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boy’s life was in danger. If the physician had consulted with a greater because his case refers to a situation where the illness has already
expert, he would not have made this fatal error. begun. For example, the patient has bronchitis, and the physician de-
This does not apply if the illness and its required treatment are termines that it is likely to develop into pneumonia. In this case, his
obvious. In this case every physician has the right to his opinion on current illness is viewed as dangerous. On the other hand, if he has
whether the patient is able to fast. The degree of expertise does not inflammation of the joints, which may turn into a cardiac illness, or if
play a role in this matter. That is why the Rama rules that if the less excessive bedrest can lead to danger, then since the dangerous illness
experienced physician believes that fasting will endanger the patient, is not yet present, one does not desecrate Shabbos for it now.
we abide by his opinion even if the outstanding physician feels oth- This is similar to the following words of the Chazon Ish (Oholos
erwise. #22:32): Pischei Teshuvah cites (Yoreh De’ah #363:5) in the name of
In view of all the above, we can understand what it says in Tractate Noda Biyehudah (Yoreh De’ah, second edition #210) and the Chasam
Avodah Zarah (72a): Reuven sold a house to Shimon and determined Sofer (Yoreh De’ah #336) that if there is a sick patient present before
that the price would be according to the assessments of three apprais- us, it is permitted to desecrate the deceased because of pikuach nefesh.
ers. After the assessments were made, the buyer demanded that three But, if there is no patient present, it is forbidden to desecrate the
more expert appraisers be called in. Rav Huna, son of Rav Yehoshua, deceased, and it makes no difference whether he is before us or not
ruled that the buyer’s claim was not valid. How do we know that the but if the matter is common, that at the time we sound the alarm
second set of appraisers made the more correct assessment? Perhaps (even if at the time there is no sick patient before us) because of a
the less expert group was more accurate? This requires explanation, contagious sickness, it is like enemies laying siege to a city close to the
being that we learn in Tractate Avodah Zarah (7a) that it is forbid- border and as it says in Tractate Eruvin (45a) and in Tractate Ta’anis
den to accept the words of a Torah scholar if there is another greater (19a), but at times of peace we do not view it as pikuach nefesh even
scholar than he in the city. (See also Shulchan Aruch (Choshen Mish- though at times it is common that one needs this just as one does not
pat #206) and Shach (ibid, #3). make arrangements on Shabbos at a time of peace because if so all
It seems to me that since the sale value of a house is fairly simple mitzvos would be nullified, but it is not called possible pikuach nefesh
and obvious, and does not require exceptional judgement, one can for future matters which are not present now at all. Truly, we are not
consider the opinion of the appraisers, even though there are greater experts on future events. At times, one may calculate to save life but
experts than them. it boomerangs. Therefore, we do not rule about distant future events.
In view of the above, when a physician estimates the degree of dis- Therefore, it seems to me that the words of Iggros Moshe were said
ability of a wounded person as 50%, and an expert physician estimates about a sickness which, if it gets worse, will endanger the patient and
it at 80%, one should not disregard the view of the first physician in then he is ruled as a dangerously ill patient, which is not the case if
favor of that of the expert physician. One should compromise be- presently there is no sign of the future illness at all and it is only a very
tween the two assessments. distant possibility.
However, if the expert’s assessment is based on some aspect not
known to the first physician, for example if the expert physician 1 SuMMaRy and Conclusion
discovered something new, or is able to take long range effects into
account, then one must heed his opinion over that of the other physi- An illness which, if it gets worse, would endanger the patient’s life, is
cian. This applies all the more so if he is an outstanding physician, in halachically considered a dangerous illness.
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264 1 Medical-HalacHic Responsa of Rav ZilbeRstein Non-Dangerous Disease 2 253