Got a medical ethics query 800 line offers advice

Health-care professionals with ethical dilemmas have a novel place to turn for advice — an 800 number that doles out advice from a Jewish medical ethics perspective.

"Issues of life and death obviously create confusion and anxiety" in caregivers, said Rabbi Pinchas Lipner, dean of San Francisco's Institute for Jewish Medical Ethics, which administers the hotline. "On many occasions, physicians and helpers have a need for guidance."

The hotline receives up to 10 calls a month from around the country on issues ranging from fertility problems to doctor-patient confidentiality to doctor-assisted suicide.

One Jewish doctor called from Los Angeles to ask if he could, according to Jewish law, administer a lethal injection to a terminally ill patient who was enduring great suffering.

When Lipner said, "No, we absolutely do not allow that," the doctor asked if he could place pills next to the patient's bed so that he could take them himself. "I said, `No, we don't do that either,'" the Orthodox rabbi recalled. "We don't believe in doctor-assisted suicide."

In another case, a non-Jewish psychiatrist in Los Angeles called for advice on a patient with AIDS who not would reveal his condition to his partner. The psychiatrist was deeply torn. Should he break the treasured doctor-patient confidentiality in the name of his patient's partner's health?

Lipner explained that although the Jewish ethical position views doctor-patient confidentiality — and indeed all confidentiality — as enormously sacred, exceptions can be made if it means saving a life.

"When it comes to life and death, we would set aside the total code of Jewish law with the exception of three things — murder, idol worship, and adulterous and incestuous relations," Lipner said.

Lipner, therefore, recommended that if the psychiatrist could not under any condition get his patient to tell his partner the truth, the doctor should break confidentiality to alert the partner to possible life-threatening danger. The psychiatrist ended up following the advice, saying it confirmed his original inclination.

Jewish medical ethics, Lipner noted, often differ dramatically from the secular humanist perspective. When the rabbi spoke with a prominent AIDS expert about the psychiatrist's dilemma, for example, the expert strongly disagreed with his advice.

"Secular humanism, in our opinion, does not value life in the way we value life," Lipner said.

Meanwhile, in another AIDS-related call to the hotline — which can be reached at (800) 258-4427 — the non-Jewish dean of a local dental school called to talk about a student who did not want to care for gay patients. The dean wanted to know whether he had an obligation, according to Jewish law, to step in and try to convince the student to alter his stance.

Lipner said he did. Unless the student's life was obviously threatened by working on gay patients, "we have an obligation to heal," the rabbi told him. Not caring for a patient because of personal prejudice is "absolutely unacceptable."

Lipner said he doesn't know how many callers follow his advice. But in his view, "those people who call me are predisposed to accept my opinion. Otherwise they wouldn't call."

Leslie Katz
Leslie Katz

Leslie Katz is the former culture editor at CNET and a former J. staff writer. Follow her on Twitter @lesatnews.