Page 89 - 20818_park-c_efi

20818_efi-ab - 20818_park-C_efi-ab | 3 - A | 18-08-20 | 13:46:23 | SR:-- | Cyan
20818_efi-ab - 20818_park-C_efi-ab | 3 - A | 18-08-20 | 13:46:23 | SR:-- | Black
#20818_efi-ab - 20818_park-C_efi-ab | 3 - A | 18-08-20 | 13:46:23 | SR:-- | Yellow
20818_efi-ab - 20818_park-C_efi-ab | 3 - A | 18-08-20 | 13:46:23 | SR:-- | Magenta
son; she can do so when the time comes. Even the physician, who said to his wife, “See, even the angel says that I am correct.” Instead,
may not find the groom years later when the time comes for him to one should seek out the guilty party, and explain to him that he is
know, is not obligated, at present, to worry about someone who is wrong. He will then admit that the other party is correct and peace 3
not presently before him. He cannot cause harm to the young boy by will be restored.
informing him now. From here we learn that in our case, the physician should delicately
There is still room to question the obligation of informing those and compassionately tell the carrier that he is the one who carries
#
children who are of marriageable age. One can argue: Why should we the gene, and will ask him to reveal this to his healthy spouse. Only
only concern ourselves with the wellbeing of the potential spouse and if there is a possibility that the carrier will hide the information from
the prohibition of marital relations without a proper kiddushin? Why his spouse should the physician himself tell her. If the physician un-
are we not concerned for the sons, who may become emotionally dis- derstands that the couple does not want to know which of them is the
traught when they are told about their condition? carrier of the disease, he should not tell them, on condition that the
One can answer that if there is a possibility of pikuach nefesh (as husband has already fulfilled his obligation of procreation.
in the case of the nurse who discovered that she has no ovaries since
birth. She went into shock when she realized she could not bear chil-
dren and tried to kill herself ), it is preferable to “sit and do nothing.” 1 AnsweR to Question B
2
This is not the situation in our case, however where the chances that
it will evolve into pikuach nefesh are quite remote. Therefore, the pro- Regarding the second question, should the physician reveal the infor-
hibition of “Do not stand idly by the blood of your fellowman” is still mation to relatives who have a high chance of siring Down’s syndrome
relevant, and one must consider the bride, lest she be deceived and children?
made miserable . It is stated in the Shulchan Aruch (Even Ha’ezer #2:7): A man
3
should not marry a woman from a family of lepers nor from a family
1 AnsweR to Questions 2 and 3 with epilepsy. This applies when the family has a presumption of hav-
ing more such children, such as if there are already three cases of this
Certainly, the sons are obligated to tell their prospective wives about disease in the family, but not based on a single case. If so, in our case,
the nature of the illness. If they do not reveal it, the physician is obli- where only one patient was diagnosed with the disease, one cannot
gated to do so, so that they not violate “Do not stand idly by….” The assume that his brothers suffer from the same disease.
physician should try to convince the sons that they should reveal their However, if genetic knowledge ascertains that the illness is ab-
problem, and in this merit Heaven will have mercy on them. solutely hereditary, and it is logical to assume that his brothers also
suffer from the disease, one should tell them so that they can cal-
1 AnsweR to Question 4 culate their own best course of action. In spite of the fact that it is
only a single case, the words of the Shulchan Aruch (above) were said
The relatives are not obligated to be tested for the carrier state of without qualification. Therefore, the physician should convince the
patient to agree to reveal the information to the relatives. If the carrier

2. See above, section 73, for details of the case. is about to marry a woman, he is obligated to reveal his situation to
3. See our explanation above, section 69, Comment 4. her. If he does not do so, the physician is then obligated to relay the

58 1 Medical-HalacHic Responsa of Rav ZilbeRstein Hereditary Defects 2 75