World Religions: Judaism

Basic Facts:

• Jewish views on and practices regarding death differ widely

• In addition to three main strands of Judaism – Orthodox, Conservative, and Reformed – regional differences contribute to varied beliefs and practices


• Additionally, Judaism has always permitted a wide latitude for differences of opinion


• Below are listed some “traditional” beliefs and practices


• May or not may not be relevant to the patient/family in your care
• Be sure to ask which, if any of these, are meaningful to them

Actions Before Death
Actions After Death
Implications for Hospice/Palliative Care
References

Actions Before Death

• Traditional/Orthodox Jews may need assistance in observing dietary laws and the Sabbath during hospitalization

• These laws may impact travel of visitors, use of elevators, signing of papers, funeral preparation, removal of the body, etc.

• Visiting the sick, giving, comfort and aid are important Jewish obligations

• Prayers for healing (Mi Sh-beirach) may be offered by the rabbi or by members of the congregation

• Psalms are frequently used to provide comfort, strength, and hope to the dying person and to their family

• Though debate remains regarding prolonging or hastening death, making the dying person comfortable is an important value

• Talmudic law encourages the removal of anything that may bind the dying person’s soul to the body


• For modern Jews, this may authorize a DNR and even removal of life support

• If the patient is a Holocaust survivor, this may directly impact medical care

• Some areas of increased sensitivity as result of this experience
• Bathing/showers
• Medical testing
• Nutrition status/weight loss
• Perception of pain and suffering
• Views of death itself
• Importance of memory
• Multiple loss and grief

• Beliefs regarding the afterlife vary widely among Jews

• Death is viewed as a natural part of life but rarely do the dying person or family find it comforting to focus on the afterlife


• Greater comfort is found in the belief that one has “left a good name” or will be remembered honorably

• Life review with the dying person is in keeping with a Jewish focus on the value of life on this earth, good deeds, and the legacy of the deceased

• An “ethical will” may be prepared by the dying person to help identify the meaning of their life, lessons for survivors, and ways in which loved ones may continue to honor their memory through words and deeds

• The Viddui may be recited by the dying person as a prayer of confession and reassurance about future well-being of loved ones

• The Shema, or affirmation of faith, is frequently recited as someone is dying/at the time of death


• Words of forgiveness may also be offered to the dying person/deceased by family and friends

• Dying persons are to be attended to constantly

• At the time of death, no one should leave the room unless they are overcome physically or emotionally

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Actions After Death

• From the time of death until the funeral, the body should be attended

• The family may fulfill this duty or assign a “shomer”

• Religious laws help preserve “Kavod Hamet,” respect for the dead

• They dictate how the body should be handled after death


• These rites may include
• Closing of eyes and mouth
• Applying clay over the eyelids
• Facing the body toward the door
• Placing the body on the floor for 20 minutes
• Placing the arms alongside the body rather than folded over the chest
• Purification of the body
• Wrapping the body in a white shroud and (for men) in a prayer shawl
• Customarily, only members of the same sex are permitted to touch the corpse
• These rituals may be facilitated by family members, the funeral home, and/or the Chevrah Kadish (burial society)

• Religious laws prohibit the mutilitation of the body

• Therefore, traditional Jews usually decline autopsy as well as organ donation unless they will directly “save a life”


• Cremation and embalming are usually not performed, though less conservative Jews may opt for these rituals


• Cremation can be a source of conflict and debate within a family, even for non-religious Jews

• The funeral and burial usually occur as soon as possible, within 24-72 hours

• Some rituals that may be included as part of a traditional Jewish funeral and burial include

• Rending of clothes of immediate family in mourning (Keriyah)
• Closed casket with a viewing of the deceased only by the immediate family before the funeral service
• Prayers of forgiveness to help mourners
• Eulogy celebrating the life of the deceased
• Procession to the graveside
• Family and friends placing shovels of dirt onto the casket
• Recitation of the Kaddish (Mourner’s prayer)
• Flowers are not customarily part of a Jewish funeral
• Family often suggests charities to receive contributions in lieu of flowers

