The Role of Faith in Medical Decision-Making

Abstract Background Ultra-Orthodox Israeli Jews face complex decisions when their doctors’ instructions contradict their rabbis’ advice. This study examines how their belief system affects their trust and decision-making in such situations, using socio-economic club theory and Gilligan’s listening guide. Methods Excerpts from 16 focus groups with 128 ultra-Orthodox Jews were analyzed to understand their perspectives on the relationship between doctors and rabbis. The socio-economic approach of Berman’s club theory was applied to explain their behavior, and Gilligan’s listening guide was used to analyze the focus group results. Results The strict behaviors in the relationships between doctors, rabbis, and patients function as social capital, raising the status of ultra-Orthodox Jews as members of an exclusive club. They balance critical health decisions with the social demand to obey religious leaders. However, listening to different voices (‘I,’ ‘we,’ and ‘they’) provides nuanced insights into their decisions, revealing dynamic changes in the community’s perceptions of the doctor-rabbi relationship and varying perspectives within the heterogeneous ultra-Orthodox community. Conclusions Combining Berman’s theory with Gilligan’s listening guide is an effective method for conducting in-depth qualitative research on sensitive issues with religiously strict groups. Understanding the belief systems underlying healthcare decisions is essential for providing culturally sensitive medical care to religious communities and training medical staff serving these communities. Key messages • Ultra-Orthodox Jews balance complex health decisions with social demands, revealing nuanced perspectives through strict doctor-rabbi relationships. • Combining theories and qualitative methods effectively studies sensitive issues in religious groups, informing culturally sensitive healthcare.