Tuesday, 19 September 2023

Getting a second opinion

While many people respect and even venerate their physicians, they do not always unquestioningly accept their word. When the prognosis is unfavourable or the treatment is unpleasant, they can seek a second opinion which, they hope, is more favourable or congenial to them. The second opinion may be better than the first, or it may not. It may even corroborate it. Until you receive it, you never know.

Jewish tradition has no objection to getting a second medical opinion. But it is different with questions we ask our rabbis. When a person is facing a religious or ethical problem that requires the input of a rabbi, “shopping around” for the desired answer is strongly frowned upon. You stick to your rabbi and take him as you find him: if you accept his lenient rulings, you accept his stringencies too. Pirkei Avot appears to buttress this position. Avot 1:6 (Yehoshua ben Perachyah) and 1:16 (Rabban Gamliel) both teach: “Take for yourself a rabbi”. One of the explanations of this teaching is that a person’s religious position should be consistent, and this degree of consistency is achieved by learning one’s Torah—and receiving personal advice—should be from the same source.

As the world has become increasingly complex, specialisation has become the norm. We never expect a single medical practitioner to be expert in every branch of medical science. Rabbis too frequently acquire halachic expertise in specialisms that were unrecognised in past generations. Advances in science and technology now demand a high level of detailed knowledge before a rabbi can give a ruling in many areas today. Food production, electronics, communications technologies, hydraulics and in vitro fertilisation are obvious examples. 

Just as a family doctor will refer complex issues up the line, sending it to a consultant who possesses the knowledge and experience to understand the true nature of a problem and ideally resolve it, so too do many communal rabbis increasingly refer questions to colleagues who have made a particular study of Jewish law in fields that are technologically advanced, obscure or recondite. But the situations of the family doctor and the communal rabbi are not entirely the same.

In most areas of medicine, what is treated is the condition itself and the applicability of the expert’s answer does not depend on the nature of the individual patient (though psychiatry is an obvious exception). When a rabbi sends a question up the line for an expert opinion, the expert may not have in front of him the person who seeks the answer—and this factor can be of critical importance where there is a spiritual or social dimension to the question itself. Is the person asking the advice someone who is moving towards religious observance or struggling with it? Does he or she have a strong or supportive family? Will a strict ruling strengthen that person’s Jewish commitment or drive them away from it? These are side issues when viewed in terms of pure halachah, but they are in practice vital.

Rabbi Yaakov Hillel (Eternal Ethics from Sinai) observes this problem from another angle, finding a novel interpretation of Hillel’s teaching at Avot 2:5: “אַל תָּדִין אֶת חֲבֵרָךְ עַד שֶׁתַּגִּֽיעַ לִמְקוֹמוֹ” (“Do not judge your fellow until you reach his place”). He writes:

If we always consult the same rabbi, we will eventually develop a personal connection, enabling him to better answer our questions. Because he knows us and is familiar with our circumstances, he knows if it is appropriate to rule leniently or strictly … We find allusion to this principle later in Avot: Do not judge your fellow man until you reach his place”. … I often explain these words differently: a man should not judge—or in other words, issue a halachic ruling—until he is aware of the questioner’s “place”—his spiritual standing. Only then can he know whether the questioner can handle a stricter ruling, or whether it is ultimately better to provide a more lenient, yet still halachically acceptable answer.

There are a couple of things we can extract from this. One is that a communal rabbi who passes a question on to a halachic expert should always take care to communicate not only the question itself but as much relevant information as may be relevant. The other is that, when we help ourselves to halachic rulings that we find online, we should remind ourselves that these rulings were not necessarily given with us in mind and we should exercise prudent caution before treating them as our “second opinions”.

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