Page 270 - 20818_park-c_efi

20818_efi-ab - 20818_park-C_efi-ab | 9 - B | 18-08-20 | 13:46:24 | SR:-- | Cyan
20818_efi-ab - 20818_park-C_efi-ab | 9 - B | 18-08-20 | 13:46:24 | SR:-- | Black
#20818_efi-ab - 20818_park-C_efi-ab | 9 - B | 18-08-20 | 13:46:24 | SR:-- | Yellow
20818_efi-ab - 20818_park-C_efi-ab | 9 - B | 18-08-20 | 13:46:24 | SR:-- | Magenta
#
ly, then, it is permissible to do it, even though the main goal is still to
benefit the patient at a later time.
My father-in-law’s assertion is probably based on the words of the
Noda Biyehudah (second edition, Yoreh De’ah #210) who writes: “In
order to violate a Torah prohibition because of pikuach nefesh, the
patient must be ‘before us.’ Therefore, if at the moment there is no
danger to the patient and there is no patient ‘before us,’ one should
not expose him to a slight danger for the benefit which perhaps may
occur at a later time.” It thus follows that if there is immediate benefit
to doing the procedure, we can risk the slight danger, because the
patient is already ‘before us’ and the benefits are obvious as well.
This principle probably applies to the first question as well. The
physician made the right decision by doing nothing, because if there
is no present danger, one should not expose the patient to a slight
danger that will possibly benefit him at a later time.
In summary: it is preferable to do nothing.
256 1 Medical-HalacHic Responsa of Rav ZilbeRstein
2. An expert physician with a lot of experience.
3. An outstanding physician (muflag). This refers to someone who
is outstanding in wisdom and has long range vision.
We learn in Shulchan Aruch (Orach Chaim #618:2) and in Mishnah
Berurah (ibid, 8) that if one physician says the patient needs to eat on
Yom Kippur and another physician says he does not need to, we make
him eat, even if the one who said he does not need to eat is a greater
expert. If he is an outstanding physician, his opinion is accepted and
the patient has to fast (unless many people disagree with him.) This is
the view of Magen Avraham (#5), and the view of the Rama is that the
outstanding physician’s opinion notwithstanding, we feed the patient.
We also learn in the Shulchan Aruch (Yoreh De’ah #336:1): One
should not practice medicine unless he is an expert, and there is no
greater expert than he, for otherwise, he is spilling blood. The Gra
(Vilna Gaon) explains: All the more so, based on other laws and rules
and regulations in the Torah, one is forbidden to practice medicine
under any other circumstances. We say at the beginning of the tenth
chapter of Sanhedrin (84b): Rav would not let his son remove a thorn
from his flesh, and in the end of Kiddushin (82a) it states that “the best
of physicians are destined for Gehinom.”
His words can probably be explained as follows: It says in Tractate
Avodah Zarah (7a): If there are two Torah scholars with differing
views- one declares impure and the other pure, one prohibits and
one permits- then if one of them was greater in Torah wisdom and
number, we follow his ruling. In other words, when it comes to legal
judgments and rulings in the Torah, the opinion of one Torah scholar
is nullified by that of a greater Torah scholar, whether he rules leni-
ently or stringently. If so, all the more so with lives, one physician’s
opinion is nullified by a physician who is greater than he. Therefore, if
a physician practices medicine in a city and there is a greater physician
in the city, he is spilling blood. The Gra added that it says in Ch. 10
of Sanhedrin that Rav would not let his son remove a thorn that was
embedded in his flesh, lest he wound him and violate the prohibition
of wounding of his father. The Gemara asks: If so, why was Rav not
Physician Versus an Expert Physician 2 261