Loneliness: Causes, Consequences, and Cure
![handle is hein.journals/medquar11 and id is 113 raw text is: situation it would be preferable to take a chance
with medical experimentation on the dim prospect
of promoting survival of the patient, over the present
certain, although short life expectancy. So much for
the biblical reference.
Turning to Talmudic references, there is an explicit
Halakhah, that concerns a Jewish patient who is un-
able to receive proper medical care. The treatment to
be rendered, with a high degree of probability, may
precipitate the patient's death. The Talmud states: [i]
Rava taught in the name of Rabbi Yohanan: if the
patient's condition is such that, if he is not treated, he
has an even chance at life or death, then do not pro-
vide him with any medical treatment and [ii] Rashi
taught that he would choose to precipitate the patient's
death, so that it would be preferable to leave the pa-
tient without any treatment, on the chance, that by re-
maining medically unattended the patient will survive.
The Talmud then further discusses, if, however,
there is a determination that the odds are against
unattended survival, then any possible beneficial
treatment should be rendered so as to prevent im-
minent death. Thus the Halakhah [per Rashi] per-
mits the taking of a chance with experimental/ob-
jectionable treatment on the improbable prospect that
the treatment may save the patient's life.
Thus the Talmud has resolved our dilemma as to
whether medical treatment that may have the uncer-
tain potential of prolonging a patient's life is to be pre-
ferred to inaction that would ensure a short certain life
expectancy. In conclusion, the Talmud promotes the
acceptance of risk as the preferred course. m
Loneliness: Causes, Consequences, And Cure
Reuven P Bulka
If loneliness were a sickness, it would merit the
dubious distinction of being branded as a mass North
American epidemic. Telephone surveys of the popula-
tion indicate that at any one time, approximately one-
quarter of North Americans are likely to feel lonely.
Loneliness is not a sickness, but it is a disease,
an uncomfortable and undesired human condition.
The noted psychologist Harry Stack Sullivan de-
scribed loneliness as the exceedingly unpleasant
and driving experience connected with inadequate
discharge of the need for human intimacy. Loneli-
ness, then, is the built-in alarm clock which tells the
person that something or someone is missing in one's
life. Loneliness is not the same as being alone, nor
is being alone the likely cause of loneliness. Lone-
liness is caused not by being alone but by being with-
out some definite needed relationship or set of rela-
tionships, says Robert S Weiss, who has been hailed
as the guru of loneliness. Weiss has been in the
forefront of the movement to place loneliness on
the agenda of priorities for the social sciences. Long
a neglected area in research and treatment, loneli-
ness is only now beginning to command the atten-
tion it demands.
Because serious research on loneliness is not
yet forthcoming, much of the information concern-
ing it is still tentative. Nevertheless, some common
Reuven P Bulka Rabbi PhD Ottawa Ontario Canada.
sense perceptions about the structure of 20th cen-
tury North American society offer some clues as to
why loneliness is such a widespread condition.
Increasing Mobility: Many families find them-
selves constantly moving from city to city because
of job-related situations. Some may move in search
of employment, others to continue the climb up the
company ladder. When one is not firmly ensconced
in a community there is a natural hesitancy to enter
into relationships which will more than likely be
short-lived.
The usual means for getting to work are either
private auto or mass transit. In the privacy of one's
automobile, one is locked into a lonely world. In the
mass transit system, one is likely to be crushed in a
rush-hour mass which is as overwhelming as it is
impersonal. The extremes of complete privacy and
being part of the crowd are equally removed from
meaningful relationships, and even from the proper
climate to develop friendships.
Separation From Nature: The assembly line af-
fect is at work in a large percentage of jobs. The
worker who has one specific role which is constantly
repeated never sees the stages of progression from
the start to the finished product. Whatever pride
one would normally take in work is grossly under-
cut by being the one who knocks in the hubcaps, or
who seals the boxes. We no longer see the food,
LEGAL MEDICAL QUARTERLY/VOL 20 1996/PART 4/9
II I](ViewImageLocal?handle=hein.journals/medquar11&div=18&collection=&method=preview&ext=.png&size=3)
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Loneliness: Causes, Consequences, and Cure
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