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law does not allow us to desecrate Shabbos since there is currently which case both the Magen Avraham and Elya Rabbah (Orach Chaim
no danger and it is only permitted to save him from a possibility #618) rule that his opinion nullifies that of the ordinary physician.
of danger that has befallen him, but not to preempt and save him
from the possibility that he will fall into danger. Think for yourself: 1 SuMMaRy and Conclusions
If someone standing in prayer sees that a snake has already harmed
someone else, he certainly has to interrupt his prayers in order to save We can summarize with some practical examples:
his friend from danger, whether by amputating his limb or by any
other available treatment. But before the snake has bitten, even the 1. A patient is recovering from hepatitis. The physicians disagree
person himself should not stop his prayers, because it is forbidden to about whether or not he needs to eat and drink on Yom Kippur.
interrupt his prayers because of a possibility of danger in the future… The regular physician says he must eat because the level of his
And by the way, we also learned that if a patient is not currently in liver enzymes is not yet normal, while the expert physician be-
danger but the disease will definitely cause him danger later, one can lieves it is okay for him to fast since the enzyme levels are tending
permit desecration of Shabbos to save his life, even for a future danger, toward normal. They have no difference of opinion about the
if it is definite. But the matter needs Torah study and I did not come facts and the diagnosis, but only about how to proceed. In this
to rule. case, we feed the patient, and the opinion of the expert is not
It is explained in the Gilyon Mahara’i that for a possible danger the decisive one (unless he is an outstanding and extraordinary
in the future, we do not desecrate Shabbos. He probably understood physician, in which case the Magen Avraham holds that we heed
that this snake will not cause harm unless it is stimulated or aroused. his opinion). A lesser physician is allowed to offer his opinion in
Therefore, the snake is only a possible danger for the future. front of a greater one when the diagnosis is obvious.
Sefer Binyan Tzion answers in a similar way (Vol. 1 #137). He writes 2. A person complains of chest pain and his regular physician is
as follows: Although we have a principle that nothing stands in the concerned that he may be developing a general coronary disease.
way of pikuach nefesh and for pikuach nefesh we do not follow the Therefore, he feels it is forbidden for the patient to fast on Yom
majority, this is only if there is definite danger before us, such as a Kippur. The more expert physician believes that the chest pains
building collapsing on someone where we are concerned even with are not from the heart but rather from the digestive system. In
a minority, or a minority of a minority. But if at present there is no his view, the patient is not sick and is allowed to fast. There is no
pikuach nefesh, but only a concern for danger to come, there we follow way to verify the diagnosis. In this case, the view of the expert
the majority. For, if it were not so, how is it permitted to sail on a boat is decisive, and the regular physician’s opinion is not taken into
or go into a desert, which are dangerous, and to violate “And you shall account.
watch over your lives.” It must be that, since at the time that he goes on 3. When assessing the level of damage of the wounded person, if
the sea or into the desert there is as yet no danger, therefore, we follow the damage is fairly apparent, both views are taken into account.
the majority. Proof for this is also in the Rambam’s ruling regarding a If there is a difference between the assessment of the regular
snake. He writes that since the snake does not usually bite, we do not physician and the assessment of the expert, one should compro-
have to stop praying in order to deal with it. In other words, although mise between them. If the greater expert ascertains that there
we do we not follow the rule of the majority in pikuach nefesh, when will be future effects of the accident, then his view is the decisive
there is no actual danger, we can go by the rule of the majority. one.
It seems to me that these words do not contradict the Iggros Moshe,
252 1 Medical-HalacHic Responsa of Rav ZilbeRstein Physician Versus an Expert Physician 2 265
