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will be longer as a result, something the administration of the 7 take away from the quality of care given to others, the hospital is not #
hospital is demanding that the director of the clinic avoid? obligated to do so.]
In Responsa Iggros Moshe (Choshen Mishpat, Vol. 2 #73) he writes
1 Question 5 that if there are two patients, one with a short life expectancy (chayei
sh’aah) and the other with a longer life expectancy (chayei olam), and
A seriously ill patient went to a physician privately and booked an there is only one bed available in the intensive care unit (ICU), one
appointment for a number of days later. This physician also works in should give it to the patient who has a chance to live longer. However,
the hospital and serves as the Associate Director of the department. if the other patient with a short life expectancy was already given the
He has known the patient for a number of years and already began to bed, he acquires it and one cannot take it from him in order to give it
review the patient’s file. Before the appointment date, the patient was to the other patient.
hospitalized. The department arranged to consult with the Director, In view of the above, if the seriously ill patient can be treated well
who casually asked his associate director to join. The staff presented by an intern (A) (especially since the intern is in touch with an ex-
the case to the director, who suggested a solution. The associate di- pert) then we do not transfer him to the more experienced resident
rector, who knows the patient well, thinks this is the wrong solution. in unit B. Even though physician B has more experience and will pro-
Should he express his opinion despite the fact that he was not vide better treatment, being that the seriously ill patient’s presence in
asked for it? Some points to consider are the following: a) It is pos- the unit may impact negatively on the other patients, we transfer the 20818_efi-ab - 20818_park-C_efi-ab | 7 - A | 18-08-20 | 13:46:24 |
sible that he is making a mistake. b) If he is correct and they follow patient to unit A.
his instructions and the patient is healed, she will not return to him The Gemara explains in Tractate Yoma (56b) that because of the
and he will suffer a financial loss. c) The Director of the department Kohen Gadol’s weakness on Yom Kippur, he will not sense that a note
is paid for the consultation. was placed before him, and this will cause serious problems. We sus-
pect that the Kohen Gadol, who was a strong person, will mess up on
Dr. Uriel Levinger, Expert in internal medicine, Beilinson
Hospital, Petach Tikvah the instructions. (We can see that truck drivers who stay awake all
night can tragically come to accidents and killing people.) Certainly,
then, if a physician stays awake all night, he will be incapable of prop-
1 AnsweR to Question 1 erly caring for dangerously-ill patients the following morning.

One can ask: What would happen if another patient would come
I heard from my father-in-law, Rav Y. S. Elyashiv zt”l, that if a patient to the emergency room? Certainly physician B would treat him, if his
is receiving adequate treatment, and the hospital doesn’t give him even unit was in line for admitting patients, as explained in the question.
better treatment, so as not to cause harm to the other patients, they He would not claim, in such a situation, that he is busy with other
have not committed a sin. This is not a violation of the Torah prohi-
bition “Do not stand idly by the blood of your fellowman,” (Vayikra patients and must devote himself to their care. Why then can’t he
take a patient even when it isn’t his technically his turn? Perhaps if a
19:16) since this patient is being cared for properly. [While the Birkei situation is not possible, it’s different, and we do not bring proof from
Yosef (Yoreh De’ah #336:4) writes that “the patient is obligated to re- the impossible to the possible.
quest the most expert physician, and if not, he is wounding himself,”
these words apply to the patient. The hospital, on the other hand, is Had the hospital asked for the Torah view on this, they would
obligated to all the patients. If giving one patient the very best will probably have been advised to transfer two mildly ill patients from
unit B to unit A, freeing up the more experienced resident to deal with

194 1 Medical-HalacHic Responsa of Rav ZilbeRstein Division of Work in Hospital 2 195