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person in danger without supervision. They should be removed from
their jobs without compensation, as brought in Tana Devei Eliyahu
(as mentioned above in regard to the anesthesiologist who acciden-
tally opened the gas spigot instead of the oxygen one.)
Case 3:
This case is the most severe of all three. Out of a desire for money
the doctor did not hire an anesthesiologist and left the patient after
the surgery with no supervision. He specifically scheduled the surgery
for early in the morning in order to receive a very large fee and did not
want to lose even part of his income by hiring an anesthesiologist.
According to Torah law, he should be fired from his job and should
pay a monetary fine, as the Tana Devei Eliyahu writes (above).
Responsa Rabbi Akiva Eger (second edition #3) gives instructions
as to how to repent to someone who caused two deaths. He writes as
follows:
“Regarding repentance, it is, in my opinion, a very severe
matter, and the man requires great repentance. We will
not deal with the topic of exile because the obligation of
exile only applies when there are Cities of Refuge [i.e. in
Biblical and Talmudic times], to which one could be ex-
iled…Perhaps he would be exempt from exile because his
act was close to intentional, making fully loaded horses
gallop at night, and a human being is always accountable
for an act that borders on being criminal. He should have
been careful lest the wagon fall due to the horses running
at night…The beginning of repentance for the death of his
son and his servant, both of whom did not have offspring,
is to establish continuity for them. He should make an
accounting, had he merited to marry his son off - how
much would he have spent on his dowry and clothing and
other expenses? He should take that sum and make it into
an everlasting fund, using the dividends to support a poor
person and teach him Torah and Gemara etc. And these
140 1 Medical-HalacHic Responsa of Rav ZilbeRstein
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One can cite proof for the above from maseches Yoma (86b) where #
the Gemara asks: The verses seem to contradict each other. In Tehillim
32:1 it says, ”Blessed is the one whose transgression is forgiven, whose
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
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
and the other to a sin not widely known.” Rashi explains that if a sin
is widely known it is good for him to confess and not try to hide it.
But if his sin is not widely known, he should not reveal it, as the rev-
elation would be a Chillul Hashem. Whenever a person sins in public
it diminishes the honor of Heaven.
In view of the above, it seems that a person should not reveal his
transgressions in order not to lessen the honor of Heaven. This is the
ruling in Shaarei Teshuvah (Orach Chayim #423:1).
We should be aware that the physician who caused the death of
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
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 2081
er for him to recite kaddish for the child or hire someone to do so. He
should remember the day of the child’s yahrzeit and study mishnayos
for the elevation of the deceased’s soul. The physician should also
work on increasing his fear of Heaven and guarding himself so that
he never again make such a catastrophic error.
If we knew that publicizing the physician’s error would result in a
revolution whereby surgeons and anesthesiologists would be strictly
prohibited from working more than eight hours a day, and the govern-
ment would ensure that the salary for an eight-hour workday would
be sufficient, then we would advise the anesthesiologist to disclose
what he did. But as long as it does not seem probable that this will
occur, the anesthesiologist should not confess publicly.
The supervisor who ordered the anesthesiologist to work long
hours requires kapparah as well. By making the workday so long and
exhausting, he placed the doctor at a great disadvantage and displayed
his disregard for the value of life.
A similar case was described by a new immigrant from Russia. His
Anesthesia instead of oxygen 2 137