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Medical Ethics: Difference between revisions
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#Alternatively, if the doctor doesn’t know how to heal the first patient but does know how to heal the second one he should go to the second one. Yet, sometimes he should go to the first one even though he doesn’t know how to heal him in order to help him calm down and not think that the doctors gave up on him.<ref>Igrot Moshe CM 2:74:1</ref> | #Alternatively, if the doctor doesn’t know how to heal the first patient but does know how to heal the second one he should go to the second one. Yet, sometimes he should go to the first one even though he doesn’t know how to heal him in order to help him calm down and not think that the doctors gave up on him.<ref>Igrot Moshe CM 2:74:1</ref> | ||
#All of these criteria are for when the doctor got several calls but didn’t start to treat one of them, otherwise he shouldn’t stop the one he started to work on.<ref>Erech Hachaim Bhalacha v. 6 p. 188. See also Igrot Moshe CM 2:73:2.</ref> | #All of these criteria are for when the doctor got several calls but didn’t start to treat one of them, otherwise he shouldn’t stop the one he started to work on.<ref>Erech Hachaim Bhalacha v. 6 p. 188. See also Igrot Moshe CM 2:73:2.</ref> | ||
== Endangering Yourself == | |||
# | |||
== Endangering Yourself for a Mitzvah == | |||
# It is forbidden to endanger yourself to fulfill a mitzvah. | |||
#* Endangering Oneself to Learn Torah: Ketubot 77b records and praises the practice of Reish Lakish to teach Torah to those ill with tzarat, some translate as leprosy, even though it is contagious. The gemara explained that he did so out of his love for Torah. Daf Al Hadaf cites Mishnat Pikuach Nefesh 69:7 who asks how Reish Lakish could endanger himself and rely on a miracle. He answers that the disease he was concerned with was only dangerous to health but not life threatening. | |||
== Endangering Yourself for a Profession == | |||
# It is permitted to endanger yourself for a profession. Most poskim only permit this for a very small risk of danger but not a very dangerous profession.<ref>Igros Moshe 1:63:1, Mishpat Kohen 134</ref> | |||
# For example, Rav Moshe permitted someone to be a professional ball player, even though there were certain health risks.<ref>Igros Moshe CM 1:104</ref> | |||
# For example, poskim permit a person to go hunting as a profession, even though it involves some danger.<ref>Nodeh Beyhuda YD 10, Tzitz Eliezer 9:17:5</ref> | |||
# Some poskim permit joining the army for a pay, even though it involves danger.<ref>Imrei Esh cited by Tzitz Eliezer 9:17:5 and Chashukei Chemed Bava Metsia 112a</ref> | |||
# Some poskim use this principle that it is permitted to endanger oneself for a profession to justify why doctors may treat contagious patients.<ref>Tzitz Eliezer 9:17:5</ref> | |||
== Endangering Yourself in Minimal Danger (Shomer Petayim) == | |||
# A person is allowed to engage in normal activities in society that people aren't concerned that they are dangerous. | |||
# This principle is known as "''shomer petayim Hashem''," (lit. "Hashem protects the fools"; heb. שומר פתאים ה') which permits a person to act simple and rely on Hashem to be protected. | |||
# This principle is the reason that women may become pregnant and give birth, even though that inevitably involves some risk (especially earlier in history).<ref>Igros Moshe EH 1:63:1</ref> | |||
# Some poskim hold that this concept only permits activities that objectively don't have a risk factor of more than 1/1000. Otherwise, it is considered objectively too risky and forbidden, even if other people do it without concern.<ref>[https://www.torahweb.org/torah/docs/rtwe_shomer2.pdf Rabbi Mayer Twersky] infers from Maggid Mishna that if the danger is 1/1000 or greater it is considered too dangerous even to rely upon ''shomer petayim Hashem''.</ref> | |||
# Some say that ''shomer petayim Hashem'' is only relevant if it is a risk or danger that applies equally to everyone. However, if there's a risk that only applies to one person more than others, such as if they're sick.<ref>Igros Moshe EH 1:63:1</ref> | |||
==Endangering Yourself to Save Someone Else== | ==Endangering Yourself to Save Someone Else== | ||
