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Safeguarding Life

Pandemic Ethics

Safeguarding Life

The Jewish imperative to protect human life — pikuakh nefesh — overrides almost every other obligation. Recently, Jewish communities enacted this value by closing synagogues, suspending communal prayer and refraining from acts of hospitality, from visiting the sick, comforting mourners and celebrating weddings — all with the goal of preventing the spread of COVID-19.

As we carefully return to community activities, how can we express the ultimate value of safeguarding life in our individual and communal decisions? How do we ensure that even when our own lives are not in immediate danger, we are guided by the imperative to safeguard the lives of others?

Traditional sources

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Current thinking

‘Your neighbor is your kin’: How putting others first can help us get through the pandemic

Interview with Laurie Zoloth by Max Witynski — January 26, 2021

Ethicist Laurie Zoloth says it’s our duty to get a COVID-19 vaccine and wear masks - for our neighbors’ sake. Making use of the philosophy of Emmanuel Levinas, Zoloth emphasizes the other, as opposed to the self, in her approach to ethics.

“Both vaccines and masks are a perfect instantiation of the ethics of responsibility (…). The golden rule, in the case of COVID-19, comes down to a very basic physical act: I get vaccinated—or wear a mask—to protect you, and you do so to protect me.”

Who gets to live? How doctors make impossible decisions as COVID-19 surges

By Lois Parshley — July 24, 2020

Triage aims to provide the greatest amount of good for the greatest number, but medical staff are grappling with how to stay true to this principle as coronavirus surges. Journalist Lois Parshley’s article shows how class and racial inequality was causing people to die - and suggests a national rule-based system with transparent standards to prevent that.

“In the face of such inequality, Raymond says coordinated federal leadership is especially important—and currently lacking. He worries about conflicting triage standards, adding “we’ve already seen this with testing”—for example, the preferential allocation of scarce tests to professional athletes. Raymond believes that a national rule-based system with transparent standards is more likely to treat all patients fairly, ensuring care doesn’t just go to the richest or the most well-connected.”

Why Jewish law might require stricter social distancing than state regulations

By Chaim Saiman — April 23, 2020

Scholar of Jewish law Chaim Saiman examines the differences between the logic of “flattening the curve” that informs public policy and the logic of pikuakh nefesh as developed in Jewish law. He concludes that Jewish law demands stricter social distancing than state regulations.

“Initially the logic of the two concepts seemed to work together, but they now seem to be splitting apart. If, as the Gov. of Georgia seems to claim, a region’s health system has ample capacity, flatten the curve logic may argue for opening things up because the health system can handle the patients and manage the fallout while reaping the benefits of opening the economy. By contrast, pikuakh nefesh logic dictates that since there is no cure, it is near certain that more people will die as the infection rate increases—regardless of whether the medical system is over-taxed— we should maintain as many of the restrictions as possible.”

Restarting America means people will die. So when do we do it?

April 10, 2020

Government leaders have flirted with reopening America quickly, even as public health experts warn of the dangers. When and how can we ethically bring people back to work and school and begin to resume the usual rhythms of American life? The New York Times Magazine brought together five experts to talk about the principles and values that will determine the choices we make.

“Many Americans have responded by rejecting as monstrous the whole idea of any trade-off between saving lives and saving the economy. And in the near term, it’s true that those two goals align: For the sake of both, it’s imperative to keep businesses shuttered and people in their homes as much as possible. In the longer run, though, it’s important to acknowledge that a trade-off will emerge — and become more urgent in the coming months, as the economy slides deeper into recession. The staggering toll of unemployment has reached more than 16 million in just the last three weeks. There will be difficult compromises between doing everything possible to save lives from Covid-19 and preventing other life-threatening, or -altering, harms.”

What Jewish medical ethics can teach us about coronavirus

By Maddie Bender – April 9, 2020

Science journalist Maddie Bender presents in the following article traditional Jewish ethical responses to the novel coronavirus. The author looks into various halakhic approaches and interprets them for a contemporary context. Though this article advances the traditional view that limits halakhic decision-making to expert rabbis, the concepts and principles described can guide individual decision making as well as institutional and communal policy.

“Three basic principles underlie the halachic debate around triage: pikuach nefesh, ein ma’avirin al hamitzvot, or, “you cannot bypass a mitzvah,” and ein dochin nefesh mipnei nefesh, “you cannot choose between lives.” Interpreted literally, ein ma’avirin al hamitzvot means that a person should always choose the mitzvah — the commandment — that is closer to them, if presented with two simultaneously. “Closer” can encompass physical distance, temporality, or strength of an interpersonal relationship. The meaning of ein dochin nefesh mipnei nefesh is alternately summarized as “you may not kill to save another,” and it is often applied to issues surrounding organ donation.”

Triage and the Sanctity of Life

By Rabbi Daniel Nevins — March 2020

Rabbi Daniel Nevins, the Pearl Resnick Dean of the Division of Religious Leadership at the Jewish Theological Seminary, examines the question of how to determine which patient gets lifesaving treatment in a pandemic emergency setting. He challenges the prevailing utilitarian approach and offers an alternative set of priorities that centers on Jewish teachings about the sanctity of life.

“In the throes of a pandemic or other health emergency in which clinicians must choose among patients (or have a triage officer choose for them) to receive intensive medical treatment, utilitarian analysis is not the only ethical option. Jewish law provides several criteria for the prioritization of care based on the sacred obligation to heal those who are ill. Patients who have the most urgent need should be the first to receive treatment, unless they are unlikely to survive, in which case patients who are expected to survive with intensive therapy should receive priority. After that, the first patient to request the resource has priority.”

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