A PUBLICATION OF THE BAIS HAVAAD HALACHA CENTER 105 River Ave. #301, Lakewood NJ 08701 1.888.485.VAAD (8223) www.baishavaad.org [email protected] Lakewood • Midwest • Brooklyn • South Florida לע״נ הרב יוסף ישראל ב״ר משה גרוסמן זצ״ל Family, Business, and Jewish Life through the Prism of Halacha Dedicated in loving memory of VOLUME 5781 • ISSUE XLIV • PARSHAS SHEMOS HaRav Yosef Grossman zt"l The on the Bring the Parsha to Life! PARSHAS SHEMOS JUNK FOOD Excerpted and adapted from a shiur by LIVING ROOM: ALLOCATING Dayan Yosef Greenwald Shall I go and call you a wet nurse from SCARCE HOSPITAL SPACE among the Ivri women, that she might Adapted from the writings of Dayan Yitzhak Grossman nurse the child for you? Shemos 2:7 Our previous article introduced the halachic Consequent to an intricate analysis, Rav Sternbuch framework used to determine the prioritization was inclined to permit the policy, on the grounds Because she brought him to many Egyp- schedule when allocating limited medical re- that the principle that a chayei olam patient has tian women and he didn’t nurse, because sources. As discussed there, one of the key rules priority over a chayei sha’ah patient applies even he was destined to speak with the Shechi- is that a patient whose life we expect to be able if the chayei olam patient is not currently present nah. to preserve for the long term (chayei olam) has but is anticipated based on an established pattern Rashi ibid. precedence over one who is not expected to sur- of daily arrivals of such patients at the hospital. Why is a child subject to food prohibitions? vive for more than a brief period (chayei sha’ah). Due to the gravity of the issue, he submitted the The Gemara says in Yevamos that forbidden In this article we consider a particular application question to a number of gedolim in Eretz Yisrael, foods are metamtem es haleiv (create a of this rule that has been the subject of extensive and he reports that they agreed with him. He also spiritual blockage in the heart). This applies discussion by the poskim: the allocation of scarce reports R’ Yitzchok Zilberstein’s “clever” solution even to children; though not yet subject to mechanical ventilators or emergency room/inten- of controlling the ventilator with a timer, which the prohibition, they still suffer the effects. sive care unit (ICU) beds. would allow it to be disconnected while inopera- What in a gentile mother’s milk causes tive, but he was told that this would be impractical timtum haleiv? Some say that the milk is R’ MOSHE STERNBUCH due to the strenuous objections of the relatives of kosher, but because it transmits the nutri- R’ Moshe Sternbuch was asked by the head of the the patients who would be disconnected. emergency department in a Johannesburg hospi- ents from the nonkosher food the mother If the chayei sha’ah patient was connected to the tal about a policy the doctor had instituted of not ate, it causes spiritual impediment. Others ventilator against hospital policy, Rav Sternbuch attaching a chayei sha’ah patient to the hospital’s explain that milk transmits to the child the cannot reach a definite conclusion as to whether sole advanced ventilator, even if he was currently essence of the woman who produced it, so he should be disconnected from it in favor of a the only patient in need of it, and instead reserving if it comes from an impure source, it will im- chayei olam patient, and in such a case he recom- it for anticipated future chayei olam patients. His pact the baby negatively. mends the timer solution.1 2 reasoning was that once they connected a chayei The Rishonim point out that the food you sha’ah patient to the ventilator, they would be un- consume becomes a part of your body. The 1 It is not entirely clear to me whether he means that a timer may be able to transfer the machine to an arriving chayei introduced to the connection even after the chayei sha’ah patient has capacity of your body to be a receptacle for olam patient, because that would constitute ac- already been connected without it, or simply that the machine should be configured to always operate on a timer, and we should resort to its use in devarim shebikdusha can be damaged tive murder of the first patient. this case in particular. 