Prologue: The Zohar tells the story of a certain philosopher who approached the rabbis with a particular dilemma. He wanted to know how the Jews have the right to declare “Ata Bichartanu” that they are indeed the chosen nation if normally, the chosen child receives many entitlements and dispensations. However in regard to the Jews, Hashem makes many stipulations – requiring us to be careful with what we eat, what we drink, and what we are allowed it to view.
One might consider adding Tumah and Tahara to this list. A non-Jew is unable to contract Tumah. Only Jews can become Tamai. Doesn’t this imply hashem was the Jews least?
Both Ramban and Seforno respond by citing the same midrash (Tanchuma, Shimini) which compares the situation between jew and non-Jew to two individuals who were ill. To the first, the doctor placed no restriction. For the second, he ordered a very strict diet. When asked, the doctor explained that since the first one was hopeless he was allowing the dying man to enjoy the pleasures of the world. However, when considering the potential for health in the second patient, the doctor realized that with a bit of strict guidance the patient’s condition could improve. The nations of the world are like the first patient. The Jews are like the second.
Rav Zaidel Epstein (Heiaros, vol. 2) explained but this point can be seen quite clearly in regard to the Metzorah. The Torah opens this week’s Torah portion by noting “Zos Tiheiyeh Toras HaMetzorah B’yom Tohoraso” – “this will be the Torah of the Metzora on the day he becomes Tahor.” According to Rav Zaidel, it is only when the person recognizes the errors of his errant ways – the very errant ways that brought him the Tzoraas – and commits to changing those ways and return to complete and total Torah observance and equitable communal life, that he can improve on his status and reclaim his place as part of the ascent toward the holiness of Hashem. Short of this, a Jewish soul remains ill and in need of spiritual rehabilitation.
This week’s Chaburah examines the choices of doctors during a rehabilitation period. It is entitled:
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Grand Rounds
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Sometimes personal ethics can get no way of an individual’s ability to function professionally. In these cases, ethical dilemmas are born and an individual must choose between his ethics and the job. Many interesting cases arise specifically in the field of medical ethics. One such example arises in regard to this week’s Parsha.
Very often, attending Physicians will often engage our and the rounds with their residents. The purpose of the grand rounds is to train students, not necessarily to assist the sick. The question therefore arises, May 1 engage grand rounds and reveal a patient’s diagnosis to his students? Or perhaps this practice is actually antithetical to the Hippocratic oath which binds the doctor to a general environment of confidentiality?
When asked about the situation, the Tzitz Eliezer (vol. XIII:81) noted that there is no contradiction between the doctor’s obligation to his Hippocratic oath and teaching students. After all, at the time that every doctor takes the oath, he knows and expects to train students. This is the way he himself was trained. Ergo, he assumes the limits of confidentiality do not apply to all his students and grand rounds. Moreover, medicine, like Torah, appreciates the principle of “U’M’Talmidai Yoser Mi’Kulam” – that the attending himself gains from the dialogue with the students. Rav Waldenberg notes, many cases where a student’s idea led to a better treatment of a patient, and as a result, having grand rounds is actually to the patients benefit.
There is a difficult though, that is raised by grand rounds. Namely, very often in the process of rounding, doctors will need to display certain sores, wounds or other unsightly areas of a patient’s body. When doing so, a patient is often on full display in a compromised and sometimes embarrassing position. The question arises, is there a problem of Malbin Pnei Chaveiro – embarrassing one’s fellow man – when displaying a patient?
The Torah sums up the laws of the Metzorah are telling us “L’Horos” – “to teach” the specifics on the day of Tumah and on the day of Tahara (Vayikra 14:57). The Raavad (commentary to Toras Kohanim) notes that the word L’Horos, implies a hands on practicum – wherein a Kohein would call his students together in order to show them the laws of Tzoraas. The Netziv (HaAmek Davar Vayikra 14:57) adds that this rule is unique to the condition called Tzoraas. For when many students come to look at a person’s physical ailment it embarrasses him. In most cases it’s forbidden to cause that embarrassment. Only in the case of Tzoraas where the embarrassment is part of the rehabilitation, do we permit, and sometimes demand, that others come and check it out.
If that is indeed the case, Rav Waldenberg forbids a doctor from displaying his patient’s wounds to his students without express permission from the patient himself. Anything short of that, would be forbidden because of the potential embarrassment.
Shabbat Shalom