Page 136 - 20818_park-c_efi

20818_efi-ab - 20818_park-C_efi-ab | 5 - A | 18-08-20 | 13:46:24 | SR:-- | Cyan
20818_efi-ab - 20818_park-C_efi-ab | 5 - A | 18-08-20 | 13:46:24 | SR:-- | Black
#20818_efi-ab - 20818_park-C_efi-ab | 5 - A | 18-08-20 | 13:46:24 | SR:-- | Yellow
20818_efi-ab - 20818_park-C_efi-ab | 5 - A | 18-08-20 | 13:46:24 | SR:-- | Magenta
PATIENT OPPOSES TELLING
#
HIS WIFE THAT HIS DAYS
83 ARE NUMBERED
1 Question
In the framework of my job as a social worker, I am dealing with a
cancer patient whose days are numbered, a man who is ill with CP,
married, and a father of two young children. His wife is also ill with
CP and depends on him completely.
The patient refuses with all his might to tell his wife about his
situation, so that she can prepare herself technically and emotionally.
This situation put me into an ethical dilemma of serious import.
On the one hand, I must be faithful to my patient and protect his
medical confidentiality. On the other hand, it is my obligation, as part
of my profession, to prepare the wife and the children for what lies
ahead, so that they don’t break down and collapse.
Can the Rav refer me to Torah sources that deal with my ethical
dilemma in the field of medicine? I would appreciate your opinion,
as a Rav of a congregation- how would you deal with something like
this?
1 AnsweR
It is a serious prohibition to reveal a secret. As explained in Mishlei
(20:19) “He who reveals secrets is a talebearer.” It says in Tractate
Yoma (4b): How do we know that if one hears something from his
friend, it is in the category of those things that cannot be repeated,
122 1 Medical-HalacHic Responsa of Rav ZilbeRstein
5
TRANSFER OF A PATIENT
FROM WHERE HE IS, TO A
85 PLACE WITH WORSE CARE
1 Question
In the framework of my work in geriatrics, I am often faced with the
following scenario: A patient is confined to a wheelchair, is incon-
tinent, and needs assistance every day or most days with the daily
activities of washing, dressing and eating.
Often, an elderly person who lives in an old-age home deteriorates
to the point where he is in need of such care. Under these circum-
stances, as medical director, I am obligated by law to fill out a medical
report on his functional aptitude, to be sent to the Ministry of Health
in order to approve his need for nursing care. After the approval,
many nursing-care patients wait a long time until they are assigned
to geriatric hospitals. (This process may drag on for many months
because of budget constraints of the Health Ministry.) Until then,
the patient remains in the old-age home or at home, under medical
care and supervision which, in some cases, does not meet even the
minimal requirements.
Some of the elderly patients are of sound mind, and explicitly state
that they do not want to be transferred to a different institution, since
they are happy where they are now. Some patients’ mental state will
be adversely affected by the move to a nursing home facility. Leaving
their current place of residence, which has been a home to them, can
Transfer of a Patient 2 139