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What happens when medical protocols collide with Jewish values?

A rabbi looks at brain death, COVID quandaries and more in a new book about bioethics

In 2020, early in the COVID-19 pandemic, Jason Weiner found himself in a moral quandary. An elderly Holocaust survivor was in serious condition in Los Angeles’ Cedar-Sinai Medical Center, where Weiner serves as a chaplain. Due to pandemic public health restrictions, the man’s family couldn’t visit, but they called Weiner, saying the man had told him over the phone that he was extremely thirsty. Overburdened nurses weren’t able to check in on him, but a nurse told Weiner he could step in. Despite the risks of contagion, Weiner donned his personal protective gear and went into the room with a cup of water.

In his eagerness to drink, the man ended up coughing the water on Weiner. 

“I wasn’t wearing everything perfectly right yet, it was new, and I felt the spit on my skin,” Weiner told the Forward. “This is like the first two weeks after the hospital shut down. I’m like, ‘Oh my god, I’m gonna die.’”

The incident has stuck with Weiner, who holds a doctorate in clinical bioethics and is now the senior rabbi and director of the hospital’s spiritual care department. It raised a fundamental question that is at the core of bioethics: What do we owe to ourselves and others in the often ethically murky realm of modern health care?

A guidebook to help readers

In his new book Care and Covenant: A Jewish Bioethic of Responsibility, Weiner grapples with these foundational issues. When should a Jew tell a doctor not to attempt resuscitation on a loved one? Is universal health care or the lack of it ethical? Weiner does not provide easy answers to questions that often have no single solution. Rather, he lays out a guidebook of Jewish thought to help readers reach their own conclusions on the most pressing bioethics questions of today. 

For those working in health care, gray areas are part of the territory. Those involved are “not always looking for a resolution that’s just like, one is right and one is wrong, or you’re winning, you’re losing,” said Weiner. “A lot of times, we’re looking for compromise or trying to be good listeners.”

Rights vs. responsibilities

As Weiner writes, a Jewish approach to bioethics is often at odds with more secular takes. The latter is often more concerned with rights, or what a patient or doctor is owed, while the former deals more with responsibilities: what the health care provider or recipient owes to others. Through that framework, Weiner offers an approach to issues such as when and how health care providers can conscientiously object to providing some types of care, and reconciling the secular and Orthodox Jewish views of brain death. (Although brain death is legally almost universally recognized as the same as cardiorespiratory death, many Orthodox Jews maintain that death only takes place once the heart has stopped beating.)

“As a rabbi, I get asked lots of different types of questions and different issues that come up,” said Weiner. “These are what I felt were the issues that I was dealing with most frequently that I didn’t see a lot written about.” 

Along the way, Weiner drops interesting tidbits and anecdotes. In one chapter, he explores what a Jewish hospital’s obligations are to non-Jewish patients, while giving a brief history of the rise and fall of those institutions in America. (At one point, over 120 such hospitals existed across the country. Now, by some counts there may be as few as five.) 

Approaching controversial issues in a neutral way

Weiner’s main target audience for the book is health care providers, public health officials and others whose day jobs intersect with bioethics. But now that we’ve been through a global pandemic, where average people grappled with questions that affected not just their own health but that of the people around them, there’s broader interest in the topic. But one of Weiner’s challenges was how to approach these issues in a neutral way, given the conflicts among Americans over masking, vaccines and other protocols.

“That’s part of the reason for going to principles,” Weiner said. “Probably one of the most controversial chapters that I wrote was about universal health care. But even that, I was trying to write it in a way that didn’t sound like a Republican or a Democrat. Even though I think most people read that, like, ‘Oh, this was so liberal, he believes in universal health care,’ but I was trying to write in a way that was not politicized.”

Even on more mundane topics, like how to advocate for yourself and your beliefs in a medical context, Weiner hopes that his book could prove useful to Jews who find themselves navigating a system that can sometimes misunderstand their worldview. 

“The feedback that I’ve gotten from people who are not in health care has been they learned a lot from it, and that it helped them in terms of being able to advocate for their family members, or when they go to the hospital,” he said. “What I’m trying to do here is also apply Jewish law and Jewish values in ways that they haven’t necessarily been applied before.”

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