Tuesday, June 9, 2009

Pikuach nefesh from being labeled as abused


The following story illustrates the complexity of abuse. If you want to used the heter of rodef to call the police because the abuser is endangering the victims life - you also need to understand that it is an issue of pikuach nefesh in being labeled as a victim of abuse and having your family labeled as containing an abuse victim. That stigma is also pikuach nefesh.


Brisker Rav (Rav Zilberstein Assia Nissan 5747): There was a case of a sick person who requested that the doctor allow him to fast on Yom Kippur. This was because his condition had significantly improved and his life was no longer in danger. The Brisker Rav told the doctor that pikuach nefesh doesn’t mean that right now there is a danger that might cause death. Rather even if fasting influences him so that when he has a recurrence of the illness - that he will die before his time – that is also considered pikuach nefesh. Therefore the sick person is obligated to eat rather than fast on Yom Kippur. The doctor replied that the aggravation that is caused to the sick person by his awareness that he is categorized as being in a fragile condition is liable to endanger his life. The Brisker Rav accepted the doctor’s words and replied, “If so we have to think very carefully how to act.”

2 comments :

  1. There is a leaps in logic you have made which I would disagree with.

    The reason that a sexual abuser can be categorized as a rodef are as follows:
    1. Many sexual abusers are already known to be commiting sexual abuse over and over again at the time the allegations are made.
    2. They commit physical harm to their victims.
    3. They commit psychological harm to their victims which increases the risk of suicide, depression, bipolar disorder, schizophrenia, addictions, personality disorder--virtually every single psychiatric disorder (see the bibiography to my essay which you were kind enough to post here). There is very solid scientific evidence of this.

    There is absolutely NO EVIDENCE WHATSOEVER that reporting an abuse allegation to the police increases the risk of suicide of the victinm or his/her relatives. That would also be contrary to common sense. There is, however, strong evidence that the interventions of social service agencies, referrals for treatment, and help for the family is generally extremely helpful. The days have long passed when victims were re-traumatized through medical examinations and criminal interviews. The field as advanced and the entire process is usually seen as helpful for the entire family. Plus, there is a screening for mental health issues so that a referral can be made for treatment. (Sometimes no referral is made, and sometimes a follow up is scheduled because it is not clear if the victim needs treatment.)

    I know there are other considerations as to whether an abuser can be considered a rodef according to some authorities. However, my rabbonim have stated to me clearly that someone continuing to sexually abuse a child/children is definitely a rodef and must be stopped, and that I must call the police and should not report to a beis din.

    Regardless of how someone poskins on rodef, you cannot just invent potential risks and say that it makes something pikuach nefesh.

    As far as the Brisker Rav's psak for yom kippur--I have received the identical psak many times and by more than one posek. A patient in my practice who suffers from schizophrenia to the point that he was a shoteh al pi halakha (that was a psak also, relating to unwise financial transactions he had made) but who was recovered from his illness to an extent that he is no longer a shoteh--He is obligated to take his medication on Yom Kippur and also to eat full meals on Yom Kippur because of the risk that he will return to his acutely psychotic state. (His psychosis has an unusual feature--when he does not eat, he becomes very paranoid, to a delusinoal extent, within one day. This is also happens when he does not get a full night's sleep. I have never seen another patient where this happens so dramatically with sleep/food deprivation).

    A patient with severe depression who attempted suicide, but who recovered and had no symptoms of depression at all was also obligated to fast on Yom Kippur by a different posek lest he/she slip back into depression and become suicidal again. This was not the most dramatic she'elah in the world because the posek held that taking pills is lo-be-derekh achila,the patient used water kechetzi shiur to swallow the pills, and did not need to eat food. Eventually we switched to a different medication which could be taken once per day--just before shkiya erev yom kippur and just after tzeis kochavin motzei yom kippur. Now the psak no longer applies.

    ReplyDelete
  2. NK
    There is absolutely NO EVIDENCE WHATSOEVER that reporting an abuse allegation to the police increases the risk of suicide of the victinm or his/her relatives.
    -----------

    As long as no one has ever looked at the issue, the lack of evidence is meaningless. And suicide may not be the only issue- possibly some other repercussions could be serious enough to be considered pikuach nefesh.

    ======================================================

    NK
    That would also be contrary to common sense.

    -----------

    Why? I could think of quite a few scenarios where the victim's self esteem could take a dangerous beating. For instance, her family gets broken up, because Child Protective Services (whatever the local variant might be called) pulls the kids out of the home, and the siblings are miserable. And, in her (or his) mind it ALL HER FAULT. Maybe she's even told that.
    ===========================================

    NK
    The days have long passed when victims were re-traumatized through medical examinations and criminal interviews.
    --------

    This may be true in a purely social services setting. But in a police setting? Not on this planet! Even if every other aspect the police handling of a suspected rape were perfect, the demand for payment to prosecute the crime would traumatize any victim. Many states make rape victims pay for the "rape kit" or its processing - a fee that can be as high as $1,500

    According to Human Rights Watch
    "Women who report being raped are asked to undergo a lengthy, extensive examination to collect DNA and other physical evidence that might identify their attacker, corroborate testimony about the assault, or connect their case to other rape crime scene evidence.

    If you think that's not traumatizing, you need to think again.

    After doing a study in Los Angeles they discovered:
    But Human Rights Watch analyzed data from the Los Angeles Police Department, the Los Angeles Sheriff's Department, and Los Angeles County's 47 independent police departments, and found that as of March 1, 2009, there were at least 12,669 untested rape kits sitting in storage facilities. In those cases, officers never sent the kits on for forensic testing.

    SNIP

    Thousands more rape kits were destroyed untested.


    Do you REALLY think that the attitudes that lead to this behavior don't also affect the kind of treatment victims get?

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