2 Shu”t Teshuvos V’hanhagos cheilek 1 siman 858. (continued on page 2) from Swelling Bee the My son was stung by a bee on Shabbos. What may I do for him? Q&ABAIS HAVAAD Q HALACHA HOTLINE A If the victim is known to be allergic to the insect’s venom or displays symptoms of an allergic reaction (difficulty breathing, tightness in the throat or chest, severe swelling, hives, cramps, or unconsciousness), 1.888.485.VAAD(8223) A then there is danger to life and one must do whatever is necessary, as if it were a weekday. Seconds count, and one should not hesitate in any way because of Shabbos. Call Hatzolah or 911 immediately, [email protected] (continued on page 2) (continued from page 1) from the The moral paradox of this position is striking: located a bed, whether he is paying for it or it was Q&ABAIS HAVAAD Since the chayei sha’ah patient cannot have provided gratis, it is his for as long as he needs it, HALACHA HOTLINE the machine permanently (because the future and he is under no obligation to relinquish it and 1.888.485.VAAD(8223) chayei olam patient takes precedence), and give up whatever chayei sha’ah he may yet have [email protected] taking it from him later would constitute active in favor of someone else’s chayei olam. He may murder, we do not give it to him at all, and thus even be prohibited from doing so.6 (continued from page 1) cause him to die sooner than strictly necessary! R’ YITZCHOK ZILBERSTEIN and be ready to resuscitate if necessary. R’ SHLOMO ZALMAN AUERBACH R’ Yitzchok Zilberstein limits R’ Moshe’s ruling to One of the Israeli gedolim who responded to a private hospital, where a physician’s decision to If, as is usually the case, there Rav Sternbuch was R’ Shlomo Zalman Auer- allocate a bed to a chayei sha’ah patient is bind- is no concern of an allergic re- action, the issue is only local bach. He wrote that it is possible that the hospi- ing, even if incorrect. In a public hospital, howev- DAYAN YEHOSHUA tal’s policy is correct if it results in the saving of er, a physician’s unauthorized decision to allocate pain, which halacha does not GRUNWALD chayei olam patients on a daily basis, but even a bed to a chayei sha’ah patient where a chayei consider an illness (choli) but a minor ailment (meichush). One may remove if this is unclear, once this is the hospital’s poli- olam patient is present and also in need of it is the stinger and apply ice or run the site under cy, it should be followed, and the ventilator may not binding, and in such a case the bed should cold water (Shulchan Shlomo 328:37), because not be used for a chayei sha’ah patient without be transferred to the chayei olam patient.7 Rav 3 these aren’t considered medical treatments, the hospital’s permission. Zilberstein notes, however, that a ventilator may but actual medical treatment is prohibited for a never be transferred from one patient to anoth- R’ ELIEZER YEHUDA WALDENBERG mere meichush; because medicine was usually er, because that would constitute the killing of made of ground herbs, Chazal were concerned Another Israeli gadol who agreed with Rav 8 the first patient. that one might inadvertently grind the medica- Sternbuch was R’ Eliezer Yehuda Waldenberg. tion—a melacha—on Shabbos. Some explain that At the conclusion of a lengthy analysis, he, R’ ASHER WEISS Chazal were particularly concerned with regard too, ruled that the hospital policy is appropri- R’ Asher Weiss disagrees with R’ Zilberstein’s in- to medicine because one who isn’t feeling well is ate (yafeh), and that it is prohibited to violate terpretation of R’ Moshe’s ruling, arguing that stressed and more prone to inadvertently violate the policy by using the ventilator for a chayei the text of R’ Moshe’s ruling clearly includes pub- Shabbos (Shulchan Aruch 328:1, Iglei Tal Tochen sha’ah patient.4 lic hospitals.9 16). Therefore, an adult victim may not take med- Fundamentally, however, he rejects R’ Moshe’s ication on Shabbos for a bee sting. But in a case of R’ MOSHE FEINSTEIN entire position and maintains that the bed may great pain, he may ask a non-Jew to apply medi- As noted above, Rav Sternbuch is uncertain be transferred from one patient to another. He cated ointment, because amirah l’akum (asking a whether a ventilator that has been connected argues that since it is accepted practice that non-Jew to perform a forbidden act) on a d’Rab- to a chayei sha’ah patient may be transferred hospitals transfer patients from department banan (Rabbinically-prohibited act) is permitted to a chayei olam one. R’ Moshe Feinstein, dis- to department based on their staff’s medical when it is required in order to relieve great pain. cussing the similar case of an emergency judgments, it follows that patients do not ac- If the victim is under bar mitzvah, though, and room/ICU5 with only a single bed, rules that a quire any irrevocable rights to places in specific the pain disrupts his eating or sleeping routine, an chayei sha’ah patient who has been assigned departments of hospitals.