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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
