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מכון שלזינגר לחקר הרפואה על פי ההלכה

איסור והיתר בנוגע לטיפול בנפטר ע"י אחות

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23 באוקטובר 2018

הרב המשיב: פרופ' א.ס. אברהם

שאלה:

I am currently preparing an in-service presentation for fellow nurses in the oncology department of the Children's Hospital of Philadelphia. As a frum nurse, I hope to address end-of-life issues that arise on a floor that regularly, r"l, has Orthodox patients and families. Specifically, I am looking for sources/halachos regarding the procedures/post-mortem care that can/cannot be done by the nurses prior to the arrival of the chevra kadisha.

Additionally, any information regarding sensitising and informing non-Jewish nurses about the Shabbat and Kashrut needs that inevitably arise would be appreciated.

Thank you very much for your help.

תשובה:

I'm afraid I am not aware of sources to your question. Regarding what nurses do PM:

1. All contact with the niftar must be with the utmost reverence, kavod and gentleness as one would deal with a sefer Torah. All the following should be done by Jews.

2. It is customary to wait some 20 minutes after death has been confirmed before proceeding.

3. The eyes are closed, the limbs straightened, making sure that the hands and legs are on the bed and the jaw tied shut to prevent it from opening.

4. Remove all external attachments from the body – such as IV and urinary catheters, drains, etc.

5. The body is washed clean of blood stains and excreta. If the patient died of an external hemorrhage the blood is kept aside for burial with him. Orifices are closed with cotton wool.

6. The body is then completely covered and the drapes tied to prevent them from opening, ready for transportation to the special room for metim to await the arrival of the chevra kadisha.

7. The met should be transported to the appropriate room by a Jew. If not, a non-Jew may transport him there but a Jew (attendant or a family member) should accompany him for kavod of the niftar.

On Shabbat and Yom Tov the met is muktseh. Therefore:

1. The clothes are removed by pulling them off without lifting any part of the body in order to do so.

2. Appliances may be removed in a similar fashion. The body is washed to remove blood stains and excreta but one must be most careful not to squeeze any cloth that is used for the purpose; therefore this must be done using gloves (plastic or rubber) only or with a plastic cloth.

3. The eyes may be closed. The orifices may only be closed if cotton wool plugs are available or have been have been prepared before Shabbat.

4. The jaw may only be tied (using a knot and bow and not a double knot) to prevent it opening further but may not be closed if already open. The bandage used for the purpose may not be cut to length nor may it be cut lengthwise to allow it to be knotted. If this has not been prepared before Shabbat, the whole bandage must be used and the end tucked in. If a safety pin is used it should only be put in once to attach the end of the bandage to one of the folds but not in and back in again.

5. The met should be transported to the appropriate room by a Jew, if this is possible without chillul Shabbat. If not, a non-Jew may transport him there but where possible a Jew (attendant or a family member) should accompany him for kavod of the niftar. If the non-Jew uses an elevator the Jew may accompany him taking care not to open or shut the doors or to activate the elevator.

With best wishes

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