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We can add to the words of the Chelkas Yaakov, that if a physician 11 hand, if at the moment there is no danger present, but one fears future # 20818_efi-ab - 20818_efi-ab | 11 - A | 18-08-20 | 13:29:04 | SR:-- | Magenta 20818_efi-
has made the physician’s oath to safeguard patient confidentiality, he danger, then one does go according to the majority. One can therefore
is prohibited from revealing the medical knowledge that he has. Even go down to the sea or out to the desert without fearing the possibility
though the Rama (Yoreh Deah 239:7) rules that if one swears not to of danger. This is not a violation of “And you shall watch over your
reveal to his fellow something that may save him from a loss, this is lives very well,” because at present there is no danger before him, and
an oath to nullify a mitzvah, and is not valid - nonetheless, it is best to therefore he can go according to the majority (i.e., most often no harm
find a way to release the person from his oath. This law only applies occurs to one who goes to the beach or the desert). This idea explains
to someone who swore not to reveal the secret to the one specific the mishnah in Berachos (33a): “Even if a snake is wound around his
person whom it can save from a loss. If he swore not to reveal the ankle, he should not interrupt his prayer.” Both the Rambam as well as
secret to anybody, the oath is valid, since an oath is valid if it includes Rabbi Ovadiah Bertinoro explain that since in most cases the snake
things that are permitted, together with things that are prohibited, as does not bite, one should not stop one’s prayers. This is difficult to
explained in Shulchan Aruch (Yoreh Deah #236:8) and in the Mishnah understand, since we do not go according to the majority in pikuach
Berurah (#485:1). Therefore, the physician has to annul his oath of nefesh. In light of the above, however, we can explain that since the
confidentiality before revealing the medical information that he has. danger is not presently before us, we do go according to the majority.
Dr. Avraham Pinchas shlita pointed out, regarding the Chelkas (See another example brought down there.)
Yaakov, that if physicians would breach their patient’s confidential- According to this, if the seizures occur only once in a long while,
ity, people would be afraid to tell their doctors the details of their such as once a year, one does not need to worry that he will have a 20818_efi-ab - 20818_efi-ab | 11 - A | 18-08-20 | 13:29:04 | SR:--
symptoms and thus they would not receive the appropriate care. They seizure while driving, because most of the day he is not driving. Even
might even receive treatment that is harmful to them as a result, lead- if he has a seizure while driving, it is not certain that it will cause
ing to a possibility of pikuach nefesh. Therefore, physicians should not an accident. If so, the physician can then withhold the information
reveal their patients’ secrets. from the authorities so as not to impinge on his patient’s livelihood.
Even if this is correct, in any event it only relates to the situation This is the truth. Were it not so, a patient with epilepsy would not be
addressed by the Chelkas Yaakov, where if the physicians reveal the allowed to swim in the ocean or to walk on the sidewalk, lest he fall
groom’s illness, they may cause pikuach nefesh, but if they remain and endanger himself.
silent, the bride’s life is not in danger, although she may become a Nonetheless, if the driver himself would seek out our advice, we
widow. On the other hand, if a driver suffers from epilepsy, then if would advise him not to drive, since he has the responsibility to avoid
the physician is silent it will cause danger. The driver is liable to kill being trapped into the severe violation of “Do not kill.” Regarding the
himself and others, and therefore it would seem that the physician is physician, however, for whom it is a mitzvah of “Do not stand idly by
required to reveal the danger to the authorities. the blood of your fellowman,” this is not a situation that will clearly
However the Binyan Tziyon (#137) suggests that the known prin- cause damage like an open pit in a public thoroughfare, the danger of
ciple that “we do not go according to the majority when it comes to which everyone is obligated to remove.
pikuach nefesh” only applies if the danger to life is in front of us. For I heard from the gaon Rav Shlomo Berman, zt”l, Rosh Yeshivas
example, if someone is trapped under the rubble of a collapsed build- Ponovez, that Dr. Heinman - an expert on lung diseases - told him
ing, then even if the chances that he is still alive are very small, one is that the Brisker Rav, Rav Yitzchak Ze’ev zt”l, once sent him a mes-
nevertheless obligated to desecrate Shabbos to save him. On the other sage, informing him that “I ruled that a man with tuberculosis eat

330 1 Medical-HalacHic Responsa of Rav ZilbeRstein Driver has epilepsy 2 331