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The Jewish community and the marginalised: religious principles (the sick, aids sufferers and drug addicts)
A. Piattelli - Anna Palagi
Judaism is a way of life which permeates every aspect of the Jew's existence. Each one of its moments is reflected in the precepts which regulate all activity and stimulate ethical and religious reflection. It is therefore understandable that among the numerous obligations laid upon Jews, especially in relation to society, considerable importance is given to those concerning bikkur cholim, visiting the sick.
The aim of such activity in the first place is to bring comfort, inspire courage and hope and so alleviate the suffering which arises out of a state of physical and psychological depression. In Judaism, however, such activity has also a religious value because it is understood to be an "imitation of God". According to the story in Genesis 18, the Eternal One himself visited Abraham when he was sick after he had been circumcised. The Talmud links this episode to the words of Exodus "You shall make known to them the way they must follow", explaining that it was the special task of Moses to emphasize the importance of visiting the sick. This was "a path to follow", "a mode of behaviour" for each one which would strengthen the bonds of kinship and unity among all. Maimonides describes the terms of the precept in his codification of Jewish Law Yad Ha/Chazzaka as follows: "It is a positive precept of Rabbinic ordinance to visit the sick... insofar as it is an act of kindness and mercy it is impossible to measure its merit; it is part of the biblical principle 'Thou shalt love thy neighbour as thyself'. Whatever you would like done to yourself, do likewise to your neighbour."
The Talmud records "It happened that one of Rabbi Akiba's students fell sick. Contrary to the practice of the other masters, Rabbi Akiba went to visit him. Because (the master) honoured him in this way and took advantage of the visit to supply his needs and put his affairs in order, the student got better. In fact the sick man cried out: 'My master, you have restored me to life'. Then Rabbi Akiba laid down his teaching: 'Whoever does not visit the sick, it is as if he commits a murder."
The visit is a form of honour and respect and must be understood as such by the sick person. it should make a real and sincere contribution to counteracting the psychological and social marginalisation of the sick, helping their reinsertion into society with the dignity and honour that is their due. It should also be a means of comfort and support which can raise the sick out of their painful and suffering condition and prevent a later relapse. Jewish literature insists very much on normal, warm, human relationships which must be established between the visitor and the invalid, avoiding the creation of a tense or dramatic atmosphere. The visit should also include practical services which restore familiar comfortable conditions to the sick and alleviate the disruption caused to their life-style.
All that has been said so far concerns attitudes and behaviour to be adopted towards the sick in general according to Jewish teaching. But when the sickness is not understood simply as a "state" of health, but is related to the behaviour of the sick person, the difficult problem of the relation between sin and sickness arises. Today this problem is posed in a disconcerting way by the widespread existence of AIDS: the situations most exposed to AIDS are in fact largely due to behaviour related to homosexuality, sexual promiscuity, the use of hard drugs, which are practices which Judaism judges with more or less severity. The sensitivity of the problem and its implications can lead to the temptation to make moral judgments and give interpretations based on cause and effect in the context of sin and sickness (this relationship occupies a prominent place in rabbinic thought).
Although this is not the place for an in-depth discussion of difficult problems which also involve the role of the doctor and the use of medicine, it seems useful to mention the opinion expressed by Rabbi Riccardo Di Segni in an article "To Heal is a Divine Act". (R.S. Di Segni (Teveth 5748-1988) in Torath Chajim – Quaderni cli attualtteebraica 11` 12).) Basically, the existence of a possible relationship between sin and sickness must not interfere at the practical level, with scientific research, therapeutic treatment and the wider area of social solidarity. According to Judaism, the fact that someone suffers does not justify their condemnation and marginalisation. The sickness is suffering enough and no-one has the right to add to the burden by pseudo-moral preaching, but is rather under an obligation to do something to help."
The Response of the Jewish Community in Rome
Before examining the problem of illnesses which isolate the patient, it seems important to note that the Servizio Sociale is the official body set up by the Jewish community to respond to the needs and problems of those referred to it and of the people the Servizio Sociale identifies itself. Thus when describing the means employed by the community to meet the problematic situations that arise it is primarily a matter of the activities and work of this Service.
