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way. If there are explicit regulations that have been approved by the instead of another soul.”) Moreover, he adds that she should fast on
public stipulating that even an unintentional error can lead to the the eve of every new month for an entire year.
dismissal of the physician, then they have the right to enact the reg- 
ulations. If there are no explicit rules, one should conduct oneself as According to the the Yad Avraham, a mohel who mistakenly cut into
described above.
a blood vessel during circumcision and the baby died is exempt from
exile since he was involved in a mitzvah. He is not comparable to a
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1 SuMMaRy and Conclusions physician who, if he did not heal his patient, did not fulfill the mitzvah
of healing, since he accomplished the mitzvah he had set out to do,
1. One should not reveal the physician’s guilt to the family of a although unfortunately the baby died later. He resembles the agent
deceased patient because it is possible that he acted uninten- of a beis din who gave lashes to a guilty man who later died, and is
tionally, and he is close to an anuss. Even if he was negligent and exempt from exile.
sinned, he is exempt from payment. But we can still differentiate between the cases, for in the case of
the agent of the beis din, it was not the last few lashes which caused
2. If the physician or the hospital are insured by an insurance his death but a combination of all the lashes together. In other words,
company that pays in cases of death or mistakes that indirectly as he fulfilled the mitzvah of carrying out the ruling of the beis din, he
affect patients negatively, the family should be told so that they unfortunately killed the man. That is why he is exempt. On the other
can sue the physician. This payment would not be based on the hand, true, the mohel fulfilled the mitzvah of circumcision, but the
physician’s obligation to pay for damages, but is considered a cutting of a blood vessel was not part of the mitzvah and it occurred
form of business, whereby the insurance company is obligated after the completion of the circumcision.
to compensate the family for the failures of the physician in The Yeshuos Yisrael (Choshen Mishpat #24, Ein Mishpat 3) wrote
exchange for insurance payments made by the physician or the that there is a difference between a physician who did surgery justi-
hospital. Just as a person can insure himself and receive pay- fiably that inadvertently caused damage, who is exempt from paying
ment for an illness for which no one is responsible, so too in this for the damages since he “healed with permission,” and a surgeon
case.
whose mistake stemmed from an erroneous decision, who is then
Even if as a result of the suit the insurance company may exempt from paying only due to the Rabbinic decree of “the good of
demand a higher payment from the physician the follow- the world.” Applying this to the case of the mohel described above,
ing year, it is still permissible for the family to sue. They are we could say that in retrospect, the mohel erred by circumcising the
not harming the physician with their own hands but only baby, since the circumcision was accompanied by the fatal severing
indirectly. The physician who killed the patient also did so of a blood vessel. That is why the mohel is obligated to go into exile.
indirectly, and this will be a kapparah for his errors. It seems, however, that even in such a case there was a mitzvah
to circumcise the baby, but without cutting the blood vessel. When
3. It is a mitzvah for the laboratory director to rebuke the negligent Moshe’s wife Tzipporah circumcised their son, she also damaged
physician, and there is also a mitzvah for Dr. Reuven to reveal him. As it says (Shemos 4:25): “And she threw it at his feet,” and the
the mistake of the treating physician (Dr. Shimon), even though Yerushalmi explains (Nedarim 3:9) that she damaged the boy (as ex-
it may cause conflict. There is the possibility of pikuach nefesh to plained in Korban Haedah, s.v. naga beguf hatinok) since, in her haste,

148 1 Medical-HalacHic Responsa of Rav ZilbeRstein Do they require exile? 2 129

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