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But if Reuven is a Torah scholar, the Chafetz Chaim deliberates
whether or not one should reveal Shimon’s financial straits to him. If
Reuven is a Torah scholar, we need to be more concerned about the
possibility of harming him. He takes precedence to Shimon.
Rav Akiva Eiger (Hagahos on Yoreh De’ah #251:3) says that blood
relatives take precedence to Torah scholars when giving charity. This
#
may apply in our case as well, and we may instruct the physician to
give priority to his relative. Even though the probability of damage is
not very high, he should reveal it to his relative.
In spite of the above, there is still reason to be stringent in our
case, since the patient relied on the physician not to reveal his secrets.
Therefore, if the illness is serious and is accompanied by the danger
of real damage, the physician is obligated to reveal it, since he already
swore at Mount Sinai to fulfill the mitzvah “Do not stand idly by the
blood of your fellowman” (Vayikra 19:16). Near that mitzvah the To-
rah says, “Do not be a gossipmonger among your people.” The Ba’al
HaTurim explains that although one should “not be a gossipmonger,”
he is also not allowed to “stand idly by the blood” of his fellowman,
and he must tell him if someone is setting up a trap for him. How-
ever, in our case, where the possibility of damage is not certain, even
though the physician is concerned with the wellbeing of his relative,
he still has no permission to reveal his patient’s secrets. Therefore,
further study is required in order to determine whether or not he is
allowed to reveal it to a relative.
1 SuMMaRy and Conclusions
1. The physician has to weigh carefully whether or not notifying
the patient of his chances of developing a serious illness will
enable him to prevent or to treat the illness. If it will, then it is
proper to tell him about it. As the Rambam (Hilchos Rotze’ach
1:14) writes: If he hears gentiles or informers plotting some evil
for his friend or setting up a trap for him, and he does not tell
his friend… he violates “Do not stand idly by the blood of your
fellowman.”
52 1 Medical-HalacHic Responsa of Rav ZilbeRstein
If the groom claims he has recovered, the Chelkas Mechokek writes
(#117,12) that one must be concerned that his illness may return. The
Beis Shmuel disagrees (ibid, 12) and rules that it is possible that he was
completely cured. I heard from my father-in-law, Rav Y. S. Elyashiv
zt”l, that people care about this illness, perhaps even more than a
mental illness.
We passed this question on to Professor Avinoam Shofar, an expert
on neurology and pediatric epilepsy, in order to hear his professional
opinion. This is his response:
To the honorable Rav, shlita,
To the best of my knowledge there are several points which must
be considered.
One must make certain that the groom suffers from epilepsy and
not from some other illness. Tegretol has other uses, mostly for relief
of pain stemming from a neurological cause (such as trigeminal neu-
ralgia), and at times even for a migraine.
If the young man is in fact taking the medication to prevent epi-
leptic seizures, you should investigate when he was diagnosed. It is
entirely possible that he became ill after his marriage.
If he really has epilepsy, what caused it? Sometimes serious dis-
orders, or even life-endangering illnesses such as brain tumors can
express themselves as epilepsy at a certain stage.
Most cases of epilepsy are mild and respond well to treatment.
There are many medications that help prevent convulsions. There are
some patients with epilepsy who, even without treatment, only very
rarely have seizures. Patients with epilepsy serve in the army and they
get driver’s licenses. They can live a normal life, on condition that they
get consistent medical follow-up. Only about 20% of epileptics have
an uncontrolled disease.
Just from reading your letter and without knowing the real details
of this case, it would seem that if this person is using Tegretol to con-
trol his convulsions, he is dealing with a mild case of epilepsy, which
is under control enough so that even his wife is unaware of it. He is
highly functional, indicating, again, that his case is a mild one and he
only needs low doses of medication. High doses of medication would
Epilepsy 2 81