I wonder if Black Jack felt as if he were looking at another version of himself during this whole fiasco[in reference to episode 4 of the OVA, the Owl of San Merida]. Both of these characters were cast into the mold of war. In Black Jack's case, it was more of the residue of war though I still feel my point stands. It pushed both characters into valuing lives to the point of acting impulsively, terrifyingly so. Ernesto relied completely on instinct to save that child, just as Black Jack acts on instinct to immediately save or tend to his patients. Their moral compasses seem to force them into certain directions that place life above everything else. Black Jack has been seen strongly condemning actions like euthanasia, frequently arguing with people like Kiriko on what's truly more merciful and pushing all doubt against life away. In a certain volume of Black Jack(maybe vol. 3? don't remember), the man himself yells, "What is the purpose of a surgeon?!" to the heavens. Like Black Jack, Ernesto didn't even know what to do as a surgeon during the civil war. Ernesto himself didn't even consider himself a surgeon or a doctor, not even at the end of his life. There's also the fact that Ernesto and Black Jack both put up fronts instead of acting as their "true" selves. Ernesto opts to act like a too-far-gone victim of war, allowing him to slip away unnoticed or rather uncared for, while Black Jack does the inverse and charges people greatly in an effort to skew their perception of his moral character, drawing much attention to himself and therefore far more judgement. This all isn't even mentioning how similar Ernesto is to Honma. I wonder if Black Jack not only felt as if he'd committed suicide, but that he'd failed his mentor completely.
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