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answer. In my humble opinion as well, (says the Chelkas mislead the nurses and cause them to disregard [future calls] and not
Yaakov) this is so, and I will only add to his words. to come with the same speed to situations of real pikuach nefesh. One
There are two possible reasons for his guilt: 1. He did should not bother them with unessential tasks, so that they should be
not wake up his brother when he awoke from his sleep, available to respond to situations of pikuach nefesh.
2. He did not go back to wake him up later when he had Therefore, if the woman saw nothing new in her husband’s situa-
joined his friends in order to continue the march. The fact tion, she was not obligated to summon an ambulance.
that he told his brother to go to sleep is nothing, since even Dr. Menachem Chaim Breuer,
without these words, he would have fallen asleep from his Medical Director of Maayanei Hayeshuah
extreme tiredness and weakness from the death march. Hospital in Bnei Brak
Proof of this is that he himself fell asleep as well.
1 AnsweR
The Chelkas Yaakov goes on to explain himself: The poskim discuss
whether forgetfulness is considered negligence or an accident (oness). Biyur Halachah (328:10, s.v. Verofeh) rules that if a patient says, “I feel
Even if it is called an oness or an unintentional act, the poskim rule weak in one limb or organ, so please treat me with a medication for
stringently when it comes to killing someone. For a murder, even if this weakness,” we listen to him because he knows best what he is
the act was “unintentional close to oness,” the person needs atonement. feeling. Even if the physician says he needs no medication, we do not
But in our case there is much greater room for leniency. In the cases listen to the physician.
discussed by the poskim, the person actually caused the death. If King The Shulchan Aruch (Orach Chayim #618:1) says, in regard to eating
David had not asked for the showbread (lechem hapanim) the murder on Yom Kippur, that if the patient says “I must eat today,” then even
of 400 men in Nov, the city of kohanim, would never have occurred. if one hundred physicians say he does not need to eat, we listen to
In our case, however, had his brother been without him, he would the patient because ‘the heart knows the bitterness of the soul’- i.e. he
also have been killed by the murderous Nazis had he not awakened knows his own needs best.
from his sleep in time. We can only say that he did not fulfill the Thus the patient is to be believed more than the physician, and so,
mitzvah of “Do not stand idly by the blood of your fellow man” and if a patient says “This limb or organ feel weak,” then even if the phy-
this, too, by oness. He also says that if we measure by this standard, sician examines him and finds nothing, we rely on what the patient
no man would be innocent.
says. Therefore, one might conclude that every time a person asks for
The ChelkasYaakov concludes as follows: an ambulance, we are obligated to order one for him. Even if there
The man need not be broken-hearted, for this can only lead to have been many false alarms, we are prohibited from assuming that
sadness, and this is an even greater sin, for it harms him and hinders he does not need the ambulance when he claims he does. When it
his avodas Hashem, which requires joy. He can repent in keeping with comes to pikuach nefesh we pay attention even to the slightest chance
the tiny drop of sin that he may have done by telling his brother he of danger. (Rashi’s commentary (Bereishis 26:8) on the verse “And it
could sleep and he would wake him, although he would have fallen came to pass when he had been there a long time” seem to imply the
asleep anyway from tiredness and weakness of the march. (Perhaps same thing.)
he would not have fallen into such a deep sleep had his brother not In maseches Sanhedrin (42b) it says: If someone is being taken out
assured him he could nap.) to be executed and says “I have something to say for myself ”, one takes

168 1 Medical-HalacHic Responsa of Rav ZilbeRstein Ordering an ambulance 2 173