Involvement of Rabbinic and communal authorities in decision-making by haredi Jews in the UK with breast cancer: An interpretative phenomenological analysis
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Abstract
This paper examines how Rabbinic and communal authorities participated in treatment
decisions made by a group of strictly orthodox haredi Jews with breast cancer living
in London. Semi-structured interviews were conducted with five haredi breast cancer
patients. The transcripts were analysed using interpretative phenomenological analysis.
Demographic and personal data were collected using structured questionnaires. All
participants sought Rabbinic involvement, with four seeking rulings concerning religious
rituals and treatment options. Participants' motivations were to ensure their actions
accorded with Jewish law and hence God's will. By delegating treatment decisions,
decision-making became easier and participants could avoid guilt and blame. They could
actively participate in the process by choosing which Rabbi to approach, by providing
personal information and by stating their preferences. Attitudes towards Rabbinic
involvement were occasionally conflicted. This was related to the understanding that
Rabbinic rulings were binding, and occasional doubts that their situation would be
correctly interpreted. Three participants consulted the community's 'culture broker'
for medical referrals and non-binding advice concerning treatment. Those who consulted
the culture broker had to transcend social norms restricting unnecessary contact between
men and women. Hence, some participants described talking to him as uncomfortable.
Other concerns related to confidentiality. By consulting Rabbinic authorities, haredi
cancer patients participated in a socially sanctioned method of decision-making continuous
with their religious values. Imposing meaning on their illness in this way may be
associated with positive psychological adjustment. Rabbinic and communal figures may
endorse therapeutic recommendations and make religious and cultural issues comprehensible
to clinicians, and as such healthcare practitioners may benefit from this involvement.