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1 AnsweR
It appears that according to the Torah it is forbidden to place two
physicians who do not like one another in the same department.
In Tractate Sanhedrin (29a) it says that “Two Torah scholars who
hate each other should not be put on the same beis din.” The Rambam
rules likewise (Hilchos Sanhedrin 23:7). It also says in the Shulchan
Aruch (Choshen Mishpat 7:8): “If two Torah scholars hate each other,
it is forbidden for them to sit in a beis din together. Due to the hatred
between them, each of their intentions is to contradict the words of
the other.” It is likely that the same would apply to two physicians.
The Birkei Yosef writes (ibid, 35) that one should not appoint two
people who are vastly different in their customs and natures to work
together. This applies even to animals, whereby the Torah forbids
plowing a field with an ox and a donkey together (Devarim 22:10)
because the animals are anxious around a different breed (Chinuch
#550). We learn from here that one should not assign two physicians
who are different from each other in conduct and in nature to work
together in one department. Their work will be impaired and they
will not reach the truth.
The Beis Yaakov (#67) was asked if it is permitted for a dayan who
differs greatly from his colleague to sit silently on a case without re-
vealing his opinion. He answered that it is prohibited. He proved this
from the words of the Tosfos (Sanhedrin 18b, s.v. vehoh, the first one).
The Tosfos writes that all those who are disqualified from judging are
allowed to sit in beis din silently, except for two Torah scholars who
hate each other, for whom it is forbidden for even sit silently in on
the case judged by the other. This is implied by the words “We do
not seat two Torah scholars who hate each other, together.” In other
words, even if one sits silently without expressing his opinion, they
are still forbidden to be together.
In view of all the above, it seems correct to add that if the atmo-
sphere in the closer hospital is fraught with tension, and more patients
die there, there is room to permit the desecration of Shabbos in order
206 1 Medical-HalacHic Responsa of Rav ZilbeRstein
7
A PHYSICIAN WHO CAN BE
HARMED BY REFERRING
89 PATIENTS TO EXPERTS
1 Question
I am an orthopedic surgeon. I studied and benefited from the ortho-
pedic department of Hospital A. That is where I studied orthopedics
and also, on a personal level, I received much friendship and support
there. I now work in a Kupat Cholim and maintain the connection
with my former department, by constantly seeking advice for urgent
cases, and by participating in staff meetings.
I usually refer patients from the healthcare clinic to have surgery
performed in the orthopedic department of Hospital A. However,
for hand and knee surgeries, I send my patients to the orthopedic
department of Hospital B, where there are excellent, expert surgeons.
While Hospital A also has good orthopedic surgeons and the results
of their work are good, the results of the surgeries at Hospital B are
even better. This is what I have always done. Recently, my colleagues
at Hospital A, who heard that I send patients to Hospital B for or-
thopedic surgeries, have become angry at me and stopped consulting
with me about our work.
My question is: Should I continue as I have until now, for the ben-
efit of the patients? If I do so, I am liable to lose the support I receive
from my department in Hospital A, which will affect my patients and
cause me to lose out on greater expertise. Which is preferable?
Referring Patients to Experts 2 183
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