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supervisor ordered him to work a crane when he was feeling ill. He 5 one of them returned to the operating room, the patient had died. # 20818_efi-ab - 20818_efi-ab | 5 - A | 18-08-20 | 13:29:01 | SR:-- | Magenta 20818_efi-a
hit a fallen electricity line and electrocuted a passing man, who died What is the halachah in regard to these physicians?
as a result. Does he need atonement for the death occurred when he A private surgeon operated on a patient during the very early
was feeling sick? It seems to me that the supervisor is the one who morning hours. He did both the surgery and the anesthesia and did
needs the atonement. not enlist an anesthesiologist. After the surgery, he left the patient
alone in the recovery room without supervision. A complication
1 SuMMaRy and Conclusions occurred and the patient died. What is the halachah regarding this
physician?

1. The physician should not expose his error, unless he knows that
as a result extended shifts will become prohibited. 1 AnsweRs
2. The physician needs to repent. He should say kaddish for the Case 1:
first year for the boy who died while under his care, or hire
someone to do so in his place. He should learn mishnayos for The anesthesiologist could not have imagined the possibility that
the elevation of his soul and recall the boy’s yahrzeit for the rest the oxygen line would be crushed by something. He is considered to
of his life. have acted unintentionally, close to an anuss, because such an occur-
rence is very rare. Nevertheless, the physician needs to seek atone-
3. The supervisor requires atonement because he is the main ment because he should have watched the patient conscientiously to 20818_efi-ab - 20818_efi-ab | 5 - A | 18-08-20 | 13:29:01 | SR:--
transgressor – he is the one showed disregard for the value of see that she was receiving adequate oxygen.
life.
The Noda Biyehudah (first edition, Orach Chayim #34) rules on a
 case where Shimon asked Reuven to give him merchandise to sell in
a nearby town. Reuven gave it to him and Shimon was killed on the
road while transporting the merchandise. The Noda Biyehudah obli-
gated Reuven to fast for a number of days because he was the cause
A medical error that caused a patient’s death of Shimon’s death. Had he not given Shimon merchandise, Shimon

would not have been killed. The laws of Heaven apply even to an
1 Question indirect cause such as this, because it says (Samuel I 24:13): “From the
wicked there emerges evil.” In other words, if he was the agent [from
During anesthesia, one of the tools in the operating rooms com- Heaven] to kill Shimon, he is obviously viewed as a wicked person
pressed the oxygen pipe. As a result, the oxygen did not reach the pa- on high. This applies all the more so in our case, where the physician
tient who was having surgery and she died. Does the anesthesiologist should have supervised the patient better.
need atonement?
Two anesthesiologists who were responsible for a patient undergo-
ing complicated and lengthy surgery took a break and left the oper- Case 2:
ating room to drink coffee and smoke a cigarette. In the meantime, a This case is more severe than the first one because the physicians
complication occurred with no anesthesiologist present. By the time were negligent to the point of not doing their job properly, leaving a

138 1 Medical-HalacHic Responsa of Rav ZilbeRstein Anesthesia instead of oxygen 2 139