Is Knowing Your Expiry Date a Blessing?

Previous Column – What's the harm in seeing a doctor who's hurt me?

There’s an old saying from the Talmud: a doctor who heals for free is worth nothing. In other words, if someone offers free medical treatment, the patient has every right to refuse, doubting the value of free care. The simple implication is that a doctor who isn’t financially compensated might not put in the effort, potentially leading to less effective care. However, there's more to it:

Even if the free doctor gives their utmost care from the heart, ignoring their lack of payment, the treatment might still fall short because the patient doesn’t trust a doctor who doesn’t charge. A patient's healing isn't just about the physical treatment but also their trust in the practitioner. When a patient pays for their care, they believe they’re receiving the best possible treatment, enhancing the chances of recovery.

On the other hand, free treatment might make the patient question the doctor’s professionalism. This doubt can affect the outcome because emotional health heavily influences physical healing success.

In a responsum from "Shu't Shevut Yaakov" (Vol. 1, No. 6), the question arises if a doctor in mourning can leave their home to treat patients and if they can charge for their services during this time. The conclusion is that while the doctor may treat patients, they should not accept payment. Yet, the "Shu't Shevut Yaakov" emphasizes that the doctor should agree upfront on a fee, only refraining from taking it later. Knowing the doctor expects payment strengthens the patient’s trust and thus the treatment’s potential efficacy.

Research often shows that placebos achieve outcomes similar to real medications, thanks solely to the patient's belief in its efficacy. The faith in a treatment, even a dummy one, can trigger self-healing.

How Long Do You Have Left?

This intertwining of physical and emotional states often presents doctors with a profound ethical dilemma: Should they inform terminal patients about their prognosis and lifespan?

On one hand, someone who might naturally be nearing the end of life might want to know how much time they have left to make the most of it. However, experience shows different patients with identical diagnoses often receive varying prognoses and frequently those forecasts turn into self-fulfilling prophecies. Many outlive those timetables, especially when not given an estimated time of remaining life.

This ethical matter is complex and nuanced, deserving more than these pages. Yet, it’s worth noting how a doctor’s prediction might create anxiety that weakens the body, causing the prophecy to fulfill itself!

Imagine someone fleeing from a snake, running like never before. Fear drives them, and the snake is always in pursuit. How long can this person realistically keep running? An hour? Two? Imagine running for months on end...

Even without physical constraints, relentless anxiety would eventually cause collapse. This happens when a person's life comes with an expiration date dictated by doctors. The stress and anxiety from grim news alone can weaken them, potentially leading to their untimely demise, Heaven forbid.