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IS A PHYSICIAN OBLIGATED
TO PUBLICIZE THAT A
63 PATIENT IS MALINGERING?
1 Question
If a physician discovers that a patient is receiving payment or favors
from public or private institutions by feigning illness or exaggerating
his limitations, what is he to do?
1 AnsweR
It is a basic rule in medical practice that no information that concerns
the patient is revealed. This decree was enacted for the benefit of the
patient; it enables him to speak freely without fear that his secrets
will be publicized. As a result, the physician can prescribe the proper
remedy for the illness.
This law also allows for the imposter to speak freely with the phy-
sician, knowing that the latter will not reveal anything (except in cases
of murder).
This is not the way of the Torah, nor that of a Jewish physician
whose values are based on Torah principles. The Zohar (Part 3, p.
299a) refers to the greatest and wisest of physicians, Kartana, who
writes that a physician is obligated to try to heal the patient and to
find a remedy for his spiritual as well as physical illnesses, because
they are interrelated.
This is the Torah way. The doctor is obligated to make the patient
aware, in the case of our question, that he is violating two prohibitions:
338 1 Medical-HalacHic Responsa of Rav ZilbeRstein
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him, in which case he cannot be released from the oath without his #
fellowman’s consent.
The Malbim also explains that Rachav’s words “And now” implied
that at this point in time, the obligation to “let no person live” did not
yet apply, as the nation had not yet crossed the Yarden. At this point,
they were still allowed to accept proselytes from the seven nations.
Thus, this would be a valid oath since it would not violate a current
commandment of the Torah. (See Tosfos Sotah 35b s.v. lerabos.)
According to the view of my father-in-law, Rav Y. S. Elyashiv, one
can perhaps add another intent to the word “now.” Since Rachav could
have given them over to die at the hands of the King of Yericho, and
then they would not have been able to perform the mitzvah of “Do not
leave anyone alive” anyway, the oath actually saved them and enabled
them to fulfill the mitzvah of “do not leave anyone alive” with the rest
of the seven nations [who occupied the land of Israel]. So certainly,
the oath should be valid and binding.
The Taz (Yoreh Deah, there, 30, in the name of the Beis Yosef) wrties 20818_efi-ab - 20818_efi-ab | 11 - A | 18-08-20 | 13:29:04 | SR:-- | Magenta #20818_efi-ab - 20818_efi-ab | 11 - A | 18-08-20 | 13:29:04 | SR:-- | Yellow
that if a worker was assigned a job by an employer, and because of this
he swore to him, it is considered an oath made because of a favor, and
one cannot release oneself from it. If so, when the physician receives
payment for treatment, it is viewed as if he swore to the patient be-
cause of a favor. But if he receives no fee or if he receives a salary from
the hospital rather than the patient, he can release himself from his
oath if the beis din decides it is the correct thing to do.
It seems to me that in a case of pikuach nefesh, one can release the
physician from his oath even if he gets paid. Then he would not have
to violate his oath for pikuach nefesh. Although normally there is no
way to release a person from a vow made in exchange for a favor (ac-
cording to the Taz), in the case of pikuach nefesh, it can be nullified.
Since in either case, the physician is permitted to violate his oath
because of pikuach nefesh, there is no benefit to the patient from the
oath.
Furthermore, we learned in the Rama (ibid.) that some poskim say
that for a mitzvah one is allowed, lechatchilah, to release person from
a vow he made. Therefore, in a case of pikuach nefesh, the physician
Is a doctor obligated to report deficient vision? 2 323