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the damage, but he would not deserve to be hit by the gentile. Thus, woman clean for her husband (Vayikra 12:2ff). Moreover,
had the Gaon spoken up he would have been giving over a Jew to in whatever I do I seek the advice of my teacher, Mefi-
undeserved punishment). He would then have to return to the world boshes, and I tell him, “My teacher, did I judge well? Did I
as a barking dog, and neither his Torah nor his good deeds would convict correctly? Did I properly declare the innocent to be
have saved him from this punishment. innocent? Did I properly declare that something is tahor?
Why was it forbidden for the Vilna Gaon to tell the gentile that Did I properly declare that something is tameh? And I
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he was not at fault? His intent was to save himself, so why should he was not ashamed. Rabbi Yehoshua, son of Rabbi Idi, said:
bear responsibility for the fact that the gentile might hurt the Jewish Which verse can be recited in support [of this assertion
coachman as a result? One can answer that his own innocence and by David]? “And I will speak of your words, Hashem, to
rescue from harm and the coachman’s suffering at the hands of the kings, but I will not be ashamed” (Tehillim #119:46).
gentile were irrevocably linked; one could not occur without the oth- The teacher of King David wasn’t Mefiboshes but Ish
er. Thus he had no right to clear his own name and bring harm upon Boshes. Why was he called Mefiboshes? Because he hu-
his fellow. (So, too, writes the Chafetz Chaim (Principle 10, #17) in
Be’er Mayim Chayim, and cites proof from the Shulchan Aruch (Chos- miliated (mevayesh) King David in halachah.
hen Mishpat #388) and the Biyur Hagra, there.)
It is especially forbidden to be ashamed to ask in a case of danger to
 life, and specifically when the case concerns an illness, such as inflam-
mation of the appendix, where errors in diagnosis are common (up to
1 SuMMaRy and Conclusions 20% of cases, as cited in the question), or any internal illness the facts
of which are largely hidden from us.
A physician who was supposed to remove a kidney for transplanta-
tion and erred and removed the wrong kidney, which was then shown What is the law regarding a physician who is widely known as
to be cancerous, is exempt from paying the patient compensation for an expert and is certain that his diagnosis is correct? If he has the
removing the wrong kidney. The patient must pay the usual fee for re- opportunity to consult with another physician greater than he, is he
moving a diseased kidney but not the fee paid for removing a kidney obligated to consult with him? And if he does not consult and the
for the purpose of transplantation. patient dies under his care, is he classified as a murderer?
The Shulchan Aruch says: “A person should not practice medicine
unless he is an expert and there is no greater physician there than he.”
The Vilna Gaon, there (104) cites the source: We learn this as a kal va-
chomer from other laws and rulings in the Torah which are forbidden.
But the Rama (Yoreh Deah #242:31) writes: A person should not issue
halachic rulings until he is forty years old if there is another Torah
scholar greater than he in the city. This means that if a rav reached
the age of forty years, he is allowed to issue halachic rulings, even if
there is a greater rav than he in the city. If so, the same may apply to
a physician. If he reached the level of being an “expert,” he is allowed

92 1 Medical-HalacHic Responsa of Rav ZilbeRstein Do they require exile? 2 121

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