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3. The information should be given by the physician or by another 5 If that is so, there is no justification for telling a woman that her fe-
person whom the patient relies on and feels close to, such as a tus seems to have Down’s Syndrome or any other blemish, especially
member of the family or a Rav. if it is only a suspicion. Therefore, the wise man will not inform the
4. The information should be limited to that which is essential, pregnant woman of this. As it says, “the spirit of man maintains his
and relayed with a positive outlook, providing hope, encourage- illness” (Mishlei 18:14). This implies that faith, prayer, and good deeds
ment, and support. can reverse the bad Heavenly decree to good. Therefore, one must
give the patient hope.
5. One should promise medical and emotional support for the On the other hand, if one informs him of the bad news, he may
patient for the duration of the illness.
die. As it says, (Bereishis 44:30-31) “And now, when I come to your
In summary: In the case of an advanced disease or disease that servant, my father … and when he sees that the lad is not there,
has spread throughout the body, where there is no possibility of he will die.” Rashi explains that Yaakov was liable to die because of
treatment, one should refrain from reporting to the patient. On the his woes. The Midrash in Bereishis Rabbah (65:9) brings that Yaakov
other hand, if there is a complicated treatment option using different Avinu introduced illness to the world, while the King Chizkiyahu
modalities, then we are in need of the patient’s compliance and un- introduced healing to the world. He said to Hashem, if You do not
derstanding. Therefore, we would have to give the patient complete enable healing, then you “have stood” a sick person on his feet until
or partial information about his medical condition, with great care. the day of his death. When someone gets sick and is healed and then
Dr. Menachem Chaim Brayer gets sick again, this causes him to repent. Perhaps Chizkiyahu’s intent
Supervising Physician, Geriatric Center, Givat Hashloshah was that without a possibility of healing, every sick person would be
frozen into a state of depression and pain until the day of his death,
like someone convicted to die, who suffers terribly while awaiting
1 AnsweR the enactment of his sentence. Hashem thus heeded his request and
One should appoint a wise and discerning individual in every lab- brought healing to the world.
oratory, who will know how to impart information to the patient if Therefore, we believe that the job of informing the patient should
there is a possibility of danger. He should do so in a way that will not be given to a wise man, who will know how to do so properly.
cause melancholy, depression, or suicide. If the patient has relatives,
the lab-representative can use his judgement to decide whether or
not to tell the patient or only his relatives, or perhaps to give over the
information only to the family physician.
There are also ultrasounds done on pregnant women, causing How to Reveal Painful News
those who do not abide by the Seven Noahide mitzvos to have an
abortion performed if the ultrasound reveals blemishes in the fetus. The following anecdote is related in the Navi regarding Dovid and
However, “Not like the Egyptian women are the Israelites” (Shemos Yehonason (Shmuel 1, 20:18):
1:19). Those who observe the mitzvos of the Creator do not have an
abortion unless there is a possibility of danger to the mother. If there “And Yehonason said to him, ‘Tomorrow is the New
is no danger to the mother, then “they let the boys live.” (Shemos 1:17) Moon, you will be missed because your seat will be emp-
130 1 Medical-HalacHic Responsa of Rav ZilbeRstein Providing results of X-Ray 2 131
