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 whether we follow the thoughts of a person or the result of his action.   3
 This topic is addressed by the Gemara (Menachos 64a): “If he spread
 out a net on Shabbos to trap and catch fish and he pulled in a child
 who was drowning in the sea, Rabbah says he is exempt for violating
 the Shabbos, but Rava says he is guilty. Rabbah says he is exempt be-
 cause of his action, as it turned out in retrospect that he saved a child’s   A PHYSICIAN WHO
 life (Rashi). Rava says he is guilty because we go by his intention,   33  PERFORMED AN
 which was to trap fish, an act prohibited on Shabbos. The Rambam   UNNECESSARY CAESAREAN
 rules  (Hilchos Shabbos 2:16) like Rabbah, that the man is exempt.   SECTION
 The Chazon Ish explains (Menachos #42:18): This act was clearly an
 act of saving a life. Therefore, although he sinned in thought, there
 is no prohibited act here, and one is not held accountable for one’s
 thoughts.     1    Question
 Does this rule (that we consider the act and not the intention)
 also apply to damaging acts? We may differentiate between Shabbos   It came to my attention that a gynecologist who treats many women
 and damages, because doing a prohibited act on Shabbos constitutes   privately performed Caesarean sections when unnecessary. He did
 a desecration of Shabbos’s holiness - as it says (Shemos 31:14): “You   this for two reasons:
 shall keep the Shabbos, for it is holy unto you. Anyone who profanes   For his personal convenience, so that he would not have to wait to
 it shall surely be put to death.” Where there is danger to life, these   deliver the baby naturally.
 words do not apply. The Shabbos laws are set aside and cease to exist,   He is paid more for a Caesarean section than a normal vaginal
 so to speak, because saving a life is not called a desecration of Shabbos.   delivery.
 On the other hand, the prohibition regarding damaging someone’s   Now he has recognized the wrongness of his deeds and he wants
 body or assets does not cease to exist where there is danger to life.   to repent and achieve atonement. He knows that he has to return all
 Therefore, if the physician in our case did a prohibited act of damage   the money obtained deceitfully. He wants to know what else to do so
 that ended up saving a life, we would still require proof that the act is   that his repentance is complete.
 not called an act of damage but one of saving a life.  It is significant to note that a Caesarean section may cause a wom-
 Before we answer the question, let us rule on several similar cases:  an problems in future births.
              In the course of one of these Caesarean sections, he discovered
 
           that the woman had ovarian cancer. Without the surgery, the cancer
           would not have been discovered in time. Does he have to return the
           payment he received from this particular patient?
 1.  Hit a friend and saved his life

 1   Question


 Reuven drove carelessly and hit Shimon. Shimon required medical




 78   1  Medical-HalacHic Responsa of Rav ZilbeRstein  Unnecessary Caesarean section  2   71
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