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5
PATIENT OPPOSES TELLING TRANSFER OF A PATIENT
#
HIS WIFE THAT HIS DAYS FROM WHERE HE IS, TO A
83 ARE NUMBERED 85 PLACE WITH WORSE CARE

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

122 1 Medical-HalacHic Responsa of Rav ZilbeRstein Transfer of a Patient 2 139