Q&A: Compelling Medical Treatment
Compelling Medical Treatment
Question
Hello Rabbi,
The Rabbi writes in several places that the idea of “we compel him until he says, ‘I want to’” is not some mystical notion, as Maimonides is commonly interpreted. Rather, the idea is that coercion will lead him to give the bill of divorce of his own free will, since as a God-fearing person, once he understands that his opposition will not help and his wife will in any case be divorced, his true will is revealed—a will that had been denied and wrapped in the guise of false theories.
My question is whether, in the Rabbi’s view, this is also how one can understand the provision of the Patient Rights Law (section 15(2)): “In circumstances in which the patient faces grave danger and objects to medical treatment that should, under the circumstances, be given promptly, a caregiver may provide the medical treatment even against the patient’s wishes if the ethics committee, after hearing the patient, has approved giving the treatment
provided that it is convinced that all of the following have been met… (c) there is reasonable basis to assume that after the medical treatment is given, the patient will retroactively give consent.”
Can this too be understood as coercion revealing the patient’s true will—that any normal person presumably wants to preserve his life, only sometimes that will is wrapped in the guise of a false theory?
Answer
I’m not a lawyer, but that sounds entirely reasonable to me.
By the way, some time ago I saw that there are several halakhic decisors who wrote this explicitly, as I did. I think the Maharik, for example, was mentioned there.
Discussion on Answer
Were you asking me? In my opinion, an unconscious opinion doesn’t count.
I’m not sure I understood. The opinion is always conscious to the person who holds it, but not always to those around him. The law allows the committee to make a psychological assessment (whether he will regret it), but one that can be statistically validated after the fact. And if even after time passes all the patients insist they would have preferred to die, then from that point on they will stop treating them. In the Jewish law case of “we compel him,” there is a psychological assessment (whether when he says “I want to,” he really wants to) that is not subject to any test. Is that distinction correct?
As for forced treatment of Jews against their will but for the benefit of humanity, the famous illustrious doctor was particular about that.
The Torah gave the doctor permission to heal. Permission only.
1. An opinion is not always conscious to the person who holds it, at least not in real time.
2. I’m not sure that under the law anyone actually bothers with statistical validation either.
3. In Jewish law too, one could try to do such validation (ask people after they were compelled to give a bill of divorce whether they are pleased with it). But I assume no one has done that here either.
Could you please point me to a place where the Rabbi explains in detail the rule of “we compel him until he says, ‘I want to’”? If there is one, of course.
For example, here: https://mikyab.net/posts/61377#_ftnref4
The law relies on an empirical claim that can be statistically disproven. (If we assume that “reasonable basis” means 15%, then we would expect 15% of patients to give retroactive consent. Otherwise, the committee would need to be stricter in approving treatment.) Is that what you mean too, or do you mean that even if all the patients stick to their view, there is still room to assess their true opinion and think they are not telling us their current truth—that they are glad they were treated—for various human reasons? With a bill of divorce, I’ve never heard that you have to wait a period of time until the husband (or a certain percentage of all husbands) sheepishly admits that his true will had been to agree to the divorce.