Features

Diversity in practice: Judaism

12 March 2018

In the first of a new series on how religion and culture can impact on practice, journalist Lauren Hoffman looks at Judaism.

The religion of the Jewish people, Judaism is based on the Old Testament of the Bible, known as the Torah. A monotheistic religion, it is built around a central belief in one God as the transcendent creator of all things. Halachic law is derived from the written and oral Torah and dictates what a Jewish person can and can’t do. How closely the laws are followed can vary from person to person depending on their level of observance. Traditions, customs and attitudes can also vary. It’s fair to say that a client who defines themselves as a practising Jew may have certain requirements you should be aware of. On a very basic level, this includes holy days and festivals, dietary laws and customs surrounding birth and death. It’s also fair to say that strictly Orthodox communities will be the most observant.

Informing practice 

Mark Johnson, professor of diversity in health and social care at De Montfort University, believes that an awareness, rather than in-depth knowledge of these faith requirements is often enough when it comes to providing clients with the best possible care. ‘I would say what one needs is an awareness of the dimensions that might be affected by faith. A person’s self-identity is wound up with their belief system. There’s also, in many cases, an overlap between that and their life practices. Consequently, their diet, their daily routines and their observances will be affected by their religious beliefs.’

Simple in theory, but faced with offending a client by getting it wrong can create anxiety for practitioners (Baldwin and Johnson, 2017). This series aims to give an outline of different religious and cultural practices, particularly highlighting aspects that may impact on practice.

Additionally, Professor Johnson offers this advice: ‘Why are we making barriers? Is it so difficult to say: “I don’t know very much about [Judaism] but I appreciate that it’s important to you. Does this mean I need to take this into account when I’m talking about your medical or other care issues?” Being prepared to take a few minutes in getting to know a client to express an interest, a concern, a familiarity and to say to them: “If you think I’m suggesting something that is at odds with your belief system, we will find a way round it, but talk to me.” In my experience, clients are delighted that you take it seriously and actually ask that sort of question.’

There can be additional help at hand in understanding the needs of the Jewish community as Professor Johnson explains: ‘The Jewish care system is second to none in having qualified care assistants [for various life stages], often attached to synagogues or care homes who will be really expert in guiding, supporting and helping you.’ 


Your guide

The Sabbath 

Known as Shabbat, the Jewish Sabbath begins at sunset on a Friday and ends when the stars appear on Saturday night. During this time, which is referred to as the ‘day of rest’, certain activities, such as work, travelling by vehicle, the use of electricity, handling money and using the phone, are not allowed. This weekly event takes place at both the home with family and friends, and synagogue, and is considered to be a special time for Jewish families. The day-of-rest rules are permitted to be broken however if a life is at stake.

Holy days and festivals 

There are many festivals throughout the calendar, each with their own rules and traditions, but the major ones include Rosh Hashana (Jewish New Year); Yom Kippur (Day of Atonement); Pesach (Passover); and Succot (The Festival of Tabernacles). As with the Sabbath, festivals begin at sunset and end at nightfall the following day. Unlike the Western calendar, the Jewish calendar is based on Lunar cycles with months varying in length. So while Jewish festivals are celebrated on the same date of the Jewish calendar each year, they will vary from year to year on the standard calendar. Rosh Hashana is celebrated over two days and is a time of contemplation and prayer. Yom Kippur is the holiest day of the year and is spent fasting (around 25 hours) and in prayer – asking for forgiveness for wrong doings over the past year. Pesach marks the exodus of the Jewish people from Egypt and a special diet is followed over eight days. During Pesach, it is not permitted to eat anything which has or may have leaven, and people will eat Matzah (unleavened bread). Only foods which have been specially produced for Passover are permitted.

How does this affect you? 

While an in-depth knowledge of the Sabbath and Jewish holidays is not required, advises Professor Johnson, basic comprehension of when they take place can help you plan client visits (see calendar, below). For instance, your client may prefer to avoid non-urgent appointments on Yom Kippur, and there may be dietary implications at Pesach. ‘Recognise that people have cycles of prayer in their life and that timing of that may be important to them. And I think sometimes explaining or discussing with them whether or not their religion permits an alternative or derogation from strict observance in health terms is important,’ says Professor Johnson. That said, the guiding principle in Judaism’s attitude to medical and healthcare is that the saving of life is paramount (Jewish Visiting, 2018). 


