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A taxi driver claims he is not an epileptic
1 Question
A man fainted in the street. A physician was summoned, and he
recognized the classic convulsions of epilepsy. The doctor remained
on site for a few moments, as required, and left once the patient had
regained consciousness. Afterwards, he was shocked to see the recov-
ered man enter a taxi on the next street and drive it.
“You are not qualified to drive. Why are you driving?” he asked the
man.
“I do not know what you are talking about,” replied the taxi driver.
“I was never sick with epilepsy.”
“Why, just a few minutes ago you had a seizure and I treated you,”
replied the doctor.
“You must be talking about a man who resembles me,” countered
the driver. “You are not the first to mistake me for another.”
The physician wants to know if he should report to the police that
an irresponsible person is endangering himself and the public by
driving despite the possibility of his having an epileptic seizure while
on the road, or should he believe the driver’s claim that he is not the
patient, although it seems far-fetched?
1 AnsweR
It seems to me that even if the driver lied, the physician is exempt from
dealing with this. There is no clear possibility of danger involved. It is
possible that he will not have a seizure while driving, and that even if
he will, he will feel it coming on and stop. Even if he loses control of
the steering wheel, who says this will cause a tragedy?
The matter resembles what the Aruch Hashulchan describes (Or-
ach Chayim 316:22). He writes as follows:
It is permissible to kill a wild dog on Shabbos because it
poses a clear danger. When it is unclear if it is really a wild
334 1 Medical-HalacHic Responsa of Rav ZilbeRstein
cessful, since the man’s veins were hidden. After the fifth attempt,
the patient cried out that he was not prepared to be pricked with a
needle anymore and he did not care if he would not be healed. Trying
to calm him, the physician swore that he would not prick him more
than 15 times. The patient calmed down. After the 15 attempt, the
th
physician had still not succeeded in finding a vein. He did not know if
he was allowed to try again or was prohibited from violating his oath.
1 AnsweR
It seems that the physician’s oath is not valid, since he swore to bypass
a mitzvah, as explained in the Shulchan Aruch (Yoreh Deah #239:4).
The physician is obligated to heal the patient, and creating an opening
through which to administer the medication is part of that obligation.
The difficulty in finding a vein in elderly people is a known problem,
so the insertion of the needle is also viewed as part of the treatment.
Perhaps we can rule that the oath is valid based on the law of “in-
clusiveness.” (Rama, ibid., 8) Had he succeeded in his seventh attempt,
then there is no mitzvah to make additional insertions, and the oath
would apply since those insertions would have no medical value. In
that case, the oath would be valid by “inclusiveness,” and apply even to
the necessary attempts at insertion. Perhaps it depends on the exact
wording of the oath. Did he swear “not to prick him more than 15
times,” or did he say “I will not try more than 15 times,” in which case
the oath would only apply to those medically necessary attempts?
This requires further study.
If we decide that the oath is valid, then it cannot be nullified on the
basis that it was made under coercion since the physician had to act
in order to calm the patient (as we stated above regarding the cancer
patient). In this case, the physician was not compelled to swear, since
there are other physicians in the department and this physician is not
obligated to treat this patient specifically. In the former case, the ill
man was a regular patient of this particular physician. He knew that
only this physician understood his condition and could answer his
questions. The physician could not escape the situation by referring
Is a doctor obligated to report deficient vision? 2 327