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person to use his knowledge, in the best possible way, and at the given hospitals is equally good. If the treatment provided by one of the hos-
time. pitals is much better for a specific case, then the physician is obligated
Two- the trust and connection between patient and doctor. If there to send the patient to the better place. He is forbidden to prevent the
is no cooperation between the medical staff, they may contradict each patient from receiving better treatment because of his own obligation
other, which will destroy the patient’s trust in them and impinge on to show gratitude to the place where he trained.
his recovery. If however, the physician may lose out on support and increased
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Dr. Uriel Levinger medical knowledge by sending patients to the better hospital, the
Internist, Belinson Hospital, Petach Tikvah physician does not have to forego his private benefit for his present
patient. The basis of the obligation to heal is the mitzvah of returning
1 Consultant 5 a lost object, which in our case is the patient’s lost health, as explained
in Tractate Sanhedrin (73a). Regarding this mitzvah, one’s own lost
Why is it that physicians who hate each other are likely to adverse- object takes precedence to his friend’s lost object (Tractate Baba
ly affect their patients? There are many reasons for this. Metzia 33a). Therefore, especially since the physician’s connection to
1. They will not cooperate together for the patient’s benefit. his hospital is for the benefit of the entire public, it comes before the
benefit of his present patient. Although the patient pays the Kupat
2. They are liable to cause each other to err, at the expense of the Cholim, and can claim that he deserves the best possible treatment,
patient. it is known that regular insurance of the Kupat Cholim does not
3. They are likely to hold back from pointing out to their colleague promise to provide the best treatment, but rather treatment that is
that he had made a mistaken diagnosis or treatment. adequately good.
4. They do not consult each other on medical matters. If the patient is dangerously ill and in order to heal him one must
send him to a specific hospital, then there is nothing to be done. This
5. The point of the physicians’ visits is to bring up various points is the will of Hashem and one cannot consider the loss to the physi-
of view and reach the correct diagnosis and treatment for the cian. He is obligated to send the patient to the hospital that can save
patient. This can only be achieved if the opinions are free of his life. This is what I understood from the words of my father-in-law,
ulterior motives. If not, then the physicians’ rounds and consul- Rav Y. S. Elyashiv zt”l.
tations can turn into a battlefield at the expense of the patient.
One can cite some proof to my father-in-law’s opinion. The mitz-
6. A person who hates another is occupied all the time with how vah of returning a lost object does not obligate one to seek the very
to hurt his friend. He is liable to waste his time at work in slan- best treatment for the patient. As explained in Tractate Sotah (12a),
der, idle gossip, and dirty intrigues. Using up vital energies on Yocheved chose an ark of reeds to protect Moshe rather than an ark
these undesirable activities will decrease his mental and physical made of solid wood, even though it would have offered even better
acumen, and take away from the peace of mind that his work as protection. We derive from here a new halacha. There was no obliga-
a physician requires. tion to use very strong wood if the reeds offer adequate protection.
7. A study conducted in England some years ago that relates to 18 Likewise, if one physician’s treatment is good enough, there is no
consecutive years, clearly showed a reduction in Jewish mortal- obligation to seek out a better one.
ity one week before Pesach. The same was proven with elderly The Maharsha (Chidushei Iggros, s.v. tayvas) adds that we must as-
204 1 Medical-HalacHic Responsa of Rav ZilbeRstein Referring Patients to Experts 2 185
