Projections about COVID-19’s impact on the nation’s health, economic, and emotional wellbeing evolve daily as the virus spreads through large cities and small towns. Last month, the White House coronavirus coordinator predicted that the pandemic could kill as many as 200,000 Americans.
The probable needs of healthcare providers as well as of the overarching healthcare system in anticipation of the unique and tragic events that are approaching the Tidewater community caused by the COVID-19 pandemic, prompted Jordan Asher, MD, senior vice president and chief physician executive at Sentara Healthcare, to ask
Alan Wagner, MD, about the Jewish response to autopsy during this unique circumstance.
Wagner, an ophthalmologist, and an active member of Tidewater’s Jewish community, set out to find the answer. Along the way, he enlisted the assistance of Harry Graber, immediate past executive vice president of United Jewish Federation of Tidewater.
Jewish communities throughout the world are grappling with a host of concerns as they pertain to COVID-19’s impact on halakhic principles, Jewish law, and customs, including burial on Shabbat and having a minyan to say Kaddish.
As a Jewish people, “we are always concerned about the quality of life, but we are also concerned about the quality of death,” says Wagner.
“We must have a clear understanding of how our people, traditions, and laws deal with delays in burial, need for post mortem fluid sampling, and autopsy,” says Wagner.
During this time of a public health care crisis, Wagner and Graber asked, “what are the guidelines and circumstances under which a deceased Jewish person may undergo an autopsy or have fluids drawn without the authorizing party being in violation of Jewish law?”
“The rabbis all agreed that in a healthcare emergency such as the one that currently exists where and when the performance of an autopsy on a deceased Jewish patient is done for the specific purpose of benefitting the health of human life, that it is allowed,” says Graber.
Chabbad’s Rabbi Aaron Margolin’s immediate response was that an autopsy is not generally allowed. But, he says, in unusual circumstances, it’s okay if it is necessary to wait to have a funeral, and an autopsy is allowable if it can save another life. There must be, he says, “an identifiable purpose” for performing the autopsy.
According to the Reform Movement, if a life is being saved, performing an autopsy is allowed and doesn’t require further discussion. “Saving a life is of utmost importance,” says Rabbi Rosalin Mandelberg of Ohef Sholom Temple.
“It is absolutely justified, and the responsible thing to do…especially during a pandemic,” says Mandelberg. She also notes that the patient (or the family, if the patient is unable to decide) should be consulted.
On the subject of burial, B’nai Israel’s Rabbi Sender Haber says, “If in this unusual situation people have to wait to get in to a hospital to be cared for, it’s reasonable to understand that it will take some extra time for them to be buried.”
For post mortem bodily fluid sampling or autopsy, Haber makes clear that there has to be concrete value, a tangible benefit, a clear case to be made “that any and all similar activities will directly help others.” Preventing further loss of life or injury to others being the primary principle to meet. An autopsy should not be performed if it is solely for “accounting purposes,” in other words, not just to add to a count of those with a disease or ailment.
“Where possible,” adds Haber, “a rabbi should be consulted on a specific case, rather than relying on general guidelines.”
“It speaks well of our Jewish community that, at a time of bruising polarization, we are able to create a consensus statement with the good of the entire community at the center of our joint focus,” says Rabbi Michael Panitz of Temple Israel.
“The rabbis are with us,” says Wagner. “Our community’s response to the current unpleasantness is united and thoughtful.”