I wouldn't go quite that far, as there are always options to overcome any health issue (usually). I don't know what you've got going on (not my business), but if you can't use in ears, Brad Delson from Linkin Park used over ear monitors. There are ways around most issues, if you don't mind getting creative.
Main thing about going the cab route is it has (in my opinion) more flexibility out of the box than going direct does, both for playing and recording. Plus the aforementioned ReAmping, then again, you could probably do that with direct, now that I think on it. /shrug
Course, you don't have to limit yourself to a Marshall speaker cab. Find a speaker you like the sound of, don't be afraid to mix it up. For instance, my da really likes Vox amps, but friggin' loves the speakers in his old Orange combo my uncle fried. Next thing you know, his Vox now has Orange speakers in it. Now, with cabs, you don't have to rewire anything like he did, you just pick a cab, pair it up, and rock.
I got to run my Orange through some Celestion G12H Redbacks not too long ago, they had a great sound to 'em. Felt it was really balanced, really crunched up nice with the Orange doomy tones, kept tight and punchy when it did, didn't get real loose like some speakers do. Downside? That sumbitch is nearly 5kg a speaker, so if you're doing a full cab, that's 20kg just in speaker weight if you go with those--then you've got the cab itself. That'd be one heavy rig!
Anyroad, that's about all I've got. As I said, options, plenty of. Just depends on you. I'm a mic the cab kind of guy, and seriously, look into a ReAmping device for when you record. REALLY opens up options!
EDIT: I keep forgetting I'm Scottish and the majority of people here are probably not using Metric (forgetting the metric bit, not that I'm Scottish, only forget that after I've had too much juice of the barley). So for everyone using Freedom Units: Bit over 10lbs, (they're actually 4.7kg) so make no mistake, it's a heavy cab. You'd want a cart for it.