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pected of taking a bribe, he is not obligated to do so, as long as him and his work conditions will suffer as a result? Is he obligated, 7
there is no danger to life involved. However, if there is concern even then, to reveal the truth?
about pikuach nefesh, then “there is no wisdom or discernment One can answer that if the treatment in this Hospital A is good,
against the Lord.” Since there is nothing that stands in the way there is no obligation to reveal that things are even better in the other
of pikuach nefesh, the physician would be obligated to do what Hospital B. All the halachos of saving lives are based on the mitzvah
must be done, despite the cost. “And you shall return a lost object,” in this case, one’s lost health (San-
hedrin 73a). The halacha is that one is not obligated to return a lost

object in a case where he would not do so even for himself, because of
the costs (See Baba Metziah 32b). It is likely that he would not do this
even for himself, since the other physicians and the administration

At Times Salvation Comes Not from the Very would be angry at him.
Best All this applies if the treatment in Hospital B is better. But if the
treatment in Hospital A is not adequate and reliable, and the patient
The great tzaddik Rav N. Tfilinsky zt”l studied in Yeshivas Etz Chaim is likely to become endangered, the physician is obligated to hint to
in Yerushalayim. He had a daughter who had come of age, and not a the family members that they should go to Hospital B.
penny to marry her off. He decided to ask the gabba’im of the yeshivah
for the contact information to one of their greatest patrons, so that 1 AnsweR to Question 4
he could ask for his assistance. The gabba’im had difficulty deciding
whether or not to fulfill his request, since doing so would possibly Should the bronchoscopy be performed by a specialist, even though
interfere with the Yeshivah’s income from the patron. Since they did this is likely to lengthen the patients’ wait, which the administration
not want him to leave empty handed, they gave him the address of of the hospital wants to avoid?
one of their smaller contributors. Amazingly enough, this donor, who It seems to me that it is for the patient’s benefit that the test be
was not a very rich man, sent Rav Tfilinsky all the expenses for the done by an expert. However, if doing so will seriously hold up other
wedding, as well as a dowry. patients, forcing the interns to do examinations, then one should tell
When asked what motivated his generous contribution, the donor the patient that this examination is only accurate 70% of the time.
answered that his own daughter, a bride, was dangerously ill. He had One is not, however, obligated to tell him that if an expert does the
vowed to give the full sum of his own daughter’s dowry to any poor procedure the rate of accuracy is 90%, if the lines will be longer as a
bride who would seek his help. Since Rav Tfilinsky had approached result. See above (Section 36).
him first, he gave Rav Tfilinsky’s daughter all he had vowed to give.
We learn from this story that not always does salvation come from 1 AnsweR to Question 5
the very best.
The Associate Director is obligated to express his opinion on the
correct solution to the problem. If the director accepts it, good, and if
not, then he has done his duty. If he is silent, he is violating the prohi-
bition of “Do not stand idly by the blood of your fellowman” (Vayikra

190 1 Medical-HalacHic Responsa of Rav ZilbeRstein Division of Work in Hospital 2 199