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Share(יח) לֹֽא־תִקֹּ֤ם וְלֹֽא־תִטֹּר֙ אֶת־בְּנֵ֣י עַמֶּ֔ךָ וְאָֽהַבְתָּ֥ לְרֵעֲךָ֖ כָּמ֑וֹךָ אֲנִ֖י יְהוָֽה׃
(14) Anyone who can save and does not save transgresses 'do not stand by the blood of your neighbour'. So too one who sees his friend drowning in the sea, bandits attacking him or a bad animal attacking him and he is able himself to save him or he could hire others to save him but he does not; one who hears idol worshippers or informers plotting harm for him or laying a trap for him and he doesn't tell his friend and inform him; or if he knows that an idol worshipper or a thug are on their way to his friend and he could appease them on behalf of his friend to change their intention and he doesn't appease him; and so too any similar case; One who does any of these transgresses 'do not stand idly by your neighbour's blood'.
הָרַדְבַּ"ז, חֵלֶק ה (לְשׁוֹנוֹת הָרַמְבַּ"ם), א’ תקפב
מַה שֶּׁכָּתַב הָרַב זִכְרוֹנוֹ לִבְרָכָה כָּל הַיָּכוֹל לְהַצִּיל וְכוּלֵי אָיְירֵי בְּמִי שֶׁיָּכוֹל לְהַצִּיל לְהֶדְיָא בְּלֹא שֶׁיִּסְתַּכֵּן הַמַּצִּיל כְּלָל כְּגוֹן שֶׁהָיָה יָשֵׁן תַּחַת כּוֹתֶל רָעוּעַ שֶׁהָיָה יָכוֹל לַהֲעִירוֹ מִשְּׁנָתוֹ וְלֹא הֱעִירוֹ אוֹ כְּגוֹן שֶׁיּוֹדֵעַ
לוֹ עֵדוּת לַהֲצִילוֹ עָבַר עַל לֹא תַעֲמֹד עַל דַּם רֵעֶךָ. וְלֹא זֹו בִלְבַד אֶלָּא אֲפִילוּ יֵשׁ בּוֹ קְצָת סָפֵק סַכָּנָה כְּגוֹן רָאָה אוֹתוֹ טוֹבֵעַ בַּיָּם אֹו לִסְטִים בָּאִים עָלָיו אוֹ חַיָּה רָעָה שֶׁיֵּשׁ בְּכָל אֵלּוּ סָפֵק סַכָּנָה אֲפִלּוּ הָכֵי חַיָּיב לְהַצִּיל וַאֲפִילוּ שֶּׁלֹּא הָיָה יָכוֹל לְהַצִּיל בְּגוּפוֹ לֹא נִפְטַר בִּשְׁבִיל כָּךְ אֶלָּא חַיָּיב לְהַצִּיל בְּמָמוֹנוֹ…מִכָּל מָקוֹם אִם הַסָּפֵק נוֹטֶה אֶל הַוַּדַּאי אֵינוֹ חַיָּיב לִמְסוֹר עַצְמוֹ לְהַצִּיל אֶת חֲבֵירוֹ וַאֲפִילוּ בְסָפֵק מוּכְרָע אֵינוֹ חַיָּיב לִמְסוֹר נַפְשׁוֹ דְּמַאי חֲזֵית דִּדְּמָא דִּידָךְ סוּמָק טְפֵי דִּילְמָא דְּמָא דִּידֵיהּ סוּמָק טְפֵי אֲבָל אִם הַסָּפֵק אֵינוֹ מוּכְרָע אֶלָּא נוֹטֶה אֶל הַהֲצָלָה וְהוּא לֹא יִסְתַּכֵּן וְלֹא הִצִּיל עָבַר עַל לֹא תַעֲמֹד
עַל דַּם רֵעֶךָ.
Radbaz, Responsa, Vol. 5, 1582
(Acronym for Rabbi David ben Zimra, a talmudist and kabbalist. Born in Spain (1479-1573). Chief
Rabbi of Cairo and dayan in Tsfat and Jerusalem.)
Regarding the statement of the Rabbi (Rambam), of blessed memory, "Anyone who is able to rescue...": this is referring to one who can be clearly rescued without the rescuer endangering himself in any way, such as one who is asleep under an unsteady wall who the would-be rescuer is able to wake him from his sleep but does not wake him, or one who knows of evidence to exonerate him (i.e., the other. E.g., from capital punishment and fails to come forward), he transgresses the prohibition of “Do not stand idly by the blood of your brother.”
