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letter containing details of a child’s illness, there are two possible
45 PUBLIC CRITICISM OF A
MEDICAL OMISSION
1 Questions
I am a veteran accredited nurse and midwife in a hospital. The director
of the hospital appointed me to assist in supervising and improving
the performance of the midwifery staff and the nurses.
As part of my job, I am to conduct a monthly discussion with all
the nurses and midwives in the presence of the director of the depart-
ment. In order for the discussion to be to the point and beneficial,
I need to review all the records, find deficiencies, point them out
publicly, and explain where the nurse made a mistake. Of course that
nurse or midwife will be shamed publicly as a result. Am I permitted
to do this since the discussion is purposeful? Perhaps I am obligated
to refuse, even if it means that I will be fired from my job, in order to
refrain from embarrassing the midwife in public?
Below are three cases of nurses’ shortcomings that were found in
the medical records and would be (or were) discussed at the general
meeting, without mentioning the names of the people involved so as
not to speak lashon haa or embarrass anybody.
An OCT is a test done by the midwife to determine the viability
of the fetus during contractions. During the test, the woman is given
medication by IV to bring on labor. Once, a midwife gave a pregnant
woman the medication and then was called to another birthing wom-
an in a nearby room, forgetting the first woman momentarily. When
196 1 Medical-HalacHic Responsa of Rav ZilbeRstein
# 20818
answers:
1. Halachically, parents are guardians and they may be permitted
to waive their children’s rights on their behalf.
2. There is a difference between dictating a negative report about
a fledgling physician and writing up a discharge letter for a sick
child. In the first case, the secretary becomes aware of shame-
ful deficiencies and character traits. Since there is no purpose
in her knowing these things, the director should write these
reports on his own. In the second case there is truthfully no
shame involved if it was decreed on high that a child suffer from
a specific illness. This is something over which the child has no
control. Therefore, it is not considered lashon hara even though
the knowledge will cause people to pity him.
On the other hand, perhaps it can be considered lashon hara since
knowledge of his illness may affect his shidduchim. Some illnesses are
not considered to be a “serious blemish,” and one need not reveal them
when searching for a mate. If the secretary who wrote the summary
reveals the child’s illness to a potential mate, thereby hurting him, this
is certainly viewed as lashon hara.
Nonetheless, I do not believe we have to consider such a remote
possibility. The secretary will be afraid to reveal the child’s illness
because she may be fired. Therefore, I believe that it is permissible for
the secretary to type the summary of the child’s illness.
The exception would be a respectable and responsible person with
AIDS. As a responsible person, he will certainly be careful not to
infect others. When he needs dental or blood work, he will inform
the nurse and the physician. As I have heard from physicians, if those
treating him are careful, there is no reason to stay away from him. But
generally, people would tend to distance themselves from him and not
allow their children to learn in the same school as an infected child,
or to become friendly with him. Therefore, it is forbidden for a doctor
to dictate a medical report on AIDS to the secretary, if the patient is
intelligent and responsible. The secretary may relay the information
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