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expert physicians who are now trying to determine the cause of brain vah of “restoring a lost object,” which only applies if he was successful
damage in the patient. in restoring his lost health. Therefore he has to go into exile.
This is a difficult task, which is likely to soil the relationship be- According to this explanation of the Yad Avraham, there is more
tween two doctors who have worked together. Nonetheless, we cannot reason to exempt the ambulance driver who killed a pedestrian in his
ignore the baby and his difficult condition and the Biblical command rush to get the patient to the hospital than the physician who erred
“Do not stand idly by the blood of your fellow man.” Therefore, we and the patient died; the ambulance driver did a mitzvah by driving
are obligated to tell the whole story to the expert physicians. the sick person to the hospital. He is exempt for inadvertently killing
If the doctor asking the question sees that his words fall on deaf someone since he did it while performing a mitzvah. In this way, he is
ears and the anesthesiologist is more concerned about his reputation just like the agent of a beis din. On the other hand, a physician who
than about the baby’s life, he is obligated to tell the experts what inadvertently killed did not essentially perform any mitzvah and has
happened and they will decide whether or not the brain damage was to be exiled.
caused by the anesthesiologist. Perhaps, however, we can differentiate and say that the ambu-
lance driver should be exiled. After all, while he was involved in the
1 SuMMaRy and Conclusion mitzvah of saving Reuven’s life, he unintentionally killed Shimon, the
pedestrian. In this way he is different from the agent of a beis din who
One should notify the expert physicians of the incident. flogged the litigant and killed him unintentionally – i.e. the mitzvah
and the sin concern the same person.

 Nonetheless we can still exempt the ambulance-driver from exile
because in maseches Makkos 8a the question is asked: If one was chop-
ping wood to build a sukkah or wood for the Altar fire, although he
was doing a mitzvah, if he inadvertently kills someone, he has to be
Informing the family of medical negligence exiled. Why?
resulting from lack of follow-up
The Gemara answers that chopping wood for a sukkah is not the
1 Question essence of the mitzvah but preparation for the mitzvah, and the mitz-
vah itself is building the sukkah. If the wood-chopping would be the
A patient of our clinic presented with a lump in the breast and was actual mitzvah and not just preparation for the mitzvah, then if he
referred by her doctor to an expert in the hospital for a tissue biopsy. killed someone he would be exempt from exile. Although the mitzvah
The expert physician examined the woman (who was nursing at the and the inadvertent sin are two separate entities, the halachah is that
time), and, suspecting a growth, he aspirated pus from the lesion but he is exempt from exile because in the final analysis he was involved
did not take a tissue biopsy. The patient was told to return in a month in a mitzvah.
to see the expert but she ignored the instructions. Over two months In our case, the ambulance driver is involved in a mitzvah every
later, the expert came to the clinic again and asked about the patient. moment, and not only in the preparation for the mitzvah. Proof for
They contacted her and heard that her condition had deteriorated. this comes from the words of the Nimukei Yosef (Bava Metzia 16, end
The woman was sent back to the expert and he found a large tumor of 16a, from the pages of the Rif) who asks: How is it possible that we
that had already metastasized. She is presently receiving chemo- allow a kohen to become tameh in a cemetery in order to return a lost

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