# Some say that it is permissible to endanger yourself to save someone who is a talmid chacham and tzaddik.<ref>Sefer Chasidim, Yabia Omer, Yavetz (Migdal Oz Otzer Hatov pina 1 n. 85)</ref> | # Some say that it is permissible to endanger yourself to save someone who is a talmid chacham and tzaddik.<ref>Sefer Chasidim, Yabia Omer CM 9:12, Yavetz (Migdal Oz Otzer Hatov pina 1 n. 85)</ref> Some forbid this.<ref>Igros Moshe YD 2:174:4</ref> | ||
#If a terrorist threatens you "either kill another Jew or I'll kill you," you may not kill another Jew and must give up your life.<ref>Sanhedrin 74b</ref> You must also give up your life and not even murder the other Jew indirectly such as by causing a dog to bite someone to showing a non-Jew where the Jew is hiding in order to kill him.<Ref>Yavetz (Migdal Oz Otzer Hatov pina 1 n. 82)</ref> | #If a terrorist threatens you "either kill another Jew or I'll kill you," you may not kill another Jew and must give up your life.<ref>Sanhedrin 74b</ref> You must also give up your life and not even murder the other Jew indirectly such as by causing a dog to bite someone to showing a non-Jew where the Jew is hiding in order to kill him.<Ref>Yavetz (Migdal Oz Otzer Hatov pina 1 n. 82)</ref> | ||
#If a terrorist threatens you "either let me cut off one limb of your body that won't kill you or I'll kill another Jew," some say that you must allow him to cut off your limb, but most poskim hold that you don't have to but it is a middat chasidut to do so.<ref>Maharam Ricanti holds that in this case it is an obligation to give up your life. However, Radvaz holds that it is only a middat chasidut. Yavetz (Migdal Oz Otzer Hatov pina 1 n. 83) agrees that it isn't obligation but it is a voluntarily mitzvah if he chooses.</ref> | #If a terrorist threatens you "either let me cut off one limb of your body that won't kill you or I'll kill another Jew," some say that you must allow him to cut off your limb, but most poskim hold that you don't have to, but it is a middat chasidut to do so.<ref>Maharam Ricanti holds that in this case it is an obligation to give up your life. However, Radvaz holds that it is only a middat chasidut. Yavetz (Migdal Oz Otzer Hatov pina 1 n. 83) agrees that it isn't obligation but it is a voluntarily mitzvah if he chooses.</ref> | ||
#If a terrorist threatens you "either give me your sword so that I can kill another Jew or I'll kill you," some say that you may not give up your sword in that case, while most hold that should give up your sword.<ref>Radvaz holds that you may not give your sword in that case. However, Yavetz (Migdal Oz Otzer Hatov pina 1 n. 82) argues because you only need to give up your life not to actively kill someone, but you don't need to give up your life not to passively watch another Jew die.</ref> | #If a terrorist threatens you "either give me your sword so that I can kill another Jew or I'll kill you," some say that you may not give up your sword in that case, while most hold that should give up your sword.<ref>Radvaz holds that you may not give your sword in that case. However, Yavetz (Migdal Oz Otzer Hatov pina 1 n. 82) argues because you only need to give up your life not to actively kill someone, but you don't need to give up your life not to passively watch another Jew die.</ref> | ||
# A minority position holds that it isn't necessary to endure difficult pain in order to save someone else's life, but most poskim disagree and hold that is necessary.<ref>Yavetz (Migdal Oz Otzer Hatov pina 1 n. 83) holds that it isn't an obligation to go through pain in order to save someone's life. However, Magen Avraham and Yabia Omer 9:12 disagree.</ref> | # A minority position holds that it isn't necessary to endure difficult pain in order to save someone else's life, but most poskim disagree and hold that is necessary.<ref>Yavetz (Migdal Oz Otzer Hatov pina 1 n. 83) holds that it isn't an obligation to go through pain in order to save someone's life. However, Magen Avraham and Yabia Omer 9:12 disagree.</ref> | ||
#Some say that it is permissible to endanger yourself to save your only son if you're too old to fulfill pru urevu again.