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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




        152              1  Medical-HalacHic Responsa of Rav ZilbeRstein                       Do they require exile?  2                                 20818_efi-ab - 20818_efi-ab | 5 - B | 18-08-20 | 13:29:01 | SR:-- | Cyan   20818_efi-ab - 20818_efi-ab | 5 - B | 18-08-20 | 13:29:01 | SR:-- | Magenta   20818_efi-ab - 20818_efi-a






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