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take a severe emotional toll, especially when they have established suddenly informed of his imminent death, can lose hope and cause
bonds with other elderly patients and with the medical staff. his mazal to become bad. In our case, we are dealing with a patient
I believe that leaving a patient in an old-age home rather than mov- who has doubt eating at his heart, and one can say that the doubt is
ing him to a nursing home against his will does not endanger his life. worse than knowing the definite diagnosis.
In summary: On the one hand, the law obligates us to move these In practice, the matter needs to be carefully clarified. It says that
patients to another institution. On the other hand, in some cases, “The spirit of a person feeds his illness” (Mishlei 18:14). Thus if the
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our conscience tells us that doing so will harm them and their mental patient is told that his condition is hopeless, his broken spirit will cer-
wellbeing. Being that we physicians are obligated to “heal he shall tainly hasten his death. Therefore, although there are some opinions
heal,” according to our Holy Torah, which implies looking out for that justify telling the patient his condition so he can put together a
both the mental and physical state of our patients, I would like to will for his assets, or so that he can repent for his sins, these still do
hear the Torah view of this dilemma. not justify telling the patient, lest his spirit be broken and his death
hastened.
Dr. Menachem Chaim Brayer
Supervising Physician, Geriatric Center, Givat Hashloshah
1 SuMMaRy and Conclusion

1 AnsweR In our opinion, it is better to be silent and hide the truth, unless we
know with certainty that telling him about his imminent death will
We presented the question to several other physicians in order to not harm him.
hear their opinion:

I was asked for my professional opinion about the transfer
of elderly people to a nursing home. I will answer from a
psychological viewpoint. As a person gets older, the num-
ber of losses he has experienced increases. He has often
endured the loss of people close to him, loss of status and
places of work, loss of health and functional aptitude, and
often a reduction in his economic status as well.
It is difficult to cope with these types of losses at any
age, but all the more so for the elderly, whose coping mech-
anisms are weaker. For most elderly people, the transfer to
an old-age home is a traumatic experience and leads to a
deterioration of their mental and emotional capabilities.
The move often requires an extensive period of adaption.
Clearly an additional transfer would be extremely difficult.
Throughout the world, there is an increasing phenom-
enon of treating patients at home. In every medical field,

140 1 Medical-HalacHic Responsa of Rav ZilbeRstein Parents Gave Birth to a Blind Child 2 121