Lashon HaRah - saves life /Tzitz Eliezer

Tzitz Eliezer(15:13.1): Question: A doctor discovered that his patient has defective vision which can cause him to have auto accidents when driving under certain circumstances – such as under the conditions of his job or at night….The patient doesn’t want to stop driving or to change his job. Is the doctor obligated to keep this confidential or is he obligated to notify the appropriate agency (whether governmental or his employer) concerning this matter? It is likely that this information will cause his patient economic damage or his interaction with society. What if the patient asks him to keep this confidential and he promises to stop from driving under the dangerous circumstances – but the doctor is not convinced that he can be believed to stop driving? Answer: There is no question that the doctor is obligated to notify the appropriate governmental agency or employer so that they can have the patient drive within his limitation. Even if the patient requests the doctor to keep his illness a secret and promises to stop driving… As long as the doctor is not convinced that he will do so – he is obligated to notify the agencies. It is also not only obvious that if the doctor is summoned to testify concerning this that he must go and testify. [Furthermore his oath as a doctor to keep medical information secret does not apply to these cases nor does a private oath to the patient. That is because it would mean that he is taking an oath to nullify a mitzva and thus it is simply invalid. His oath as a doctor shouldn’t apply to information which if it is withheld would constitute a crime. (All this is discussed in greater detail in Tzitz Eliezer 3:81 part 2 and 3.)]. But even if he was not summoned he is still obligated to take the initiative to inform the appropriate agencies because otherwise the patient might be a danger to the lives of others. If the doctor refrains from notifying the agencies than he has transgressed the Torah command of “not standing by the blood of your fellow.” Therefore the doctor should not take into consideration that his act of informing might cause economic or social damage. That is because nothing stands in the way of saving life (pikuach nefesh). I want to add to this what I found in the Pischei Teshuva (O.C. 156): “And I want to comment on the issue that all the mussar books make a big deal about speaking lashon harah, but I want to make a big deal about the opposite. That is the greater and more common sin of refraining from speaking lashon harah when it is needed to save a person from harm …” These words express much clearer and forcefully what I have been saying. The Pischei Teshuva notes that a person’s intent should not be to harm the person he is speaking about but rather for the benefit of the person he is telling and others that he is saving from harm. Because by focusing on helping he fulfills a great inestimable mitzva. I also found a similar case in the Chelkas Yaakov (3:136) concerning a young man who the doctor found had cancer. The young man and his family didn’t know about it at all. The man was engaged to marry a young woman. His question was whether the doctor was obligated to reveal the sickness to his fiancée as well as well as the fact that he only had at most one or two years to live. It was obvious that if she found out this information she would not marry him. The Chelkas Yaakov replied that the doctor was obligated to inform the fiancée because the main halacha issue is that the doctor should not violate the mitzva of “not standing by the blood of your fellow.” He based his psak on the Rambam (Hilchos Rotzeach 1:14) and Shulchan Aruch (C.M. 426)…. So surely this is true in our case where the matter might cause actual danger to the lives of others. So there is absolutely no question that if the doctor does not reveal the information to the appropriate agencies now, he will be transgressing by this withholding - of the prohibition of “not standing by the blood of your fellow.” Therefore it is absolutely permitted for the doctor and also is clearly obligatory for him to notify the appropriate government agency or employer concerning the limitation of his patients vision.