Telling the Truth to a Terminally Ill Patient
אמירת אמת לחולה סופני
Question: When a very seriously ill patient asks about his condition, must the doctors and his family tell him the truth about the gravity of his condition and that he is about to die soon, or is it preferable to conceal this information from him so as not to break his spirit?
Answer: The main thrust of our approach to a sick person is to encourage and strengthen him, in order to lift his spirits and ease his suffering. The mitzva of bikur ḥolim (visiting the sick) is meant to strengthen the spirit of the patient. Therefore, when a relative of a sick person has died and there is concern that if he finds out it may break his spirit, we do not tell him about his relative’s death (SA YD 337:1). On this basis, several poskim wrote that one should not tell a patient about the gravity of his condition (Responsa Be-Tzel Ha-Ḥokhma 2:55).
On the other hand, however, it is important that the patient confess and repent for his sins before his death, so that he may come before the Heavenly Court in a state of repentance, as R. Eliezer said: “Repent one day before your death.” Likewise, the Shulḥan Arukh rules (YD 338:1) that if a sick person is close to death, we say to him: “Confess.” And so as not to break his heart, we add that many sick people confessed and did not die. On the contrary, it may be precisely in the merit of the confession that he will live. And certainly, if he confesses from the depths of his heart, he will merit a share in the World to Come. However, these things are not said to him in the presence of faint-hearted people who might burst into tears and cause him heartbreak and despair, as a result of which he might weaken and die sooner, God forbid.
About a month before the passing of the great Rabbi Shlomo Goren zatzal, I was studying these laws, and I asked him his opinion: to what extent must one tell a sick person the truth about the gravity of his condition? He answered that one must take care not to break his spirit, and under no circumstances should one say that all hope is lost; rather, one should always explain the situation while leaving an opening for hope and deliverance. He further related that he knew a man whose doctors told him that he had cancer, and they did so insensitively; immediately afterward his condition deteriorated drastically, and within two weeks he died. In his opinion, the reason for his rapid death was that they broke his spirit by the blunt way in which they told him about the gravity of his illness.
In summary, the patient’s welfare is the foremost consideration. Most important is that he not fall into a mood of despair and depression, for if he despairs his end will draw nearer, and he will also be unable to confess properly and repent. Therefore, gently and sensitively, he should be told that he is suffering from a dangerous illness, and that it is proper for him to increase his prayer and repentance and to confess his sins so that he will be worthy of healing. In each and every case, one must consider the matter on its own merits: what will be better for the patient, detailed knowledge of his illness or only general knowledge. There are people to whom it is better to tell more, and there are those to whom it is better to tell less. But in every situation and circumstance, under no circumstances whatsoever may one tell a patient that his chances are completely lost. First, because this can never be known with certainty; and second, so as not to break his heart (see Assia vol. 7, pp. 12-41).