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to a good place, although he will not receive the best care, from the Why did Rabban Gamliel not allow him to repay the lost mitzvah
physician he feels close to, in an environment that is familiar to him. with a chicken, worth less than ten gold pieces?
This is not considered spilling of blood. It is no different than the Our case, it seems, is dependent on this disagreement between
fact that we cannot provide – because of budgetary restrictions – the Rabbenu Tam and Rav Yitzchak. According to Rabbenu Tam, who
choicest calf and a fattened goose for the infirm people, even though is of the opinion that one can repay him with a chicken to slaughter,
we know that if we provided them the best and most nourishing food and the blessings on the slaughtering will replace the blessings that he
they would live longer. missed, then here too, one can say that the new patient replaced the
My father-in-law continued: Think about it. Would it be permis- mitzvah of healing that the doctors lost. According to Rav Yitzchak,
sible to dig a hole and steal money from people in order to admit who is of the opinion that one cannot “replace” a lost mitzvah, the
such a patient to a superior institution for the elderly that he wants?! husband in our case would have to pay the doctors ten gold pieces.
I would say that although it is important to keep this elderly patient Practically though, it seems to me that even according to Rav
in an institution familiar to him, and the transfer will undoubtedly Yitzchak, if the hospital is completely full, the husband is exempt
harm him, nonetheless, this is not real pikuach nefesh and does not from paying them. This is because regarding the mitzvah of being
justify violating the Torah prohibition of stealing, and the like. Thus called up to the Torah, (ibid. Baba Kamma) the chicken is inadequate
one is not allowed to steal from the elderly population in need of this as payment, since theoretically the victim could have done both
institution in order to prolong the life of one man. mitzvos (being called up, and slaughtering a chicken and covering its
However, if the situation is such that the patient would be actually blood). In our case, however, if the hospital is full, it is not possible
liable to die in transfer to a different place, such as if we know he will to admit both patients and thus the physicians did not lose anything.
have a heart attack or go mad, then in such a situation, Torah law My father-in-law also added that if the husband acted out of con-
allows us to steal from others and to desecrate Shabbos in order to cern for his wife, even though his calculations were not correct, it is
prevent his transfer him to a nursing home. In this type of circum- not possible to obligate him to pay because it is viewed as a mistake
stance, it would be permissible to steal the services of the institution made while doing a mitzvah, where he is exempt.
from the other infirm people in order to save the life of this patient.
The general rule, then, is as follows: As long as the Torah does 1 SuMMaRy and Conclusions
not permit stealing and desecrating Shabbos in order to lengthen the
patient’s life, one should transfer him to a nursing home. 1. If Hospitals A and B are equal in the level of medical care they
The same would apply to the transfer of a patient with a very short offer, the husband did not act according to halacha. However,
life expectancy (chayei sha’ah) from the intensive care unit to a reg- the physicians are not obligated to call the police in order to
ular ward. This is not viewed as “spilling blood” because even in the prevent the transfer.
regular ward, the patient will receive good care. Until recently, this is
how all cardiac patients were treated. Even nowadays, when there are 2. If Hospital B is a private hospital and it is more pleasant for the
intensive care units providing optimal treatment, it is not considered woman to remain there, but the husband prefers Hospital A
“spilling blood” to provide the patient with care that is less than opti- because of economic considerations, the husband is right.
mal. Therefore, if the bed is designed to treat cardiac patients with a 3. If the husband is a rich man or the woman comes from a rich
longer life expectancy, one should move the chayei sha’ah patient from family, then justice is on her side.
150 1 Medical-HalacHic Responsa of Rav ZilbeRstein Transferring his Wife Against Her Wishes 2 175
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