Q. When a patient is so ill that a change of name is suggested, does he have to be consulted before or told that there will be or there was a shinui hashem or an addition of a name done for him? Maybe it should be avoided, since telling him about it may cause much worry and despair?
A. Talmud (Rosh Hashana 16b) mentions that changing or adding to the name is one of the four items that will modify the sentence dictated against the severely ill. Two reasons are given as to why it works and help. Rashb’a (Teshuvos 8: 48), maintains that a change of name changes the mazal of the ill. This being similar to the name change of Avraham Avinu and Sarah Imenu. However, Semag (Asin 9) opines that it is part and parcel of the process of teshuva; new person new name.
Ohalei Yaakov (19), explains that the difference between the two reasons is if the patient must be aware and be part of the process, which is essential to teshuva. If he is not at least told, it may be ineffective.
Sefer Hasegulos (quoted by Maaseh Avos p. 198), and others also maintain that the ill should be consulted or at least informed of the change when possible.
Horav Shlomo Miller’s Shlit’a opinion is similar. However, the Rov pointed out that there are proper and careful ways how to ask permission or to inform the choleh of the addition of a name proposed (preferred to change). Bikur Cholim and other knowledgeable Askanim familiar with the process, should be the ones to approach the ill, using true and honestly felt words of hope, comfort and above all trust in the rachamin and compassion of Hashem.
Rabbi A. Bartfeld as advised by Horav Shlomo Miller and Horav Aharon Miller Shlit’a