Yichud (seclusion)

Abstract: Jewish Law prohibits men and women from being alone together in a secluded location unless they are married to each other or are close family members. This applies to a patient being alone in a closed room with a physician. Halacha provides provisions to allow for privacy for clinical examinations.

Discussion: Within Jewish Law there is a prohibition against yichud (seclusion). The word encompasses a prohibition for a woman to be alone with a man who is not her husband or immediate family member. (It also prohibits a man from being alone with a number of women unless one is his wife or other adult immediate family member). This principle has repercussions in the context of medical care in that a male physician should not be alone with a female patient or a female physician with a male patient unless certain conditions are met. This is one of the reasons that halacha observing patients will, at times, prefer a physician of the same gender.

However, care is allowed by members of the opposite gender, particularly if they have greater expertise in the current condition. In those cases, the problem of yichud can be addressed in a number of ways. First of all, if the woman's spouse is present, then all problems are avoided. For this reason, many women who seek medical care will be accompanied by their husbands. As the law in most places allows a patient to be accompanied if they so desire, this should not present difficulty in any medical setting.

If the woman is alone, there are additional ways to circumvent the difficulty of yichud. For example, the prohibition applies only if the door of the room is locked or closed in such a way that no one will enter. Therefore, if the topic or the exam is not too private, the door can be left open a crack. If the door must be shut but it is possible for persons to enter the exam room or office unannounced (such as nurses, receptionists or other physicians), this is also not considered yichud according to most opinions. For a male patient, having his wife in the waiting room may be sufficient.

There are some differences of halachic ruling in this area so the physician may see different levels of concern among halacha observant patients. It may be advisable simply to ask before closing the door if they feel comfortable or whether they wish to have someone else present. Sensitivity to this issue is likely to make patients feel more comfortable with the care they are receiving.

Implications for Patient Care: Being alone with a member of the opposite gender raises a halachic difficulty known as yichud. By making halachically acceptable arrangements to prevent the situation, patients can be made more comfortable with the care they receive.

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