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Now in our case, if the unstable fellow can be considered a shoteh
[imbecile] who is exempt from mitzvos, neither of these reasons for
not allowing her to have relations with him apply. He did not bring
himself to his present situation in a sinful manner, for he is a shoteh,
and now as well he cannot calm himself because he is mentally defi-
cient2.

However, in the sefer Magen Avos (p.80) the Meiri writes, “Even
when doctors have told a patient that a certain measure is his only
hope of cure, G-d has many gateways through which to heal, which
are not perceived by the doctor.” The Shiltei Hagibborim (Sanhedrin,
end of chapter Ben Sorer Umoreh) writes similarly, “The proofs can
be rejected for not one of them involves accident or exaggeration of
killing and it is unclear whether he would die on this account, even if
the physicians have said so – for many [patients] are sentenced by the
physicians to die yet their cure is close at hand.”

In view of this in our case too, a Jewish daughter should not be
allowed to have relations with a shoteh. Even if the physicians say that
there is no other hope for him and unless she has relations with him
he will commit suicide, still and all,“G-d has many gateways through
which to heal, which are not perceived by the doctor,” as the Meiri
writes and“Many [patients] are sentenced by the physicians to die yet
their cure is close at hand.”

My brother-in-law, the gaon Rav Chaim Kanievsky shlit”a, told
me that in his opinion she should not be allowed to have relations
with him because she has no obligation to sacrifice herself in order
to satisfy his desire. The mizvah to heal a fellow Jew and prevent him
from dying is derived from the mitzvah of returning lost property, as

him.” [Regarding the principle that we do not help a person who is to blame for
his situation see earlier, siman 67, ‘Response to Question One,’ on the topic of
‘A Psychiatric Patient who has Admitted to Sinning, when Its becoming Public
Knowledge is Liable to Interfere with his Recovery.’]
2. See our comments earlier, siman 151, namely, that we do not permit violation of
unbounded prohibitions owing to other prohibitions – according to which even
a shoteh would not be allowed to have relations with a single woman.

410 1 Medical-Halachic Responsa of Rav Zilberstein