Training to Do Surgery

By Rabbi Chaim Chazzan

 

May a student doctor perform surgery (under the supervision of an experienced doctor) in order to gain experience, if it will necessitate putting the patient under general anesthesia for a longer period of time?

 

This question was posed by a doctor before Rav E. Y. Waldenberg[1], author of Tzitz Eliezer. The questioner reported that there is a risk associated with a general anesthesia, and that surgery done by a student doctor would take longer than if done by an experienced one. It would follow that the patient would be under a general anesthesia for a longer period of time, resulting in an increased risk factor.

The Shulchan Aruch rules[2] that one should only engage in the medical profession if he is proficient and if there is no doctor available who is more competent. One who ignores these provisions, is considered to have engaged in murder.

Though most of our doctors today are not the top in their field, it is permitted for them[3] to perform routine procedures based on accepted methods. [Furthermore, since it is impossible for the best doctor to see every patient and not everyone can afford his fee, a doctor who is not top of his field may also make more complicated medical decisions]. Likewise, it would be permitted for a medical student to administer routine medical care under supervision when there is no additional risk factor.

In our scenario, where a more skilled doctor is at hand, and prolonging the time the patient would need to be under a general anesthesia would increase the risk factor, Rav Waldenberg categorically forbade the student doctor to perform a surgery.

The doctor then questioned that this psak left no opportunity for student doctors to gain experience, which is vital to enable them to help others in the future. Rav Waldenberg replied that nevertheless this does not give him the right to endanger the life of the patient upon whom he desires to practice.

Rav Waldenberg proposed three possible solutions for a student to gain experience:

(1) If the law of the land permits such a practice, one would be permitted to follow it in the case of operating on a non-Jew, being that the course of action regarding his medical treatment is determined only by secular law.

(2) Practice with surgeries that only require a local anesthetic.

(3) Additionally, if prolonging the general anesthesia will not involve a greater risk to the patient, it would be permitted.

 

Reprinted with permission from  Lmaan Yishmeu – a project of Mercaz Anash. To see more articles visit Mercazanash.com


[1] שו”ת ציץ אליעזר חי”ד סי’ פד–פה

[2] יו”ד שלו ס”א

[3] ספר רמת רחל שבציץ אליעזר ח”ה סי’ כב

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