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to tell her husband what he indeed told him, the divorce is in- liminary testing to determine which treatment is best for this patient,
valid; but if she did not tell the physician to say so, the divorce are we obligated according to halachah to fire the dentist from his
is valid. So, we deduce from his words that if the physician did work and to revoke his medical license?
not receive a bribe, and did not say what he did because of the Is it permissible according to Torah law to publicize the dentist’s
woman’s request, the divorce is valid in spite of the fact that at name?
the end she recovered.
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And from here we learn for our case, that if the physician was not 1 AnsweR #1
careful, but made his comments without looking into the matter,
the divorce is valid, because it was up to the husband to investigate We sent this question to Dr. Zlochower for his opinion and his an-
whether or not the words of the physician were correct. And if he swer follows:
accepted them as-is, we see that his wife is not beloved to him enough To the honorable Rav…. shlit”a
to investigate. On the basis of the possibility that the physician may You asked about the dangers of dental treatments. I discussed this
have been correct in what he is saying, he went ahead and divorced with Dr. Shlomo Kalderon, Director of the Department of Mouth
her. and Jaw at Beilinson Hospital, and we came to the following conclu-
The Divrei Malkiel wrote (point #4, above) that when it became sions:
known that the woman had conspired with the physician in order to A dentist is obligated to know the medical history of his patients.
extract a divorce from her husband, the husband said in the presence Therefore, before starting the treatment on a new patient, the patient
of the rav, that he divorced her willingly and is not sorry about the should be asked to fill out a medical history form informing the den-
divorce at all. Based on this, the Divrei Malkiel wanted to validate the tist of any possible issues.
divorce. There are certain medical conditions that require extra care during
My brother-in-law, Rav Chaim Kanievsky shlit”a, said that were the patient’s dental treatment, or even limiting the extent of the den-
it not for the words of the Divrei Malkiel one could explain the hus- tal treatment. Some examples are:
band’s words differently. There is room to suspect that the husband One of the illnesses of the respiratory passages is asthma. Injecting
said what he said not because it was true but because he did not want local anesthesia that contains adrenaline can prevent an asthma attack
to appear as a fool and a simpleton, but in the depths of his heart he during the treatment. On the other hand, if the patient is suffering
would not have wanted to divorce her had he known that the words from an obstructive lung disease such as fluid (edema) in the lungs,
of the physician were a result of bribery or deception. or pulmonary insufficiency, one should avoid using a local anesthetic
However, it’s possible that the Divrei Malkiel based his final ruling that contains adrenaline.
more on his next point (#5). He writes that even at the time of the Various cardiac conditions require special attention by the dentist.
divorce it was clear that the husband was divorcing her because of If the patient suffers from high blood pressure and is taking be-
the burden of her illness. Therefore he does not have to agree to the ta-blockers, such as Dralin, or in cases of arrhthymia, it is forbidden
divorce now, and as long as he does not protest it, the bill of divorce to inject a local anesthetic containing adrenaline. Patients who have
still exists and is valid. In order to nullify the divorce, he has to object abnormalities in the cardiac valves should take antibiotics before the
and say that he regrets the divorce - and he did not do so. dental treatment begins. Patients who are taking blood thinners to
We can still differentiate between our case and that of the Divrei prevent clots, such as Coumadin, Heparin or Sintrom, should stop

186 1 Medical-HalacHic Responsa of Rav ZilbeRstein Died during a dental procedure 2 155

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