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Should a Murderer’s Pacemaker be Replaced?

Question: A pacemaker implanted into the heart of a murderer is
losing its function and needs to be replaced. Is it permissible to leave
it as it is even though he will die, or should it be replaced?

Response: It seems to me that there no need to replace a dy-
ing pacemaker implanted in the body of a murderer and that it is
permitted to let him die. Proof from this can be adduced from the
comments of the Chochmas Shlomo (Choshen Mishpat 426:1) who
was asked whether it was correct to save the life of a woman who
had killed her husband by poisoning. He responded that this is the
subject of an explicit gemara in Niddah (61a) which relates that there
were some Galileans who were rumored to have killed someone. They
came to Rabbi Tarfon and asked him to hide them, from fear of the
authorities. Rabbi Tarfon told them, “The Sages have said that even
though it is forbidden to accept a derogatory report about another
person, one should nevertheless suspect that it might be true.” Rashi
(s.v. maychash) explains, “And maybe you have [indeed] killed and it
is forbidden to save you.” Quoting the She’iltos (at the end of parshas
Shelach, she’ilta 129), Tosfos (s.v. atmarinchu) explain, “Perhaps you
have killed and if I hide you, I will be liable for the death penalty tor
the king.”

“Thus,” writes the Chochmas Shlomo, “according to Rashi it is
certainly forbidden to save her. And even according to Tosfos quoting
the Sheiltos, it can be argued that they only said this [i.e. had Rabbi
Tarfon invoke the possible danger to himself as his reason for refus-
ing their request] because [in that case] it was not certain whether
or not they had killed but if it was certain that they had killed [as it
was in the case of the wife who killed her husband,] they would agree
[that it is forbidden to save them]. Furthermore, even if there [really]
is a disagreement [between Rashi and Tosfos over whether a known
murderer should be saved] it seems that here we do not invoke the
principle that ‘Any doubt arising in judging a capital case is treated

280 1 Medical-Halachic Responsa of Rav Zilberstein