Page 172 - 20818_park-c_efi

20818_efi-ab - 20818_park-C_efi-ab | 6 - A | 18-08-20 | 13:46:24 | SR:-- | Cyan
20818_efi-ab - 20818_park-C_efi-ab | 6 - A | 18-08-20 | 13:46:24 | SR:-- | Black
#20818_efi-ab - 20818_park-C_efi-ab | 6 - A | 18-08-20 | 13:46:24 | SR:-- | Yellow
20818_efi-ab - 20818_park-C_efi-ab | 6 - A | 18-08-20 | 13:46:24 | SR:-- | Magenta
#
a stranger. If a person receives his friend’s money in a capacity of a
watchman or messenger, he is liable.
If so, the question arises: Do the physicians in the health clinics
owe their first allegiance to the community of patients that they ser-
vice, or to each individual patient on his own? It seems logical that
since the physician receives payment from each individual patient, he
has to be loyal to each patient on his own. If so, his primary concern is
providing the individual patient he is servicing with the best advice for
him. This is for the good of the other patients as well, so that if they
find themselves in a similar situation, they too, will receive excellent
treatment. As we find in Tractate Baba Metzia (27b): It is best for one
who finds a lost object to return it when its signs are identified so that
if he loses an object it will be returned when he identifies the signs.
Even if we say that the physician is employed by the community
of patients, we can still say that his first concern must be to treat
each individual patient in the best possible way. One can also wonder
whether a “private consultant” of Rav Huna would be permitted to
give advice for the benefit of Rav Huna, and not considered an evil
person as a result. If this is indeed so, then we can also say that the
health clinic’s physicians are obligated to look out for the best inter-
ests of each individual patient. If so, then the physician in our case is
allowed to refer the patient to the emergency room.
It seems to me that if the patient is a person of means who can
allow himself to pay privately for an echocardiogram, the physician
should tell him to do so. If he is poor and he cannot afford private
testing, the physician should consult with two other physicians. If
they determine that it is best for the patient, and perhaps also for the
good of the health clinic – since by possibly avoiding a transesoph-
ageal echocardiogram and the complications that may develop as a
result, we save the health clinic much money- then perhaps it may be
permissible to refer the patient to the emergency room.
The best thing to do is to go to beis din. If the beis din is under the
impression that the clinic will not lose out by the patient going to the
emergency room, then the physician can refer him to the emergency
room.
158 1 Medical-HalacHic Responsa of Rav ZilbeRstein
The Shulchan Aruch continues (#73:1-4): “How does the husband 6
provide his wife with clothing? He is obligated to give her garments
that are appropriate for her, that every housewife wears in that coun-
try. And he is also obligated to provide her with jewelry, and the like.
This applies to a poor, Jewish person. If he is rich, he has to give her
all the aforementioned items according to his wealth.”
In Chelkas Mechokek (ibid, 3) it says that “if it was appropriate for
him to buy her silk garments, embroidery and golden utensils, we
force him to give them to her. Even if her father was a poor man, her
status rises along with him and he is obligated to give her according
to his wealth.”
If Hospital B has a higher level of medical care, then the husband
has certainly acted contrary to Jewish law in taking her out from Hos-
pital B, which is better in two ways: A) Its quality of care is higher B)
The patient wants to remain there. In such a case, it would be correct
to call the police to prevent the husband from transferring his wife by
force. Below, we rule on whether or not, in this case, the medical staff
of Hospital B can demand ten pieces of gold from the husband for
breaching their mitzvah.
If Hospital A is renowned for a level of medical care higher than
that of Hospital B, but the patient indicated, with her head, that she
would nonetheless prefer to remain in Hospital B, one can assume
that a spirit of folly entered her, and the husband is correct in forcibly
transferring her. As explained in Tractate Yoma (83a), if a dangerously
ill patient refuses to eat on Yom Kippur, we force-feed him, because
we have to assume that he was seized by a moment of folly and that is
why he refuses to eat. This would apply here as well, especially since
her illness resulted from her grief over the recent death of her father,
and especially since she became paralyzed and cannot speak, but only
hints with her head. (See Tractate Gittin 59a and 67b.) In this case the
physicians should assist the husband.

Transferring his Wife Against Her Wishes 2 167