נגישות

מכון שלזינגר לחקר הרפואה על פי ההלכה

triage and treatment under limited resources and emergency

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23 באוקטובר 2018

הרב המשיב: ישראל בלפר

שאלה:

Please, if you could, I am looking for information (articles, etc.) on the halachic perspective on triage and treatment of patients in times of national emergency or disaster. Specifically, the question is what guidance does halacha provide in choosing which patients get priority in a situation where resources are limited and taxed.

Thank you for your time.

Yours,

CDR Dana Horesh, USPHS

Regional Emergency Coordinator

Assistant Secretary of Preparedness and Response

United States Department of Health and Human Services

תשובה:

For publications on the subject within the Schlezinger Institute, please see:

1. A. Steinberg M.D., Encyclopedia of Jewish Medical Ethics ; Feldheim Publishers (Jerusalem – New York, 2003) Vol. I pp. 40-50, and in the referred literature in the article.

An online version of this article is available through the Schlezinger institute website.

Prof. Steinberg has published work relating to this subject in other academic platforms: Medical ethics in an inter-religious comparison: Judaism ; in Ethik in der Medizin ; Volume 10, Supplement 1 / September, 1998.

Also, Prof. Steinberg's application of the Halachah and Jewish ethical approach to triage, as nested in medical care in it's wider scope – parallelled to other renowned ethicists and doctors (100 contributors) – is shown in Principles of Health Care Ethics ; Raanan Gillon ed. ; London University, U.K.

2. Lifesaving while Under Fire: Medical Halakha in Battle ; Shlomo Steve Jackson, M.D. ; (Hebrew){ASSIA 16, 3-4 (63-64), pp. 101-120 (1998)}.

3. Adjacent subjects, Articles in Hebrew:

Rabbi Shabtai Rappaport writes {ASSIA 51-52 pp. 46-53, 1992} of the allocation of limited resources on a national scale (for example medical & pharmaceutical aid);

Rabbi Mordechai Halperin writes {ASSIA 65-66 pp.5-6, 1999 } of the Israeli law of 'Lo Taamod Al Dam Reecha' (Good Samaritan Law) and its Halachik underpinnings.

For more Academic references outside the Schlezinger Institute:

The Allocation of Scarce Medical Resources: A Philosophical Analysis of the Halakhic Sources ; Moshe Sokol ; AJS Review, Vol. 15, No. 1 (Spring, 1990), pp. 63-93.

In this article the basic sources of Halachik discourse are analysed, but care must be taken not to confuse the dynamic nature of Halachik considerations with a unilateral and/or dogmatic philosophy of treatment. For this and other reasons, the work done by Prof. Steinberg is more suited for practical application without losing analytic rigour.

Halachic discussions available online outside the Schlezinger Institute:

The YU (Yeshiva University) based "National Medical Halacha Society (also a Blogg), contains an article on the subject of Triage in Halacha

A Jewish study Netowrk (based in California) class by Rabbi Avi Lebowitz on Triage in Halacha (Audio download)

Sincerely Yours

Israel Belfer, IRP coordinator

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