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ple involved (be they the physicians or the patients) knew in advance 7 job when the purpose of the investigation is to increase the staff ’s
that the secretary would be aware of what goes on, it is considered awareness of the value of human life.
as though they waived their right from the start. In the pediatrics It says in the Torah (Vayikra 11:30): “And the gecko and the land
department this would not apply because halachically children cannot crocodile and the lizard and the sand lizard and the chameleon…
waive their rights. these are impure for you, he who touches them when they are dead
Furthermore, writes the Tzitz Eliezer, without the help of the sec- is impure until the evening.” Rabbeinu Bachya wonders why the snake
retary, the work would not get done as needed and many mistakes (which is the source of impurity) is not counted among the eight
would be made. (For example, using the aforementioned advice, the creeping things that make a person impure when they are dead? He
letter about Reuven could be mistakenly recorded as referring to responds that since a snake and scorpion are dangerous to human
Shimon.) Since the secretary’s work is beneficial and necessary, under beings, if they would make a person impure in their death, people
these circumstances, it is permitted to relay negative information, as would refrain from killing them, and thus endanger themselves. The
explained in the Chafetz Chayim. According to this explanation, it is Torah reckons with this thought process and therefore excludes these
even permissible for the secretary to type children’s discharge letters. dangerous animals from the list.
The opinion of Tzitz Eliezer and his arguments were shown to my (We can also add to this the words of the Chasam Sofer (Toras
father-in-law, Rav Y. S. Elyashiv zt”l, and nevertheless, he ruled that Moshe, Vayikra 10:16), who writes: Why is the vav in the word gachon
the director of the department should write the letters himself (if he the half-point in the letters of the Torah? Our Sages said (maseches
could not dictate them to the secretary without names.) He explained Sanhedrin 59b): “It is a shame that the great server (the snake) be-
his reasoning as follows: came corrupt,” meaning that had the snake not become corrupted, he,
There are matters where waiving does not help. Here are three representing all the forces of evil in the world, would have provided
examples: for the needs of the world. In essence there would have been a part-
nership like that of Shimon the brother of Azariah and like Zevulun
1. In maseches Kiddushin (19b) it states: If a man says to a woman: and Yissachar. This is the ‘halfway’ mark of the Torah, as the nachash
be you betrothed to me on condition that I have no marital re- would have provided for half of the world’s needs…)
sponsibilities towards you, she is betrothed, and the condition We see from here how important it is to encourage awareness and
is null and void. So says Rabbi Meir. Rabbi Yehudah says that care in matters of pikuach nefesh.
for monetary items, the condition is valid. Rashi explains: Mat-
ters of money can be waived, but [lack of] marital relations are 
a bodily distress, and cannot be waived by the wife. We received a letter on this topic from Rav Yitzchak Zev Kohen,
shlita:
In other words, one cannot halachically forgo or waive …I present my thoughts to the Mara D’asra shlit”a (local rabbi), in
bodily distress. This may apply in our case. order to hear his opinion on this matter.
Firstly, we should see this topic as real pikuach nefesh. Human
2. It says in the Shulchan Aruch (Orach Chayim #169:1): If food is nature is that when a person is accustomed to working he no longer
brought before a person, the good aroma of which whets one’s is shocked at the sight of a sick patient who is in danger. Certainly
appetite, one must immediately give some to the waiter, and it is without heavy pressure from the administration of the hospital there
an act of chassidus to give him some of every kind of food being could be many mistakes. We do not fulfill our obligation of hishtadlus

206 1 Medical-HalacHic Responsa of Rav ZilbeRstein Criticism of a medical omission 2 199