The Torah calls for Jews to listen to religious authorities and, above almost everything else, to prioritize their health. When the advice of their rabbis and doctors clash, Haredi Jews navigate the situation in different ways, but they tend to prioritize the views of their religious leaders, Israeli researchers found.
Rivka Neriya‐Ben Shahar, Fany Yuval and Aviad Tur‐Sinai—of Sapir College near Sderot, Ben-Gurion University of the Negev in Beersheva and the University of Haifa respectively—published their findings in February in the Journal of Religion and Health.
To better understand how haredi Jews address medical decisions, the scholars convened 16 gender-differentiated focus groups of eight people each, for a total of 128 Haredim, in the winter of 2019. Participants ranged in age from 20 to 65, and most were married parents. The researchers ensured that each focus group had about an even split between Haredim who are Chassidic, Lithuanian (yeshivish) and Sephardi.
Three Lithuanian Haredi research assistants, one man and two women, helped convince people to participate in the study, for which they were anonymous and paid about $28 each. They selected participants from Jerusalem and Bnei Brak—which have the largest Haredi populations—and Betar Illit and Modi’in Illit, towns that have entirely Haredi populations. Focus groups were held in the home of one of the participants.
“We argue that the strict behaviors described here with regard to relations among doctors, rabbis and patients, function as social capital that raises the status of ultra-Orthodox Jews as members of an exclusive club that balances health decisions with the social demand to obey their religious leaders,” the scholars wrote.
The researchers wrote that although the COVID-19 pandemic altered the relationship between Haredim and medical providers, “we assume that in terms of the focus of this article, these relationships have returned to their pre-pandemic norm.”
Adopting a focus-group method and concerns about sampling and of paying participants were potential limitations of the study, the authors noted.
“We chose the focus-group method because our main goal was to understand the perceptions of the ultra-Orthodox community about healthcare providers and services,” they wrote. “Our questions covered many topics such as accessibility, prices and availability of doctors, as well as cultural perspectives.
“Finding the issue of relations between rabbis and doctors so important and interesting, we devoted this article to this topic,” they added.
Some of the participants told the researchers that rabbis and doctors often disagree. “The doctor said that when he starts to pray, rabbis will start to give medicines,” one participant said.
“They say very disparagingly: ‘The rabbi? Is he a doctor?’ Why do you disparage her? Why do they hurt her feelings?” another participant said. “She trusts her rabbi more than [she does her] doctor. It’s her right, and this is a democracy. … Or sometimes, the rabbi wants to talk to the doctor. Why doesn’t the doctor agree to talk to him? Why does he talk with the rabbi so haughtily?”
One participant said that one only bothers the rabbis with major issues. “When you have a headache, you don’t need to ask,” the participant said. Another said, “We don’t ask whether to get a strep test or take an antibiotic.”
“If it’s only a clinical issue, I would ask the doctor,” one Haredi participant said. “If the issue is clinical and halakhic, I would ask the doctor and the rabbi.”
Rabbis have the final word
Many indicated that they talk to the doctor first, and then bring the doctor’s report to the rabbi. “Most of our participants indicated that whenever tension between doctors and rabbis arises, rabbis have the final word and people are willing to sacrifice themselves to be accepted into the club,” the researchers wrote.
In addition to viewing participation in Haredi communities as “self-sacrifice” in a club, the researchers wrote about ultra-Orthodox Jews seeking rabbinic advice about health matters as a “market.”
“This market, like any other, has mechanisms that distinguish between rich and poor and between the advantaged and the disadvantaged,” they noted.
“We maintain that those who seek gold-card membership in the club can achieve it by embracing the sacrifice of accepting the strictest opinions,” they added. “Those who have abundant capital can shop around for a decision that will provide them with an acceptable choice and leave their gold membership intact. Those with less capital may have to sacrifice more for the same level of membership.”
When a rabbi and a doctor see a health issue differently, “one of them must be wrong,” the researchers write.
“When we put this question to the focus groups, all agreed that the rabbi should have the last word and that they would listen to him. They were convinced that the rabbi was always right,” the researchers write.
“If there’s a disagreement, obviously someone’s wrong,” one participant said. “So, we take it for granted that it’s the doctor’s mistake.”
The researchers noted a range of rabbinic responses even in a community that outsiders often view as monolithic.
One participant’s rabbi told her to drive her injured child to a more professional, secular hospital that was further away on a Friday, thus necessitating that she and her child stay at the hospital over Shabbat. Another participant said the opposite—that her rabbi told her to go to the local Orthodox hospital on a Friday, even though the care was not as good there.
“Indeed, her daughter received suboptimal care,” the researchers wrote.
Many participants told the researchers that they think doctors can do more to understand their community and its values.
“You should teach them what is allowed and what is prohibited according to the halakha,” one participant said of doctors.
Another said that male doctors should know that even if they are friendly with secular female patients, they should not act the same way with Haredi women. “In our community, it puts the women under stress,” the male participant said. “In our community, a woman is not allowed to laugh with a doctor. They need to take a course, have some training, on how to deal with our community.”
The researchers also found, somewhat surprisingly, that Haredi men talked freely about female bodies and vice versa when addressing halachic issues related to medical care.
“The outraged feminist reader may envision a suffering woman waiting for the rabbi’s answer to the doctor’s question as mediated by the husband,” the researchers wrote. “Among the ultra-Orthodox, however, this process is greeted with appreciation.”