Dietary laws 

The dietary regulations of Judaism are known as the laws of kashrut. The key things to be aware of are foods that are banned. Keeping ‘kosher’ means that one can’t eat pork or any of its derivations, including gelatine, and all types of shellfish. Nor is one allowed to mix milk and meat – the Torah forbids cooking a young animal in its mother’s milk (Citron, 2016). In fact, with the exception of fresh fruit and veg, products are only considered kosher if they have been approved by a specialist kosher agency. Kosher hospital meals, for example, can be obtained pre-packed and frozen. Products not bearing the kosher logo may not be suitable.

How does this affect you?

A Jewish client might avoid medications if for instance pills contain gelatine from pork-based origin. If your client is concerned, as Professor Johnson advises: ‘Ask your client to take the problem to their religious leader and see if they can advise. Once they have the facts, you may find they say, for example: “Because of the health and safety of the unborn child, this person is absolved of any need to follow that regulation in order to preserve the life of their unborn child.” 

‘In most cases, I think we’ll find most religious leaders will go with that.’ Plus note the guiding principle highlighted on page 32.


Physical contact with the opposite sex is prohibited for Orthodox Jews, which means shaking hands is a no-no. If you’re unsure whether your client observes this rule, it’s one best to avoid – unless of course they extend their hand to you, in which case, shake it.


Contraception 

Although under Halachic law orthodox women tend to have many children, there are occasions when certain types of contraception are not only permitted, but encouraged – namely for the medical safety of the mother. Medications or devices that block the passage of seed or actively destroy it do not comply with Jewish law (Rich, 2011).

How does this affect you? 

Be prepared to consider alternative treatment plans and do encourage your client to talk to their Rabbi if they feel it is necessary to do so. While orthodox women may already have a clear idea of what contraception options are permitted, it may be beneficial to take a little extra time to discuss this in detail. Especially important if your client is breastfeeding (Chertok and Zimmerman, 2007; Eidelman, 2006).


Circumcision 

To mark the covenant between God and the Jewish people, circumcision in boys is required to take place on the eighth day after birth. It is a quick procedure to remove the foreskin that overhangs the tip of the penis, and the wound usually heals within a few days. However, if the baby boy is in any way weak or unwell, this ceremonial observance is delayed until the baby is fit and healthy. Circumcisions are performed by qualified mohels – a surgically trained religious person who is highly experienced in the practice. 

How does this affect you? 

It’s important to have an appreciation of the religious and cultural reasons for circumcision. As a result, sensitivity is required when dealing with families and babies who may have recently undergone the procedure.

 

Resources

jvisit.org.uk Aimed mainly at health professionals working in hospitals, it still advances understanding of Jewish religious and cultural practices.

thejc.com The website of the oldest and most influential Jewish newspaper. Its news, features and opinion reflects the wide diversity of Jewish religious, social and political thought. 

chabad.org Information on all matters Judaism, from the Chabad-Lubavitch movement, but for all.

Working with diverse communities A useful chapter by Sharin Baldwin and Professor Mark Johnson in the fourth edition of Health visiting: preparation for practice (Wiley, 2017) relevant to all religions and cultures.


References

Chertok IR, Zimmerman DR. (2007) Contraceptive considerations for breastfeeding women within Jewish law. International Breastfeeding Journal 2:1 (1-?)

Citron A. (2016) Meat and Milk. See chabad.org/library/article_cdo/aid/1149824/jewish/Meat-Milk.htm#footnote7a1149824 (accessed 27 February 2018).

Jvisit. (2018) Jewish medical ethics. See: jvisit.org.uk/jewish-medical-ethics/ (accessed 21 February 2018).

S Baldwin, M Johnson. (2017) Working with Diverse Communities. Health visiting, Preparation for Practice, 4th Edition. Wiley

Rich T. (2011) Kosher Sex. See:jewfaq.org/author.htm (accessed 27 February 2018).

Picture credit | iStock

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