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person in danger without supervision. They should be removed from One can cite proof for the above from maseches Yoma (86b) where #
their jobs without compensation, as brought in Tana Devei Eliyahu the Gemara asks: The verses seem to contradict each other. In Tehillim
(as mentioned above in regard to the anesthesiologist who acciden- 32:1 it says, ”Blessed is the one whose transgression is forgiven, whose
tally opened the gas spigot instead of the oxygen one.) sin is covered over,” while in Mishelei 25:13 it says: “He who covers his
transgressions will not prosper,” implying that one should confess and
Case 3: not conceal one’s sins. One explanation that the Gemara brings for
the contradiction is that “one verse refers to a sin that is well known
This case is the most severe of all three. Out of a desire for money and the other to a sin not widely known.” Rashi explains that if a sin
the doctor did not hire an anesthesiologist and left the patient after is widely known it is good for him to confess and not try to hide it.
the surgery with no supervision. He specifically scheduled the surgery But if his sin is not widely known, he should not reveal it, as the rev-
for early in the morning in order to receive a very large fee and did not elation would be a Chillul Hashem. Whenever a person sins in public
want to lose even part of his income by hiring an anesthesiologist. it diminishes the honor of Heaven.
According to Torah law, he should be fired from his job and should In view of the above, it seems that a person should not reveal his
pay a monetary fine, as the Tana Devei Eliyahu writes (above). transgressions in order not to lessen the honor of Heaven. This is the
Responsa Rabbi Akiva Eger (second edition #3) gives instructions ruling in Shaarei Teshuvah (Orach Chayim #423:1).
as to how to repent to someone who caused two deaths. He writes as We should be aware that the physician who caused the death of
follows:
a patient was enacting a Heavenly decree. The physician is only the 20818_efi-ab - 20818_efi-ab | 5 - B | 18-08-20 | 13:29:01 | SR:-- | Magenta

“Regarding repentance, it is, in my opinion, a very severe agent of Hashem. Of course, he is obligated to repent. It is also prop- #20818_efi-ab - 20818_efi-ab | 5 - B | 18-08-20 | 13:29:01 | SR:-- | Yellow 20818_efi-ab - 20818_efi-ab | 5 - B | 18-08-20 | 13:29:01 | SR:-- | Black 20818_efi-ab - 20818_efi-ab | 5 - B | 18-08-2
matter, and the man requires great repentance. We will er for him to recite kaddish for the child or hire someone to do so. He
not deal with the topic of exile because the obligation of should remember the day of the child’s yahrzeit and study mishnayos
exile only applies when there are Cities of Refuge [i.e. in for the elevation of the deceased’s soul. The physician should also
Biblical and Talmudic times], to which one could be ex- work on increasing his fear of Heaven and guarding himself so that
iled…Perhaps he would be exempt from exile because his he never again make such a catastrophic error.
act was close to intentional, making fully loaded horses If we knew that publicizing the physician’s error would result in a
gallop at night, and a human being is always accountable revolution whereby surgeons and anesthesiologists would be strictly
for an act that borders on being criminal. He should have prohibited from working more than eight hours a day, and the govern-
been careful lest the wagon fall due to the horses running ment would ensure that the salary for an eight-hour workday would
at night…The beginning of repentance for the death of his be sufficient, then we would advise the anesthesiologist to disclose
son and his servant, both of whom did not have offspring, what he did. But as long as it does not seem probable that this will
is to establish continuity for them. He should make an occur, the anesthesiologist should not confess publicly.
accounting, had he merited to marry his son off - how The supervisor who ordered the anesthesiologist to work long
much would he have spent on his dowry and clothing and hours requires kapparah as well. By making the workday so long and
other expenses? He should take that sum and make it into exhausting, he placed the doctor at a great disadvantage and displayed
an everlasting fund, using the dividends to support a poor his disregard for the value of life.
person and teach him Torah and Gemara etc. And these A similar case was described by a new immigrant from Russia. His

140 1 Medical-HalacHic Responsa of Rav ZilbeRstein Anesthesia instead of oxygen 2 137