Abstract：
BACKGROUND: The Joint Commission emphasizes the importance of cultural competence and effective communication in quality medical care, particularly during end-of-life (EOL), when decisions are influenced by diverse cultural and religious backgrounds. For Orthodox Jewish patients, the philosophical framework used for EOL decision-making may conflict with that used in traditional Western medical ethics. In this paper, we explore the complexities of EOL decision-making for devout Jewish patients and highlight how approaches may differ from a Western ethical framework.
OBJECTIVE: This paper aims to familiarize clinicians with EOL preferences of Orthodox Jewish patients, organized into an ethical framework called \'casuistic deontology\'. Leading with an open-minded approach emphasizing cultural humility, we explore ways in which integrating this perspective can allow for culturally appropriate and compassionate EOL care.
METHODS: Using a case study methodology, we focus on a 79-year-old Orthodox Jewish male hospitalized with severe injuries. The patient\'s medical course is analyzed, highlighting how the decisions made by his family in consultation with their Rabbi may differ from the decisions made with a philosophy of a Western ethical framework.
CONCLUSIONS: This case illustrates the ethical tensions that may arise when Western medical practices intersect with Orthodox Jewish beliefs, particularly regarding brain death, resuscitation, and artificial nutrition. We underscore the need for cultural sensitivity when approaching EOL decision-making, allowing for compassionate and comprehensive care that respects religious perspectives. This paper helps provide a structure for clinicians to navigate the complex EOL care needs for the devout Jewish patient in a manner consistent with their cultural and religious identity.
OBJECTIVE: This paper aims to familiarize clinicians with EOL preferences of Orthodox Jewish patients, organized into an ethical framework called \'casuistic deontology\'. Leading with an open-minded approach emphasizing cultural humility, we explore ways in which integrating this perspective can allow for culturally appropriate and compassionate EOL care.
METHODS: Using a case study methodology, we focus on a 79-year-old Orthodox Jewish male hospitalized with severe injuries. The patient\'s medical course is analyzed, highlighting how the decisions made by his family in consultation with their Rabbi may differ from the decisions made with a philosophy of a Western ethical framework.
CONCLUSIONS: This case illustrates the ethical tensions that may arise when Western medical practices intersect with Orthodox Jewish beliefs, particularly regarding brain death, resuscitation, and artificial nutrition. We underscore the need for cultural sensitivity when approaching EOL decision-making, allowing for compassionate and comprehensive care that respects religious perspectives. This paper helps provide a structure for clinicians to navigate the complex EOL care needs for the devout Jewish patient in a manner consistent with their cultural and religious identity.
摘要：
背景：联合委员会强调文化能力和有效沟通在优质医疗中的重要性，特别是在寿命终止(EOL)期间，当决策受到不同文化和宗教背景的影响时。对于正统犹太患者来说，用于EOL决策的哲学框架可能与传统西方医学伦理学中的哲学框架相冲突.在本文中,我们探讨了虔诚的犹太患者的EOL决策的复杂性，并强调了方法可能与西方伦理框架有何不同。
目的：本文旨在使临床医生熟悉正统犹太患者的EOL偏好，组织成一个名为“因果关系论”的伦理框架。以开放的态度领导，强调文化谦逊，我们探索整合这种观点的方式，可以允许在文化上适当和富有同情心的EOL护理。
方法：使用案例研究方法，我们关注一名79岁的正统犹太男性因重伤住院。分析病人的医疗过程，强调他的家人与他们的拉比协商做出的决定可能与西方伦理框架哲学做出的决定有所不同。
结论：这个案例说明了西方医疗实践与正统犹太信仰相交时可能出现的伦理紧张关系，特别是关于脑死亡，复苏,和人工营养。我们强调在进行EOL决策时需要文化敏感性，允许尊重宗教观点的富有同情心和全面的护理。本文有助于为临床医生提供一种结构，以符合其文化和宗教身份的方式，为虔诚的犹太患者提供复杂的EOL护理需求。
目的：本文旨在使临床医生熟悉正统犹太患者的EOL偏好，组织成一个名为“因果关系论”的伦理框架。以开放的态度领导，强调文化谦逊，我们探索整合这种观点的方式，可以允许在文化上适当和富有同情心的EOL护理。
方法：使用案例研究方法，我们关注一名79岁的正统犹太男性因重伤住院。分析病人的医疗过程，强调他的家人与他们的拉比协商做出的决定可能与西方伦理框架哲学做出的决定有所不同。
结论：这个案例说明了西方医疗实践与正统犹太信仰相交时可能出现的伦理紧张关系，特别是关于脑死亡，复苏,和人工营养。我们强调在进行EOL决策时需要文化敏感性，允许尊重宗教观点的富有同情心和全面的护理。本文有助于为临床医生提供一种结构，以符合其文化和宗教身份的方式，为虔诚的犹太患者提供复杂的EOL护理需求。