<ref>Yavetz (Migdal Oz Otzer Hatov pina 1 n. 85). Rav Zilberstein (Shabbat Shabbaton p. 172-3) quotes Yavetz that a person may not endanger himself to save someone else unless the other person is a bigger talmid chacham and a tzaddik than you, your father, or your rebbe. Even to save your only son it is forbidden to endanger your life for him, unless the father is too old to fulfill pru urevu anymore. Rabbi Zilberstein asks why this is permitted and suggests that since the child could have more children it is like endangering yourself to save many people which is allowed. He also quotes a story about the Shaar Efraim that when his son was deathly sick he davened to Hashem to take him instead and so it happened that his son was healed and he died. However, it isn't a clear proof, says Rav Zilberstein, since davening isn't the same as doing an action.</ref> | #Some say that it is permissible to endanger yourself to save your only son if you're too old to fulfill pru urevu again.<ref>Yavetz (Migdal Oz Otzer Hatov pina 1 n. 85). Rav Zilberstein (Shabbat Shabbaton p. 172-3) quotes Yavetz that a person may not endanger himself to save someone else unless the other person is a bigger talmid chacham and a tzaddik than you, your father, or your rebbe. Even to save your only son it is forbidden to endanger your life for him, unless the father is too old to fulfill pru urevu anymore. Rabbi Zilberstein asks why this is permitted and suggests that since the child could have more children it is like endangering yourself to save many people which is allowed. He also quotes a story about the Shaar Efraim that when his son was deathly sick he davened to Hashem to take him instead and so it happened that his son was healed and he died. However, it isn't a clear proof, says Rav Zilberstein, since davening isn't the same as doing an action.</ref> | ||
#It is permissible to endanger yourself to save many Jews.<ref>Gemara Tanit 18b, Rav Zilberstein (Shabbat Shabbaton p. 173)</ref> | #It is permissible to endanger yourself to save many Jews.<ref>Gemara Tanit 18b, Rav Zilberstein (Shabbat Shabbaton p. 173), Igros Moshe 2:174:4, Mishpat Kohen 143</ref> | ||
#A doctor may take care of a patient with a contagious disease even without proper protection (when it is impossible to get proper protection) to help save the patient.<ref>Tzitz Eliezer 8:15:10:13 based on Sma 426:1 writes that a doctor does not have to place themselves at risk in order to save a sick patient. However, Tzitz Eliezer 9:17:5 presents several arguments why doctors may and should treat contagious patients. 1) He quotes Sht Harama 19 who writes that people shouldn’t be worried about any contagious disease since it isn’t the contagious disease mentioned by the gemara, namely Raatan. Tzitz Eliezer quotes Zera Emet who distinguishes between a general contagious disease and an epidemic, which a person should be worried about. However, he also cites the Knesset Hagedola (Shaarei Knesset Hagedola, Hagahot Hatur YD 335:2) who doesn’t distinguish and holds that a person should be bikur cholim even for someone who is sick with a contagious disease. Tzitz Eliezer concludes that doctors may and should treat patients, even if they have contagious diseases, and fulfill the mitzvah of bikur cholim and rapo yirapeh. 2) He suggests that it is permitted since this is the way of the world for doctors to treat sick patients. 3) Furthermore, for a paid doctor there’s another reason to permit it. Gemara Bava Metsia 112a is clear that a worker can endanger himself for his job. Nodeh Beyhuda YD 10 is a good precedent for this concept. 4) Hagahot Maimoni holds that it is an obligation to enter into risk to save someone else.</ref> | |||
#A medic in the army must save wounded soldiers on the battlefield in times of war, even though it means exposing themselves to risk. However, he is not obligated to enter the war zone to save a non-military patient.<ref>Tzitz Eliezer 12:57, Harefuah Leor Hahalacha v. 4 1:7, Rabbi Zilerbstein</ref> | |||
#A pregnant doctor who is concerned that if she treats a patient with German measles it may place their fetus at risk is not obligated to treat the patient. However, if the doctor wishes to do so, they may and they should be blessed from heaven.<ref>Rabbi Zilberstein (Bshilvei Harefuah v. 10 p. 58, Asya v. 7 p. 3, cited by Encyclopedia of Jewish Medical Ethics v. 3 p. 907) holds that a doctor who will endanger her fetus by treating her patient is not obligated to do so, but may do so.</ref> | |||
==Saving Yourself by Endangering Someone Else== | ==Saving Yourself by Endangering Someone Else== | ||