AIDS is still "unknown" in the Jewish community in Rome. The phenomenon of drug addiction surfaced in the Romano-Jewish community ten to fifteen years later than in society at large, so the possibility cannot be excluded that AIDS will sooner or later make an equally dramatic appearance. Further, it is possible that AIDS has already claimed its first victims, but these could be limited to a few isolated cases, around which families have built a protective wall.
The Jewish Community in Rome does not have a medical centre of its own to deal with the prevention and diagnosis of illness and to the care of the sick. Consequently families and individuals interested in the problem of AIDS do not have a point of reference within the Community and are forced to turn to the public health service. This lack of health facilities is the reason why there is no information on the subject. On the other hand, for the reasons given above, the Servizio Sociale of the Jewish community is potentially the most suitable point of reference for those suffering from AIDS, even if at present it lacks specialised personnel and structures. In fact, the social workers would be able to direct those interested to the specialised centres, follow them through the different states of the illness, help their re-entry into society, give other members of their families psychological support and make available to them the comforts of religion.
In spite of the availability of the Servizio Sociale, the problem of contacting the person with AIDS remains. In the concrete the biggest difficulty is to overcome the stigma attached to the illness and the fear of its consequences. Only when this has been done will the problem be shared with the community.
Over the years other maladies which isolate and marginalise in day-to-day living and relationships have received attention and professional help from the Servizio Sociale workers. For example mental illness and, to a lesser degree, drug addiction. it is not within our competence to deal with their etiology, but it is in our interest to bring out certain aspects which can help towards an understanding of the relationship between the individual, sickness and the community.
Whatever the nature and gravity of the condition or the age, sex and nationality of the patient, there is one common factor with regard to mental illness; even after decades of hospitalisation, all keep a sense of their Jewish identity and their links with the community. The ways in which these ties are expressed differ according to the condition of the people concerned; for those who live independently or with their own families the links are maintained and take on their particular character from the fact of spending the day "physically" in a Jewish environment, not always peaceful, with the other people of the locality.
The religious ties are obviously more tenuous for those whose unhappy lot it is to be confined to a psychiatric hospital for life. An example can illustrate this point. An elderly foreign lady, admitted to a psychiatric hospital in 1954 with a manic-depressive psychosis, heavily sedated and also blind, used to remind the social worker who visited her of the approach and closure of Jewish festivals, the only slight internal contact with reality that remained to her.
The community as a collectivity of individuals, generally succeeds in coping with the psychological problems of some of its members as long as these are not too great and the burden is shared by many. In fact individuals have responded with solidarity towards those who are institutionalised which complements the community ambiance. Nevertheless there is a different kind of relationship between the community and the mentally ill and the community and drug addicts. If in general mentally sick people are accepted as they are, the attitude is different towards drug addicts who try to hide their condition and present a self-image which is very different from the reality. Experience teaches that the statements and intentions of drug addicts often remain merely words while their behaviour is offensive precisely because it tears apart the fabric of the society in which they live. The ambiguity of their life-style inevitably produces feelings of distrust, if not fear, in the community at large which tend to lead to rejection rather than acceptance.
Such a factor is crucial to the subject under discussion. The hypothesis can reasonably be put forward that similar feelings could be produced with regard to AIDS. In the case of drug addiction, the Servizio Sociale has chosen to work through the family, establishing an indirect relationship with the persons in need, offering them the social, psychological and economic help best adapted to overcoming their specific problem. If the problem arises with respect to AIDS, the community attitude would need to be similar, directing its own work either towards the individual in need or their family.
In general, however, there remains the question of how to generate at community level the feelings of acceptance and solidarity Judaism demands for those who suffer, whatever the cause of the suffering may be.
* Rabbi Abramo PlateIli is one of the Rabbis of the Tempio Maggiore, Rome's principal Synagogue. He is a friend and close collaborator of the Sidic Centre.
* Dolt. Anna Palagi is an Assistente Socials, at the Social Services Centre of the Jewish Community in Rome which was established in 1E485.
