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visual acuity is almost complete (visual acuity of 6/9) for 75%-90% 2 4. Is the refusal of the physicians to examine him correct or not?
of patients. Rav Aharon Rose,
There are various causes for optic neuritis. A common cause is Bikur Cholim Hospital, Jerusalem
multiple sclerosis. A study of patients who suffered from this infec-
tion revealed that within 15 years, 30% of males and 70% of females 1 AnsweR to Question 1
are diagnosed with multiple arteriosclerosis. The clinical manifesta-
#
tions of the disease appear in varying degrees of severity. In 10% of In Chafetz Chaim (Hilchos Issurei Rechilus, Principle 9 #3) it says: If
patients, the disease appears immediately in its full severity, and is one sees that a girl is about to marry someone who has serious defects
accompanied with severe disability (paralysis of the lower extremi- of which she is unaware, and if she knew she would not marry him,
ties, confinement to a wheelchair). then one is obligated to reveal this to her. This is included in the To-
In 50% of patients, the severity of the illness is mild and only in- rah prohibition “Do not stand idly by the blood of your fellowman,”
terferes a little in activities of daily living. The other 40% will suffer on condition that the illness is serious and not just some form of
recurrent attacks, with varied degrees of difficulty and frequency, and “weakness”.
75% of them (about 30% of all patients) will become significantly There are three levels of defects and blemishes:
disabled. 1. There are some defects and blemishes which people do not ac-
Nowadays, severe cases are treated by a daily injection over the cept, even after the fact.
course of many years. The injection prevents recurrent attacks in
about 30% of treated patients. 2. There are defects and blemishes that, a priori, would not be
In light of the above, a man suffering from optic neuritis has a 30% accepted, but after the fact they are accepted.
chance of developing multiple arteriosclerosis and the danger of dis- 3. Some defects cannot be categorized as real illnesses, but rather
ability of a severe type varies between 10%-15%. For a woman, chances as a certain weakness of nature, or the need to abstain from
are between 25%-30%. eating certain foods in order to maintain one’s health.
Multiple arteriosclerosis occurs in 0.1% of the general population. We have spoken about example of things which are defined as “se-
Relatives of patients have a 1% chance of developing the illness. rious defects”, such as a groom with only one kidney, diabetes, which
Prof. P. Namet may predispose a person to sterility [or a patient with mental illness
Director of Department of Ophthalmology, Assaf Harofeh Hos- who regularly takes medications (Responsa Teshuvos V’hanhagos,
pital Vol. 2 #624)]. The same would apply to a patient who suffers from
In light of the above, perhaps there is no obligation to tell the an internal illness and has to take medications or undergo medical
young patient, nor his/her potential spouse, since the danger of se- treatments on a regular basis.
vere disease is very low and only develops after fifteen years. Perhaps Someone who seeks a mate in marriage and hide defects and
a cure for the disease will be found by then. However, one should blemishes which people would not accept (level one) violates the
pray that Hashem remove any possibly developing illnesses from prohibition of deception: “And you shall do no wrong one to another”
these patients. (Vayikra 25:17). If the physician or anyone else knows about such
I spoke to my father-in-law, Rav Y. S. Elyashiv zt”l, and he said: defects in the groom or the bride, he is permitted, and even obligated,
If a patient only has a 35% chance of becoming ill, one need not to reveal them to the other side, even if his opinion was not sought.
50 1 Medical-HalacHic Responsa of Rav ZilbeRstein Groom Sufers from Mental Illness 2 19
