Medical Ethics
From Halachipedia
Abortion
Donating Blood
- It is permissible and a mitzvah to donate blood, as it is used to save lives.[1]
Organ Donation
- One may donate an organ which without, the donor will have full health with no detrimental effects. [2]
Heart Transplant
- A heart transplant isn't allowed since it is a major dispute if taking a live heart is considered killing the donor.[3]
End of life care
Allocation of medical supplies
Triage
- Regarding the larger issue of halachic triage see Rav Schachter (Piskei Corona #15 Updated). Here is a relevant sourcesheet on Halachic Triage. Rav Asher Weiss (Teleconference April 6 2020, min 5-15) discusses triage in halacha and what doctors should do.[4]
- A doctor may and is encouraged to perform a life saving procedure if he is wearing the correct protective gear.[5]
Saving Yourself by Endangering Someone Else
Sources
- ↑ Rav Yitzchak Yosef (Motzei Shabbat Kedoshim 5779 min 1)
- ↑ See Yachava Daat 3:84, Tzitz Eliezer 9:45, Minchat Yitzchak 5:7. Similarly, Rav Asher Weiss (Aguda Teleconference, April 6, 2020, min 20-22) stated that donating a kidney isn’t risk free but it is minimally dangerous and it is life saving and therefore it is a middat chasidut to do it.
- ↑ Rav Yitzchak Yosef (Motzei Shabbat Kedoshim 5779 min 10)
- ↑ Rav Asher feels that there are only two factors that we consider for halachic triage: give precedence to someone who is in immediate danger, and give treatment to whoever has a better chance for survival. Age or spiritual need for the community are not factors for precedence.
- Rav Asher says that for choleh shebifanenu the knowledge that another choleh is going to come in soon is considered pikuach nefesh if will with certainty be helpful. Therefore, if an older patient comes into the hospital but they know a younger patient is going to come in, they can consider them as though they came in together and treat according to who is in immediate danger and who has the better chance to live. Rav Schachter felt the same way in his teshuva.
- If a hospital has a certain regulation, does he need to disregard the hospital protocols? Rav Asher Weiss felt that the doctors should not disregard hospital protocol, for multiple reasons but partly because if he doesn't he'll lose his license and having more able doctors at this time is pikuach nefesh.
- Pulling a patient off a ventilator because someone entered the hospital who has a better chance of living, Rav Asher (min 27) felt is forbidden. Rather the doctor should say that he feels uncomfortable to do this and should let another doctor do it. Rav Schachter felt that one should try to convince the older patient to sign a DNR at that point in order to save the younger patient.
- ↑ Rav Asher Weiss (Aguda Teleconference, April 6, 2020, min 18-22) explains that you can’t put yourself in danger. However, you can if you’re saving someone from an immediate danger and you’re putting yourself in minimal danger then it is a middat chasidut to do so. Therefore, a doctor should do mechanical ventilation CPR on a COVID19 patient if he has the correct protective gear.
- Rav Asher (min 33) allowed sharing ventilators when the doctors see fit in order to save another life because moving a patient from a single ventilator to a shared ventilator isn't considered doche nefesh mipnei nefesh since it isn't proven to be dangerous to use a shared ventilator. He also cited the Chazon Ish regarding turning the arrow to the side killing fewer people to save more people.
- Rav Asher (min 38) said that a doctor who isn't in that particular field or is retired or has vacation doesn't have to volunteer but his doing so would be a middat chasidut. However, if he is endangering himself such as if he's over 70, he is immune compromised, or has a family member who is, then he shouldn't volunteer.