Not only in this case, but even if [in saving him] there is a potential small risk of danger, such as the case when he sees him drowning, or bandits attacking, or wild animals [threatening] – for there exists in all of these cases a risk of danger, he is still obligated to rescue, and even if he cannot do it himself, he is not exempt for this reason, but is obligated to use his own finances [to save the victim]….
Nevertheless, if the potential risk inclines toward certainty, he is not obligated to sacrifice himself to save his fellow.
The Gemara asks: And Rabbi Yoḥanan, what does he do with this verse: “And your brother shall live with you”? The Gemara answers: He requires the verse for that which is taught in a baraita: If two people were walking on a desolate path and there was a jug [kiton] of water in the possession of one of them, and the situation was such that if both drink from the jug, both will die, as there is not enough water, but if only one of them drinks, he will reach a settled area, there is a dispute as to the halakha. Ben Petora taught: It is preferable that both of them drink and die, and let neither one of them see the death of the other. This was the accepted opinion until Rabbi Akiva came and taught that the verse states: “And your brother shall live with you,” indicating that your life takes precedence over the life of the other.
(כג) סיעה של בני אדם שאמרו להם נכרים תנו לנו א' מכם ונהרגהו ואם לאו הרי אנו הורגין את כולן יהרגו כולן ואל ימסרו להם נפש אחת מישראל אבל אם ייחדוהו להם כגון שיחדו לשבע בן בכרי יתנוהו להם ואל יהרגו א"ר יהודה בד"א בזמן שהוא [מבפנים והן] מבחוץ אבל בזמן שהוא מבפנים והם מבפנים הואיל והוא נהרג והן נהרגין יתנוהו להן ואל יהרגו כולן וכן הוא אומר (שמואל ב כ) ותבא האשה אל כל העם בחכמתה וגו' אמרה להם הואיל והוא נהרג ואתם נהרגין תנוהו להם ואל תהרגו כולכם ר"ש אומר כך אמרה [להם] כל המורד במלכות [בית דוד] חייב מיתה.
(23) A group of [Jews] to whom gentiles say, “Give us one of you and we shall kill him, and if not, behold, we will kill all of them”; they should let themselves be killed and not deliver them one soul from Israel. But if they designated [the person] to them – for example, Sheva ben Bichri – they should give him to them and not let themselves be killed. Rabbi Yehuda said, “When do these words apply? In a case when he is [inside and they are] outside [a fortified city]; but in a case when he is inside and they are inside, since he will be killed and the [other Jews] will be killed, they should give him to them and not let themselves all be killed. And so did it state (II Samuel 20:22), ‘And the woman came to all of the people in her wisdom, etc.’ – she said to them, ‘Since he will be killed and you will be killed, give him to them and do not kill all of you.’” Rabbi Shimon says, “So did she say [to them], ‘Anyone who rebels against the monarchy [of the House of David] is liable to [receive] the death penalty.’”
(כ) וַיַּ֥עַן יוֹאָ֖ב וַיֹּאמַ֑ר חָלִ֤ילָה חָלִ֙ילָה֙ לִ֔י אִם־אֲבַלַּ֖ע וְאִם־אַשְׁחִֽית׃ (כא) לֹא־כֵ֣ן הַדָּבָ֗ר כִּ֡י אִישׁ֩ מֵהַ֨ר אֶפְרַ֜יִם שֶׁ֧בַע בֶּן־בִּכְרִ֣י שְׁמ֗וֹ נָשָׂ֤א יָדוֹ֙ בַּמֶּ֣לֶךְ בְּדָוִ֔ד תְּנוּ־אֹת֣וֹ לְבַדּ֔וֹ וְאֵלְכָ֖ה מֵעַ֣ל הָעִ֑יר וַתֹּ֤אמֶר הָאִשָּׁה֙ אֶל־יוֹאָ֔ב הִנֵּ֥ה רֹאשׁ֛וֹ מֻשְׁלָ֥ךְ אֵלֶ֖יךָ בְּעַ֥ד הַחוֹמָֽה׃ (כב) וַתָּבוֹא֩ הָאִשָּׁ֨ה אֶל־כׇּל־הָעָ֜ם בְּחׇכְמָתָ֗הּ וַֽיִּכְרְת֞וּ אֶת־רֹ֨אשׁ שֶׁ֤בַע בֶּן־בִּכְרִי֙ וַיַּשְׁלִ֣כוּ אֶל־יוֹאָ֔ב וַיִּתְקַע֙ בַּשֹּׁפָ֔ר וַיָּפֻ֥צוּ מֵעַל־הָעִ֖יר אִ֣ישׁ לְאֹהָלָ֑יו וְיוֹאָ֛ב שָׁ֥ב יְרוּשָׁלַ֖͏ִם אֶל־הַמֶּֽלֶךְ׃ {ס}
