Peltan and Wright2 question the actual extent of the decline but agree that selleck inhibitor bedside teaching should be promoted for its intrinsic value in medical education. In re-evaluating bedside teaching programs, the demand of the Halacha (the corpus of traditional

Jewish law and ethics) on a patient-centered rather than student-centered experience deserves heightened consideration. Recent rabbinic discussions regarding the halachic attitude towards beside education begin with the exegesis of a biblical text; after describing how a priest diagnoses and ritually treats a particular dermatological affliction, the biblical section closes: “This is the law for all manner of plague of tsara’at … to teach when it Inhibitors,research,lifescience,medical is unclean and when it is clean; this is the law of tsara’at.”3 The nineteenth-century rabbinic commentator Rabbi Naftali Zvi Yehuda Berlin4 focuses on the words “to teach.” Referencing the twelfth-century Talmudist Rabad of Posquires, he explains that the Inhibitors,research,lifescience,medical priest would show the affliction to the student priests in the town to teach them how to identify Inhibitors,research,lifescience,medical tsara’at. The patient was the “text” for student instruction. This would seem to be ample endorsement of bedside teaching; however, Berlin

goes on to explain why “this is the law of tsara’at.” In rabbinic thought, tsara’at, infelicitously translated as leprosy, is not a medical disease but rather a physical punishment for violating the laws of appropriate speech by gossiping about others or directly Inhibitors,research,lifescience,medical embarrassing them. It is embarrassing for a person to be surrounded by a group of strangers who are closely examining his or her body, he says, and the bedside education of the student priests is tit for tat punishment

for the embarrassment the patient had previously caused another. “This is the law of tsara’at” and not a general policy of medical education. Following this logic, Rabbi Eliezer Waldenberg, the late halachic ethicist for Jerusalem’s Shaare Zedek Hospital, rules5 Inhibitors,research,lifescience,medical that, given the potentially embarrassing nature of bedside teaching, one may not allow it without explicit prior permission from the patient. In a contemporary secular context, Aldeen and Gisondi6 describe specifically asking permission from the patient before entering the room as not proper professional etiquette. Sensitivity towards the patient’s embarrassment is already recorded in the Talmudic discussion of the mitzvah of Bikkur Holim (the religious requirement to visit and care for the sick). The duty falls on everyone, obligating even people of high status to visit those of a lower station. However, the Talmud7 prohibits visiting patients suffering from intestinal ailments, because they would be embarrassed by their unhygienic state. Yet this sensitivity is tempered by the medical needs of the patient.