https://medicalhalacha.org/2021/01/21/preventive-medicine-and-disease-screening/
Predictive or presymptomatic diagnosis, whether for the purposes of assessing the risk of diseases or for early intervention, can play a critically important role in a patient’s chances of recovery or of avoiding disease entirely. Screening tests, such as mammograms or colonoscopies, tests that assess or predict the risk of developing Type 2 diabetes, or genetic testing that can identify a predisposition to an ever-growing wide range of diseases, are all essential diagnostic tools. Does the Mitzva of “v’Nishmartem” obligate a person to undergo such testing or to follow the precepts of preventive medication in general?
Would the Mitzvah of תמים תהיה disallow screenings when no symptoms are evident and the individual feels well?
ReplyDeleteYes lt seems to be ls the vlew of Rav Moshe
DeleteThen was different from today.
DeleteThere's risk in overdiagnosis, and some tests can cause harm.
It's not simply about symptoms. There can be early disease without obvious symptoms.
Sometimes diagnosing too late can be fatal.
Even doctor can't always predict an outcome.
Today there is advanced genetic screening for some diseases.
There are more complex and challenging issues than just screening. Eg rachmono presence of high risk genetics but no disease. Should a woman operate on breast or man do biopsy on prostate?
There's MRI to help discover without doing invasive tests..
There's an Hollywood actress who did the breast operation to avoid cancer that killed her mother. But she didn't yet have cancer. That's a terrible dilemma. I'm sure on such things Rav Moshe would give the best opinion.
ReplyDeleteאין הברכה שורה אלא בדבר הסמוי מן העין
https://ovarian.org.uk/hereditary-cancer-and-risk/jewish-brca/brca-fault-jewish-populations/
ReplyDeleteThe difficulty with giving halakhic advice on this subject is the ever-evolving data on screening. Dismissing a huge area of medical science with "Just trust in God and everything will be okay" is simply not acceptable.
ReplyDeleteThere is a difference between a posek's personal views and what you should do. Rav Moshe's wife reportedly complained to her husband that he was always finding leniencies for others but not for himself
DeleteSometimes one needs to make a delicate balance of risks in medical advice.
DeleteI have a growth in the gallbladder. They can remove the entire gallbladder, but it could turn nasty if it continues growing.
So monitoring it for the time being. There's no right decision
The main problem with Rav Moshe's position on screening is that it is outdated.
DeleteHis position was based on what physicians told him and what they told him was based on guideline and the technology of the time.
Both of these have changed significantly since then.
Mammography machines are far more advances and precise. Pap smears are no long done nearly as often as they used to be. Soon women will be doing at-home self-swabs for HPV instead. The role of MRI for screening has become much more common for prostate and breast cancer. Colonoscopies can often be avoided in low risk individuals by the use of faecal DNA tests. All these have improved accuracy over the tests using when he was issuing his position.
As for "tamim", it reminds one of the story of the guy who lived in a flooded valley and rejected rescue offers because he trusted that God would save him. We all know how that story ended.
Bottom line you need to ask a contemporary posek
Delete