Today’s daf (Nedarim 80b) contains a case which has been applied to various Triage situations. And to explain, I’d like to quote from Rabbi Dr. Akiva Tatz’s ‘Dangerous Disease & Dangerous Therapy in Jewish Medical Ethics: Principles and Practice’ (p. 172):
‘The Talmud discusses the situation of a town with a water source that is sufficient for the town and others beyond, but only if the locals drink and do not wash laundry. If the locals drink and wash, there will be insufficient water for the more distant population. May the locals wash or are they constrained by halacha to drink only so that there will be water for the distant population to drink too? Although at first glance it may seem obvious that they should drink only, the Talmud records an opinion that holds that they may in fact wash as well. The reason is that if they do not maintain adequate hygiene there will be a spread of disease among them that will present danger, and although the danger may not be quite as acute as the danger presented by immediate thirst, it may be taken into account. Although there are dissenting opinions in this scenario, it is apparent that broader considerations than the immediate and most obvious may be relevant to a community facing life and health risks.’
Having explained this concept, along with the position of the Sages that חַיֵּי אֲחֵרִים קוֹדְמִין לִכְבִיסָתָן – ‘the lives of others takes precedence over their own laundry’, and that of Rabbi Yossi who rules that כְּבִיסָתָן קוֹדֶמֶת לְחַיֵּי אֲחֵרִים – ‘their own laundry takes precedence over the lives of others’, Rabbi Tatz then presents a practical application where ‘broader considerations than the immediate and most obvious may be relevant to a community facing life and health risks’:
‘Some years ago, a couple suffering from long-standing infertility was assisted in conceiving and giving birth to a child by a hospital in Israel. The grateful father made a substantial donation to the hospital, stipulating that his money should be used by the hospital’s fertility unit to assist other couples in similar circumstances. The hospital’s director, however, declined the gift on the grounds that saving life ought to take priority over fertility treatment – surely, he argued, it cannot be right to spend limited funds in bringing children into the world when there are people already in existence whose lives are threatened by disease; those already-extant individuals should be treated first. The donor stood his ground and refused to make his contribution unless it were to be used for fertility treatment, and Rav Eliashiv was asked to adjudicate.
Rabbi Eliashiv ruled that the man was entitled to have his funds used for fertility purposes. When asked why that should take priority over lifesaving needs, Rabbi Eliashiv stated that a country needs a normal spread of facilities; if one allows only emergency needs, one risks developing an embattled mentality that may lower morale in a real way, and that too is a threat to a community. One cannot require this individual to contribute to a particular cause against his will; he may fund the service of his choice.’
I believe that this idea, as defended by Rabbi Yossi in our daf and as explained by Rabbi Eliashiv, is an incredibly important principle, and to further stress the point I’d like to relate a further story which I was told by one of my rabbinic mentors some years ago.
This particular Rabbi is someone who guides many people and who is often asked to help provide financial support to needy people in his community. He once related how he’d sourced some money to give to a couple facing financial difficulty, and then, a few nights later, he and his wife were out at a local kosher restaurant where they happened to see this couple having a coffee together.
The next day the husband called the Rabbi feeling the need to explain how he was out having a coffee with his wife, to which the Rabbi responded that when he raised funds for them it was to help them with their needs – which includes enabling a couple to go out once in a while. In fact, if a couple don’t do so, it can diminish their morale and their ability to cope with some of the other issues they are facing.
Ultimately, I strongly believe that whenever we support others, and whenever decisions need to be made (and this most certainly includes halachic decisions), we need to show consideration for such ‘broader considerations than the immediate and most obvious’, because as Rabbi Eliashiv explains, ‘if one allows only emergency needs, one risks developing an embattled mentality that may lower morale in a real way, and that too is a threat to a community’.
