians with the EOL preferences of Orthodox Jewish patients.
• To present an ethical framework, 'casuistic deontology,' for culturally sensitive EOL care.
• To promote culturally appropriate and compassionate EOL care through cultural humility.

Main Methods:

• Case study methodology focusing on a 79-year-old Orthodox Jewish male with severe injuries.
• Analysis of medical decisions made by the patient's family in consultation with their Rabbi.
• Comparison of decisions within the Orthodox Jewish framework versus a Western ethical framework.

Main Results:

• Ethical tensions arise when Western medical practices intersect with Orthodox Jewish beliefs on brain death, resuscitation, and artificial nutrition.
• Family and Rabbinic consultations guided EOL decisions, diverging from typical Western ethical approaches.
• The case highlights the need for sensitivity to religious perspectives in EOL care.

Conclusions:

• Clinicians must exercise cultural sensitivity when approaching EOL decision-making for Orthodox Jewish patients.
• Compassionate and comprehensive EOL care requires respecting diverse religious perspectives.
• This paper provides a structure for navigating EOL care for devout Jewish patients, respecting their cultural and religious identity.