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What is the Definition of “Chances that the
Surgery will Succeed are Significantly Greater”?

1 Question

#
Above, we cited the words of the Shulchan Shlomo, who explains that
if the chances that the surgery will succeed are “significantly greater”
with another surgeon, then helping to fund the added expense is
considered charity. If not, then the donation does not constitute the Section 9:
mitzvah of tzedakah. How do we qualify “significantly greater” chances KasHrus of Medications
of success?

1 AnsweR

Perhaps it is possible to answer according to the Gemara in Sotah,
where it is recorded that Yocheved put Moshe into an ark made of
reeds, even though other types of wood would have guarded him
better. Since the righteous value their money more than themselves,
she made do with a reed ark, which provided adequate protection,
and did not seek stronger material. Likewise, in our case, if there is an
experienced physician available, then there is no obligation to expend
more money on an even more experienced surgeon. However, if the
available physician has little experience (i.e. he has performed similar
surgeries about 100 times) and there is another surgeon who has vast
experience (i.e. he has performed thousands of such surgeries), then
certainly, the chances of success for complicated open-heart surgery
are much greater with the more experienced surgeon, and he should
perform it. The words of Rav Shlomo Zalman himself can also define
for us “significantly greater” chances of success. He asks, in Minchas
Shlomo (second edition, #37, s.v. ule’inyan), “Regarding what is defined
as a possibility of pikuach nefesh and what is not, and where we draw
the line, I too, deliberated on this matter a lot. From a logical point of
view, it seems to me that that which most people flee from, as one flees
from danger, is considered a possibility of pikuach nefesh. The dictum

180 1 Medical-HalacHic Responsa of Rav ZilbeRstein Relationships Among Physicians 2 209