All the troops with Joab were engaged in battering the wall,-g (16) when a clever woman shouted from the city, “Listen! Listen! Tell Joab to come over here so I can talk to him.” (17) He approached her, and the woman asked, “Are you Joab?” “Yes,” he answered; and she said to him, “Listen to what your handmaid has to say.” “I’m listening,” he replied. (18) And she continued, “In olden times people used to say, ‘Let them inquire of Abel,’-a and that was the end of the matter. (19) I am one of those who seek the welfare of the faithful in Israel. But you seek to bring death upon a mother city in Israel! Why should you destroy the LORD’s possession?” (20) Joab replied, “Far be it, far be it from me to destroy or to ruin! (21) Not at all! But a certain man from the hill country of Ephraim, named Sheba son of Bichri, has rebelled against King David. Just hand him alone over to us, and I will withdraw from the city.” The woman assured Joab, “His head shall be thrown over the wall to you.” (22) The woman came to all the people with her clever plan; and they cut off the head of Sheba son of Bichri and threw it down to Joab. He then sounded the horn; all the men dispersed to their homes, and Joab returned to the king in Jerusalem.
The Sanctity of Saving as Many Lives as Possible
Rabbi Elliot N. Dorff, Responsa from Committee on Jewish Law and Standards
The Jewish sources that deal with triage are therefore not about access to health care, which was ineffective and therefore cheap. The sources instead address two other conditions of scarcity that Jewish communities faced, namely, poverty and redemption from captivity. In Chapter Twelve of my book, Matters of Life and Death: A Jewish Approach to Modern Medical Ethics, I review the sources that deal with how to determine who gets the community’s limited resources to respond to both poverty and captivity. The following criteria for determining who gets what emerge from the sources (see the book for the sources and a description of how each would be used in context):
- Social hierarchy: save those who are most important in society, defined in the same source (M. Horayot 3:7-8) as variously dependent on the number of commandments to which a person was subject, or the person’s priestly status, or how much Torah the person knows.
- Concentric circles: yourself first, then your immediate family, then your extended family, then your local Jewish community, then the larger Jewish community, and then people of other faiths (B. Bava Metzi’a 62a, 71a; B. Nedarim 80b; T. Pe’ah 4:9; T. Gittin 3:18; B. Gittin 61a; S.A. Yoreh De’ah 251:3; 252:9).
- A hierarchy of social responsibilities: redeeming captives first, then the sick among the poor, then feeding the poor, then clothing the poor (with women taking precedence over men for both food and clothing), then Jewish education, then building and supporting a synagogue (S.A. Yoreh De’ah 249:16; 251:7-8; 252: 1, 3).
- Greatest needs of the individuals at risk: Save those whose lives are most at risk first, followed by those at lesser degrees of risk for their lives, followed by those at risk for harm (e.g., assault, rape) (S.A. Yoreh De’ah 252:8).
- Everyone is equal (M. Sanhedrin 4:5; B. Berakhot 17a; and the difficult case of handing someone over to the enemy in J. Terumot 7:20 and Genesis Rabbah 94:9)
- Although saving people from poverty and captivity may indeed have involved saving lives, the situations our ancestors faced were not usually as overwhelming in the numbers of people in need or in the immediacy of the possibility of death as in the situation that we are now facing in the COVID-19 pandemic. In this context, individual physicians, ethicists, and ethics committees at hospitals, including those who wrote about triage decisions years before the current pandemic and those who are wrestling with formulating hospital policies now, have identified all of the following moral principles that might guide triage decisions:
- Treating people equally, either through “first come, first serve” or through a lottery.
- Favoring the worst-off on the basis of the “rule of rescue.”
- Maximizing total benefits (utilitarianism), measured either by the number of lives saved or the number of life-years saved.
- Promoting and rewarding social usefulness, based either on instrumental value for the future of the society or on reciprocity for past contributions, including those on the front lines of fighting COVID-19.