NURS 750 Week 3 Spiritual Care Workshop Part 1 on Orthodox Jewish Patients and Families Example

Every Moment of Life Is Precious: Preparing a Spiritual Care Workshop for Nurses Caring for Orthodox Jewish Patients and Families During Serious Illness

Introduction

On a Saturday morning last spring, a newborn in our neonatal intensive care unit needed a central line, and the father, an Orthodox Jewish man, would not sign the consent form. The resident assumed he was refusing the procedure. He was not. He wanted the line placed, but writing is forbidden on the Sabbath unless a life is at stake, and the team had called the line routine. A nurse who knew that hospital policy accepts witnessed verbal consent asked whether the father would agree aloud, and the line was placed within the hour. Neither of us, a neonatal nurse practitioner and a medical intensive care nurse completing our DNP together, would have known what to do.

Our medical center serves a growing Orthodox Jewish community, yet nurses receive no education on its practices. This paper prepares a ninety-minute workshop on spiritual care for Orthodox Jewish patients and families during serious illness. It sets out the workshop's learning outcomes, explains the beliefs and practices that matter most at the bedside and describes how nurses can provide spiritual care that honors them.

Workshop Purpose and Learning Outcomes

The workshop is designed for registered nurses and advanced practice nurses in critical care, oncology and the neonatal unit. By the end of the workshop, participants will be able to:

• 1. Describe three principles of Jewish law that shape how Orthodox Jewish patients and families make decisions during serious illness.
• 2. Identify at least four accommodations nurses can make for Sabbath observance, dietary law, modesty and prayer in an inpatient unit.
• 3. Demonstrate a spiritual assessment conversation with an Orthodox Jewish patient or family that includes asking whether a rabbi guides their decisions.
• 4. Explain why some Orthodox families accept withholding a new treatment while declining withdrawal of a current one, and plan nursing communication that respects that distinction.
• 5. Plan nursing care at and after death that follows Jewish practice for the body, the family and the community.

Spiritual Care During Illness in Orthodox Judaism

A Theocentric Ethic

Much of what puzzles clinicians about Orthodox Jewish families makes sense once the underlying ethic is clear. Western medical ethics places patient autonomy at the center. Orthodox Judaism and Islam share a different starting point: life and the body are gifts from God, held in trust rather than owned, and the norms of the religious community guide decisions alongside the individual's wishes (Hossain et al., 2025). A family that asks its rabbi before agreeing to a decision is not giving up autonomy; it is exercising it in the way its faith teaches. Nurses who understand this can treat the rabbi's involvement as part of the family's spiritual care rather than as interference.

The Duty to Preserve Life

Jewish law places the preservation of life above almost every other commandment. The principle is drawn from the command to keep God's statutes and live by them (English Standard Version Bible, 2001/2016, Leviticus 18:5), which the rabbinic tradition reads as meaning that the law should not be the cause of death. As a result, the Sabbath, fasting and dietary laws are set aside when life is at risk, and an observant patient may accept treatment on the Sabbath without hesitation when it is needed. The same principle gives each moment of life great value, which helps explain the end-of-life preferences described below (Tatz, 2023).

The Sabbath and Holidays

From sundown Friday to nightfall Saturday, and on major holidays, observant Jews refrain from writing, using electrical devices, cooking and travel by car. In the hospital, this may mean that a patient will not press a call light, sign a form, adjust an electric bed or use a phone. Nurses can schedule non-urgent procedures and discharges outside the Sabbath where possible, offer to check on the patient at set intervals so the call light is not needed, leave a room light on if the patient asks, and accept verbal consent with a witness when the family will not write. Many hospitals that serve Orthodox communities also keep a Sabbath elevator or nearby rooms for family members who will not drive home.

Dietary Law, Modesty and Prayer

Kosher patients eat only food prepared under Jewish dietary law, often supplied in sealed trays; nurses should not open or reheat these in ways that would make them unfit, and should ask before assuming a family will accept unit food. Modesty is a religious value, and many Orthodox patients prefer caregivers of the same sex for intimate care and may avoid touch, including handshakes, between men and women who are not family. Prayer is part of daily life: men may wish to wear a prayer shawl and phylacteries in the morning, and families often recite Psalms at the bedside. Nurses can protect time and privacy for these practices and should never move religious items without asking.

The Rabbi's Role

For many Orthodox families, a rabbi with expertise in Jewish law guides major medical decisions. In a 2026 quality improvement survey of 73 clinicians in intensive care, oncology and palliative care, respondents reported that terminally ill Orthodox Jewish patients were more likely than other patients to request aggressive measures and less likely to have advance directives or a health care power of attorney, but that not every patient had a rabbinic authority involved; the clinicians recommended early, direct communication with the rabbi when the family wants it (Ornstein & Harris, 2026). The nurse's spiritual assessment should therefore ask, not assume, whether a rabbi is part of decision-making and how to reach that person.

