Do dying persons have the right to know about their condition?
Ask the rabbi….Rabbi Raymond Apple.
Rabbi Raymond Apple
A DYING PERSON’S RIGHT TO KNOW
Q. Do the dying have a right to know the truth about their condition?
A. Despite what others do or do not tell them, dying patients often have a reliable feeling about their condition.
But your question asks about a “right” to be informed, and the Jewish criterion is not the patient’s rights but their welfare.
Both truth and peace are fundamental Jewish ethical values, but there can be a time when truth can affect peace, and truth might then not be an absolute requirement.
If the truth may negatively affect the patient and leave them in a state of despair that compromises their will to live, then in the interests of their peace of mind the full details about the seriousness of their condition may be withheld.
“The Medical Ethics Compendium” edited by Rabbi MD Tendler states (5th edition, page 53), “Patients suffering from a fatal illness should not be so informed where there is a reasonable indication that such knowledge may further impair their physical or mental health… The patient should be made aware that he is seriously ill but that there is every expectation that he will be healed. Thus the patient, whose intellectual and religious background requires that he ‘set his house in order’, will be forewarned to do so without yielding to pessimism or hopelessness.”
Two additional points need to be made:
One – no matter how hopeless the doctors think the case is, they must never give up on a patient. When the Torah says, “v’rappo y’rappeh” – “He shall surely heal” (Ex. 21:19), this obligation continues to the patient’s last breath. A Chassidic teacher refused to pray for one of his followers whose doctor had told him there was no hope; the rabbi said, “The doctor’s duty is to heal, not to despair”.
Second – it is unwise for doctors to predict how long the patient still has to live. As Rabbi Tendler says, “such estimates are usually destructive of the defence energies of the patient and his family”, as well as generally being unreliable.
If on balance it is considered appropriate to give the patient the full facts of his/her condition, the decision has to be made by doctors and family in consultation, and together they should work out how to convey the news.
Unfortunately it sometimes happens that a doctor gives a patient an unpleasant message in a brusque, brutal way which further undermines the patient’s morale. Giving bad news is one of the hardest things for any doctor to do, and it calls for sensitivity and tact.
IGNORING YOUR CHILD
Q. Recently I read “The Chosen” by Chaim Potok. Is it true that some Chassidic fathers deliberately ignore their children?
A. There are many types of Chassidim – some of them quite jolly, others rather sombre – but I am not certain that Potok is claiming this as a Chassidic practice, just that a certain fictional father acted in this way.
He might have known a father of this kind, but readers should not generalise from a possibly lone example.
The general Chassidic approach is quite different. They enjoy their children and their family life is warm and exciting – and parents and children certainly talk to one another.
Some people who have no sympathy with Chassidism have a rather dangerous attitude that anything and everything can be blamed on Chassidim.
Rabbi Raymond Apple served for 32 years as the chief minister of the Great Synagogue, Sydney, Australia’s oldest and most prestigious congregation. He is now retired and lives in Jerusalem where he answers interesting questions.
The Jewish criterion is not the patient’s rights but their welfare: the question is, who is the judge of their welfare? And another question is, how exactly is that welfare defined? Ultimately, the patient has a right to truth and indeed might both seek it and prefer it. It is not for someone else to take on the role of deciding not to give it. And it is not for non-medical persons to negate the role of medical professionals. Not everyone yields to a sense of hopelessness when given a diagnosis that could mean their death. Indeed, there’s a cycle to be navigated, emotionally and psychologically, where natural preparation takes place – you could call that G-d-given. Leave people to their own state of dignity and their own possibilities.
As to the Chassids and children, there will be a variety of personalities and types of human beings involved, as in any sector of society. ‘The Chosen’ is a wonderful piece of literature and fiction is never only imagination, always compounded by experience or knowledge of a kind.
Yes of course.
My local Rabbi is Chassidic (Chabad). He delights in his six children – constantly, playing with them, laughing with them and teaching them by example. His love and affection is on display for all the world to see and I hope the father in question is nothing more than a product of Chaim Potok’s wonderfully fertile imagination.