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    A dying person’s right to know – Ask the Rabbi

    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 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.

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