End of Life and After Death

End-of-life care is where conflict between Orthodox families and clinical teams is most likely. Because each moment of life has value, many authorities permit withholding a new treatment that would only prolong dying, such as not starting dialysis, but forbid withdrawing a treatment already in place, especially a continuous one such as ventilation (Tatz, 2023). Questions about brain death, resuscitation and artificial nutrition may be decided differently than a Western ethical framework would predict, and a case analysis of a 79-year-old Orthodox man after severe injury shows how a family's decisions, made with its rabbi, followed a coherent religious logic that clinicians initially misread (Eitingon et al., 2025). The nurse who knows the difference between withholding and withdrawing can keep a hard conversation from becoming a battle.

Information needs vary. In a study of 51 ultra-Orthodox women with advanced cancer in Israel, 86.3% wanted to be told if their condition worsened, yet only 17.6% said their doctor had discussed future care options with them (Simhi & Yoselis, 2023). The common assumption that Orthodox families do not want prognostic information is therefore unreliable; nurses should ask each patient how much they want to know.

At and after death, Jewish practice asks that the body be treated with great respect. A person who is actively dying should not be moved or touched unnecessarily. After death, family members often wish to stay with the body so that it is not left alone, the body is prepared for burial by a community burial society rather than by staff beyond basic care, and burial takes place quickly, ideally within a day. Most Orthodox families object to autopsy unless the law requires it. Nurses can ask the family before removing lines or washing the body, help arrange for the burial society and release the body promptly.

How Nurses Provide Spiritual Care

The common thread of the workshop is that nurses do not need to be experts in Jewish law. They need to know enough to ask good questions and to recognize when a practice is religious rather than resistant. Nurses vary in how readily they bring in spiritual support. In a survey of 51 nurses at a Catholic hospital, religious nurses were more likely than nonreligious nurses to contact a chaplain across scenarios such as a new diagnosis, anxiety or depression, or a difficult family situation (Goetz et al., 2024). The workshop will therefore teach a routine rather than relying on personal inclination: assess, accommodate and connect, which means asking about observance, making the practical adjustments the patient needs and offering contact with the family's rabbi, the hospital's Jewish chaplain or a community visiting society.

Assessment of Learning and Next Steps

Outcomes 1, 2 and 4 will be assessed with a ten-question case-based quiz before and after the workshop. Outcomes 3 and 5 will be assessed through observed role-play during the learning activity, scored with a short checklist. Part 2 will develop that learning activity: a case of a premature infant and his family across a Friday afternoon, a Sabbath and a decision about continuing ventilation, in which participants practice the assessment conversation, the accommodations and the end-of-life communication the outcomes describe.

References

Eitingon, J., Doberman, D., Berger, Z., & Tapper, C. X. (2025). End-of-life care for the devout Jewish patient. Journal of Evaluation in Clinical Practice, 31(1), Article e14109. https://doi.org/10.1111/jep.14109

English Standard Version Bible. (2016). Crossway. (Original work published 2001)

Goetz, L. E., Brannon, K. J., Felix, Z. P., Meyers, K. R., & Spilman, S. K. (2024). Religious characteristics of nurses who refer patients to chaplains at a Catholic hospital in the northwestern USA. Journal of Religion and Health, 63(6), 4549-4558. https://doi.org/10.1007/s10943-024-02118-0

Hossain, F., Gabbay, E., & Fins, J. J. (2025). Clinical ethics and the observant Jewish and Muslim patient: Shared theocentric perspectives in practice. Cambridge Quarterly of Healthcare Ethics, 34(2), 247-263. https://doi.org/10.1017/S0963180124000379

Ornstein, M. C., & Harris, D. (2026). Medical professionals' perceptions of and experiences with terminally ill Orthodox Jewish patients. American Journal of Hospice and Palliative Medicine, 43(2), 133-138. https://doi.org/10.1177/10499091241312395

Simhi, M., & Yoselis, A. (2023). Support and informational needs of ultra-Orthodox Jewish women coping with advanced cancer: A pilot observational study. Journal of Social Work in End-of-Life & Palliative Care, 19(2), 150-167. https://doi.org/10.1080/15524256.2023.2220080

Tatz, A. (2023). Life-threatening and terminal illness: Considerations for hospitalised Orthodox Jewish patients. British Journal of Hospital Medicine, 84(6), 1-5. https://doi.org/10.12968/hmed.2022.0118