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rector of the Maayanei Hayeshua Hospital in Bnei Brak, and he
answered as follows:
To the honorable Rav… shlita:
I want to bring two arguments against continually calling for an
ambulance in the case of the man’s constant false complaints:
Magen David Adom has a limited number of ambulances it will
pay for per area, and an even more limited number of emergency ve-
hicles with a paramedic and resuscitative equipment included, as well
as vehicles that have a physician attached to them. Repeated calls for
an ambulance from one person will cause the emergency-equipped
ambulances not to be available when urgently needed for true emer-
gencies such as heart attacks. This certainly endangers the lives of
patients who urgently need immediate emergency care.
The multitude of false complaints by one person dulls the alacrity
and devotion of the life-saving paramedics and delays their arrival on
the scene of a true emergency. It can cause a disregard for the concept
of pikuach nefesh.
I saw a similar case discussed in Sefer Chut Shani by Rav N. Kare-
litz shlita (Part 4, Ch. 89, p. 157, in Shaar Haziyun). There it says:
“One should minimize the amount of unessential tasks placed on
people who are in charge of attending to emergencies, such as phy-
sicians, ambulance drivers or firemen, even on Shabbos, so that they
are available to save lives, and so that they not come to disregard the
importance of saving life.” He also adds that “If the firemen were sum-
moned to put out a fire on Shabbos and the fire extinguished itself, it
is permissible on Shabbos to call the ambulance or fire stations to tell
them that there is no need for them to come. The reason is that if they
show up and see that there was no need for them to come, it might
lead to disregard for situations of pikuach nefesh. [The call] might also
reduce the desecration of Shabbos.
“Once, on Shabbos, a man was sitting with his son in the pediatric
unit, and the IV ran out. The instrument began beeping and there
was no gentile available [to shut it off]. Rav Karelitz ruled that the
father himself could turn off the beeping instrument on Shabbos
because there are other cases of pikuach nefesh, and the beeping can
172 1 Medical-HalacHic Responsa of Rav ZilbeRstein
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It is correct that he make every effort to perform mitzvos of the #
same sort, such as:
1. Not to shame a person, which is equivalent to killing him.
2. If he is able to procreate, he should not refrain from doing so, as
this is like spilling blood
3. To raise an orphan in his home.
4. To support those who learn Torah, as it says (Mishlei 20:27):
“The light of Hashem is the soul of man,” and “A mitzvah is a
candle and Torah is light.”
He should do all this according to his abilities and his situation, and
his heart should rejoice to fulfill mitzvos of Hashem.
In short, the Chelkas Yaakov rules leniently on this man, who out
of forgetfulness did not rescue his brother. He instructs him to re-
lease himself from his guilt and to be careful with the aforementioned
four things as an atonement. The same may apply in our case. The
physician should try to be careful with the above four things and this 20818_efi-ab - 20818_efi-ab | 6 - B | 18-08-20 | 13:29:02 | SR:-- | Magenta #20818_efi-ab - 20818_efi-ab | 6 - B | 18-08-20 | 13:29:02 | SR:-- | Yellow 20
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1 SuMMaRy and Conclusions
If the physician did not question the patient to see if he was in danger,
he did not do his job faithfully and requires repentance and atone-
ment. Nonetheless we can be lenient in regard to his teshuvah, and
follow the instructions of the Chelkas Yaakov.

A physician did not convince a cardiac patient
to go to the hospital by ambulance, and the patient
died on the way to his car.
1 Question
A healthy man, about 50 years of age, saw a physician with his wife.
He related that the previous day he had felt pressure in his chest for
Physician did not respond and patient died 2 169