• A seven day period of intense mourning and visitation follows the burial (Shiva), though many modern Jews may shorten this period to 2-3 days

• A wake or visitation before the funeral is not customary for Jewish persons


• In some homes of the bereaved, mirrors are covered, the family sit on stools, and men do not shave during this period of grief


• The prayer of Kaddish is said daily

• Sh-loshim is the thirty day period that marks the end of ritualized mourning for all deaths except that of a parent

• Mourners refrain from entertainment and recite prescribed prayers during this time, though they may return to work


• Rituals of mourning for the death of a parent last up to a full year


• The “unveiling” of the tombstone customarily occurs shortly before the one year anniversary of death


• Mourners may place small stones near the tombstone

• Deceased loved ones are remembered with the lighting of a Yahrzeit candle at the year anniversary of their death

• During four Jewish Holidays (Yom Kippur, Shemini Atzeret, Passover, and Shavu’ot) a memorial prayer (Yizkor) is recited as a regular part of these religious observances


• Kaddish, the mourners’ prayer, does not mention death, loss, or grief. Rather it reaffirms faith in G-d during a time when a person’s faith may be shaken

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Implications for Hospice/Palliative Care

• Until recently, the primary emphasis in Judaism on the value of life has led to a resistance to palliative care and a preference for life-prolonging medical interventions

• Modern Jews and members of the more liberal strands of Judaism have shown greater openness to the goals of palliative care

• Once palliative care is accepted, there should be no religious obstacles to pain management

• Given the wide variance of belief and practice in Judaism, as early as possible the palliative care team should request information regarding religious beliefs, practices and prohibitions

• Many Orthodox Jews are used to educating the secular world about specific ways to assist them in remaining observant or in adapting to the regulations of medical institutions

• Many persons who count themselves Jews are not religious either in belief or observance

• However, Jewish culture, history, and ethnicity may be of great significance
• Burial practices may reflect this connection to “tradition” even if the person is not religious

• The Holocaust may be a factor in medical care not only of someone who is a survivor of the concentration camps but for the children and relatives of survivors as well

• Mourning may be complicated for family and friends of Holocaust survivors

• A history of persecution and attempts at conversion by Christians means some Jews will be suspicious of chaplains and spiritual care

• Staff will need to dispel common misperceptions and myths and/or arrange for spiritual care by a rabbi

Example

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References

James E. Ponet, “Reflections on Mortality from a Jewish Perspective,” pp. 129-136 in Facing Death, eds. Spiro, Curren, and Wandel (New Haven: Yale University Press, 1996)

Rabbi Earl A. Grollman, “Death in Jewish Thought,” pp. 21-32 in Death and Spirituality, ed. Kenneth Doka with J. Morgan (Amityville, NY: Baywood Publishing Co., Inc., 1993)

AAHPM, Unipac Two “Alleviating Psychological and Spiritual Pain in Terminally Ill”, pp. 101-103

Ellen Levine, “Jewish Views and Customs on Death, “ pp. 98-130 in Death and Bereavement Across Cultures, eds. Parkes, Laungani, and Young (NY: Routledge, 1997)

Riemer, Jack and Stampfer, Nathaniel, eds. So that Your Values Live On: Ethical Wills and How to Prepare Them (Woodstock, VT: Jewish Lights, 1991)

Brener, Anne. Mourning and Mitzvah: A Guided Journal for Walking the Mourner’s Path Through Grief to Healing (Woodstock, VT: Jewish Lights, 1993)

Shapiro, Rami M. Last Breaths: A Guide to Easing Another’s Dying (Miami: Temple Beth Or, 1993)

Lamm, Maurice. The Jewish Way in Death and Mourning (NY: Jonathan David Publishers, 1969)

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