Patients` Voices in the Talmud

This paper analyses a number of Talmudic sources in the light of modern thought in medical ethics and doctor-patient relationships.

There are a number of bedside scenes in the Bavli where we hear the patient`s voice in various registers. One theme is expressions of suffering. At one extreme, we hear Rav cursing the doctor for causing him to suffer (Shabbat 108a), while at the other extreme Rabbi Judah HaNasi first weeps over his loss of Torah and mitzvoth (Ketubot 103b), but later, in the poignant deathbed scene, though his suffering is recorded, his voice is not heard (Ketubot 104a). Rabbi Eliezer accepts comfort from Rabbi Akiva who sees meaning in his suffering (Sanh 101a); Rabbi Elazar weeps over the end of a beautiful body, and rejects suffering as having any value, as do Rabbi Yohanan and Rabbi Hiyya when they are ill. (Berakhot 5b). The accounts of visits to these sick rabbis constitutes a second theme – the dialogue between the visitors and the patients, presenting examples of reflection, support, and empathy. A third theme is the force of the patient`s wishes. In a discussion of what to do when a patient wants to eat on Yom Kippur against expert advice, or vice versa, the principle of "the heart knows its own bitterness" is adduced to strengthen the case for listening to the patient. (Yoma 83a-b) This should be understood, not as implying a principle of personal autonomy, but rather as acknowledging the patient`s privileged perception of the situation.