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the drug before surgical procedures, in consultation with their car-
diologist.
In addition, one must take into account that tension and anxiety
during the treatment cause the secretion of adrenaline in the body,
which is liable to aggravate the condition of cardiac patients. There-
fore, one should calm the patient before the dental treatment.
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In conclusion, dental treatments in patients who have heart disease
or any chronic illness are liable to be dangerous. Therefore, the dentist
must be aware of the health status of his patient and implement mea-
sures in order to give correct and proper dental treatment.
Dr. A. Zlochower, Dentist, Bnei Brak
1 AnsweR
First, let us establish that if there are government regulations ac-
cepted by the public that stipulate when a physician should be fired,
one should follow these regulations. As explained in maseches Bava
Basra 8b, the people of a city have the authority to determine wages of
workers, which the Rash explains as “to fine them for transgressions of
the rules...” This is explained in the Shulchan Aruch (Choshen Mishpat
#231:28). Moreover, the Shulchan Aruch states (#331) that “everything
follows the custom of the land.” The words that follow refer to a place
that has no regulations on this topic.
Regarding revoking the license of a negligent physician who caused
the death of a patient, we already wrote (in Section 39), that the
Shulchan Aruch’s view is that one fires the expert following even one
act of negligence but only if he is employed by the local community.
According to the Rama, however, he is fired only if he was negligent
three times, and even if he is self- employed.
I heard from my revered father-in-law Rav Yosef Shalom Elyashiv
zt”l that this ruling relates only to a bloodletter who sinned, such as
if he let more blood than needed, because in this case he damaged
directly. If he did not cause damage directly, such as if he prescribed
harmful medications, we have not heard that he should be fired. On
the other hand, my father-in-law also said that nowadays every phy-
156 1 Medical-HalacHic Responsa of Rav ZilbeRstein
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woman had tricked him into divorcing her, the husband said he
had done so willingly and was not sorry at all about the divorce.
(Later he changed his mind and said that he did not willingly
want to divorce her. Maybe people convinced him to say so, in
order to pressure her to give him more money for the second
divorce.) The Divrei Malkiel pointed out that according to this
revelation the bill of divorce is valid. We would need the hus-
band to say, specifically, “Had I known that my wife’s illness was
not dangerous I would not have divorced her.” This is similar to
the case in Gittin, that if a man divorces his wife because of a
rumor, he can nullify the divorce by saying “Had I known that
the rumors were false, even for 100 maneh I would not have
divorced her.”
5. Another proof the Divrei Malkiel brings to validate the divorce
is that the rav asked the husband: Why not wait for half a year?
Maybe she can be healed. The husband answered that after they
married he became aware that she was already ill, but since he
married her he was forced to bear the illness. But in the past
three months the illness has worsened, she cannot eat anything,
and for half a year she has not been able to ritually purify herself
to be with her husband. Therefore, he wants to divorce her. So,
even at the time he gave her the divorce he revealed that even
if there were no danger involved, he would have divorced her
anyway. Therefore, we can validate the divorce. He concludes
there: In any event, if when he found out that there is no danger
he would have complained immediately, there may have been
room to nullify the divorce. But if he did not object, the bill of
divorce is valid.
6. This case also came before the Gaon of Sochaczew, and he invali-
dated the bill of divorce. Witnesses also testified that the reason
he divorced his wife was because the physician said her illness is
dangerous to both of them.
7. The conclusion of the Divrei Malkiel is that the determining
factor for the halachah is that if the woman asked the physician
Divorce due to erroneous medical information 2 185
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