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Ish to ask whether the chicken was kosher, as there was a possible Why should the surgeon decide now, when the woman is still un-
case of derisah, whereby his pressing on the knife would render the der anesthesia? Why shouldn’t he complete the Caesarean section,
chicken unkosher (as explained in the Rama, Yoreh Deah #24:6). The and after she recovers, ask her whether she consents to the first op-
Chazon Ish, after looking into the matter thoroughly, declared the tion, which is only to remove the mass, or whether she prefers that 4
chicken kosher bedi’eved, since the shochet did not apply pressure to he excise the entire Fallopian tube, so that she will not have another
the knife. The shochet then asked, “What should I do if this happens ectopic pregnancy? Although this will require additional surgery, it is
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to me again?” Chazon Ish answered him: “This will not happen to you preferable to making a decision without asking the patient, especially
again!” In fact, the shochet is now retired, and he says that indeed, such since the physician is under pressure from the unexpected circum-
a mistake never happened to him again. stances.
A worker was once caught stealing scissors in a factory. The own-
ers thought they could fire him, as they had established proof that he 1 AnsweR
stole constantly. However, my brother-in-law Rav Chaim Kanievsky
told them not to do so. He cited proof from Sanhedrin 26b, where it In my humble opinion, I would rule as follows:
says: If a worker stole in Tishrei and he stole in Nissan, he is not yet
called a stealer. Since workers who do agricultural work during the If the chance of a naturally-occurring pregnancy for this woman is
months of Tishrei and Nissan work long hours, they may assume it is less than 5% and the concern of ectopic pregnancy is more than 10%,
permissible for them to steal a little. Therefore, in spite of the fact that then according to Torah law, one should not rely on the slight chance
stealing is prohibited, these workers are not disqualified from serving of a natural pregnancy (as explained in Mishkenos Yaakov, Yoreh Deah
as witnesses and are not called “destructive witnesses” (eidei chamas). #17). Therefore, it is not damaging to the woman to remove the entire
In view of this, my brother-in-law said that a worker who steals a pair tube. In fact, it will enable her to lead a normal married life with her
of scissors from an established enterprise may have thought he was husband without fear of a pregnancy developing outside the uterus.
allowed to steal a cheap pair of scissors. Therefore, although he is in If so, the physician was justified in removing the entire Fallopian tube.
fact a thief, we do not fire him. Had the woman been conscious, she would have consented to this
decision, which is certainly for her good.
However if the chances of a naturally-occurring pregnancy are
Now, we can return to the pediatrician’s questions: greater than 10%, there is room to consider the other option and it
would then be logical to postpone the decision until she recovers and
1. Why should compensation from the Bituach Leumi not suffice? can make her decision.
The patient is still receiving full medical treatments according Thus, if it is absolutely clear to the physician that the best ap-
to the health insurance laws. If so, what gives him the right to proach is to excise the entire Fallopian tube, he is permitted to do so.
demand additional compensation from the physician?
We can assume that when the woman first relied on him to perform
The answer is, that if the physician had license from a beis din the surgery, she also relied on the fact that if something unexpected
to practice medicine and he did not sin (i.e., was not negligent), would come up, he would act according to his understanding. This is
then the patient does not deserve any money at all from the especially so if the signed consent-form for the surgery indicates so.
physician. Even if there were no National Health Law and even (If the physician feels he is under pressure and cannot decide what to
98 1 Medical-HalacHic Responsa of Rav ZilbeRstein Failing to inform a patient of possible risks 2 115
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