Maryland Medical Examiner Meets With Frum Advocates: Autopsy Concerns Allayed Amid Pledge of Cooperation


marylandsmalllWhen it comes to enlisting government agencies’ sensitivity to Orthodox Jewish concerns and cooperation with Orthodox advocates, the proverbial ounce of prevention is often worth many pounds of cure. A case in point was a pair of meetings in December at the Office of the Chief Medical Examiner for the State of Maryland between the CME, Dr. David Fowler, and a delegation of Orthodox Jewish advocates and rabbis. The meeting, the brainchild of Rabbi Ariel Sadwin, director of the Agudath Israel of Maryland office and Mr. Dovid Hess, noted Baltimore askan, was intended as an opportunity to review and discuss autopsy protocols and procedures, and Jewish religious sensitivities to treatment of the deceased.In a number of instances, explains Rabbi Sadwin, members of Jewish communities have passed away in a manner that left doubt about the cause of the death or were the victims of a homicide. In such situations, understandably, law enforcement authorities need to determine the facts, and they employ a group of medical professionals to conduct examinations and, if deemed necessary, autopsies. In cases where the deceased was an observant Jew, or was reasonably assumed to have wanted his/her body treated in accordance with Jewish law (or whose next-of-kin express such concern), local rabbis and Jewish advocates have had to scramble to find the right person in the hierarchy of various medical examiners’ offices to intervene on behalf of the deceased.

In some cases, autopsies were successfully avoided, or limited. In others, there was less success. In all cases, though, unnecessary pain and frustration was created by the fact that there weren’t already-opened channels of communication between authorities and Orthodox community representatives and established sensitivity to the concerns of Jewish religious law, or halacha.

It was determination to create precisely such channels and sensitivity that impelled Rabbi Sadwin to request a meeting with Dr. Fowler, a request facilitated by Dr. Morton Rapoport, a member of Baltimore’s Orthodox community and the former CEO of the University of Maryland Medical System.

Rabbi Ariel Sadwin, director of Agudath Israel of Maryland, and Dr. David Fowler, Chief Medical Examiner of Maryland, review consruction plans for Maryland’s new Medical Examiner Facility.
Rabbi Ariel Sadwin, director of Agudath Israel of Maryland, and Dr. David Fowler, Chief Medical Examiner of Maryland, review consruction plans for Maryland’s new Medical Examiner Facility.

Helpful in arranging the meeting and establishing its agenda were Dr. Michael Elman, Mr. Aharon Gibber, Esq., and Rabbi Hillel Tendler, Esq.

The first meeting took place on December 8 in the Medical Examiner’s office, on the Baltimore campus of the University of Maryland, which is home to the university’s medical school. Besides Rabbi Sadwin, representing the local Orthodox community were Rabbi Moshe Heinemann, Rav of Agudath Israel Congregation of Baltimore; Mr. Ira Levinson and his son Matt, of the Sol Levinson Funeral Home; and Mr. Avrohom D. Sauer, the president of Hatzolah of Baltimore. Joining the delegation as well was Rabbi A.D. Motzen, director of Agudath Israel’s Ohio Region, who has considerable national experience with post mortem matters. In addition to Dr. Fowler, Mr. Mike Eagle, director of communications at the Office of the Chief Medical Examiner, was also present.

First on the agenda was familiarizing Dr. Fowler, and through him his staff, with the unique post-mortem concerns of the Orthodox Jewish community.

“In keeping with the Jewish ideal of kovod hameis, or ‘honor for the deceased’,” explains Rabbi Sadwin, “we always seek to avoid, or at least limit to the degree possible, any invasive procedures.” Toward that end, he notes, he wanted to talk about the use of “virtual autopsies,” where the body is scanned by CT or MRI, where the cause of death can sometimes be determined without violating the body’s integrity. While such technology is not widely utilized by medical examiners at present, Dr. Fowler has used the technology, and Rabbis Sadwin and Motzen considered it prudent to stress the benefits of its more widespread use.

Whether or not an autopsy is performed, though, other halachic concerns include the request that a shomer, or “guardian,” be within sight of the deceased until burial; and that the body be released without undue delay, so that the burial-preparation, or taharah, process can commence quickly. According to Rabbi Sadwin, Dr. Fowler was “unusually empathetic” and pledged to do everything in his power to accommodate Jewish religious concerns.

The Chief Medical Examiner explained that a new medical examiner facility is being constructed, scheduled for completion in 2010, which will provide increased capacity to facilitate the presence of a shomer. He was also enthusiastic about establishing a means of direct communication between his office and the Jewish community, a change that is expected to significantly streamline interaction both before any examination or autopsy and afterward, with regard to the expeditious release of remains. The CME made a point of informing his guests that they should not hesitate to contact the forensic examiner any time of day or night with regard to a case in which they have any concerns.

A follow-up meeting between Rabbi Sadwin and Dr. Fowler on December 24 solidified the expression of mutual cooperation that characterized the first interaction. The CME requested a digital version of an expanded procedure protocol that had been compiled by the earlier Agudath Israel delegation in conjunction with Rabbi Elchonon Zohn, director of the Chevra Kadisha of Queens, New York, and expressed his intention to incorporate it into the state’s official autopsy manual. Rabbi Sadwin floated the idea of a training session for the medical examiner’s pathology staff to familiarize its members with Jewish concerns and the procedure protocol. Dr. Fowler enthusiastically endorsed the proposal.

Rabbi Sadwin was deeply impressed with what he described as Dr. Fowler’s “good will and clear determination to be of help.”

“While we hope to never need his services,” it is reassuring to know that if, G-d forbid, we do, there will be someone on the other end of the line who we know cares about our concerns.”

{Elisha Newscenter}