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Thought for the Day: Risking Your Life to Save Your Life

Bike the Drive was amazing. Beautiful weather and... actually, once you have beautiful weather for the event, there isn't much more to say. Did I mention that I also do this ride to help raise needed funds for Chai Lifeline? And that you can still make donations? I did? OK; just confirming. I actually ended up biking more than 54 miles. Why I did that is only semi interesting (even to me), and certainly not something with which I need to waste your time on this venue. Feel free to ask, though.

In any case, being as I was on the road for more than 3 1/2 hours, I had lots of time do listen to shiurim; some twice. One in particular peeked my interest: a shiur based on a topic discussed on Sanhedrin 78 about whether one is allowed to undergo a risky surgery. R' Chaim Ozer was presented the following question: a Jew with a condition that -- left untreated -- would surely claim his life withing a few months had been offered a surgery that -- if successful, would extend his life by sevearl years. "If successful", aye, there's the rub. The surgery itself had a very high mortality rate. The question was: Should he risk the surgery? In fact, was he even allowed to risk the surgery? Or, perhaps was he required to risk the surgery? Such questions need extraordinarily broad shoulders. R' Chaim Ozer was one of the very few who could shoulder that burden.

The reason I found this case so interesting is that it was precisely the position in which my grandfather, עליו השלום, found himself in the early 1960's. My grandfather had atherosclerosis and was told that he would not be able to live more than another six months without treatment. There was, however, a new surgery (first successful procedure was only accomplished in 1960) that was very promising: coronary artery bypass surgery. The down side was the risk; 50/50 chance of dying on the table (as the expression goes). My grandfather opted not to have the surgery and died in 1963, when I was six years old. I was not allowed to attend the funeral, but I remember how it shook my family.  My grandmother left to stay with her sisters for several months and my father never was able to talk about it. I decided immediately that my first son would be named for him, and so it was.

The basic question turns on a few fundamental principles. First, there is a positive Torah mitzvah to live. This fact has many practical ramifications regarding end of life issues, of course.  But it also has ramifications on risks one is allowed to take in general. Race car driver, for example, might be forbidden as an occupation option for a Jew. Part of that consideration is also the benefit from the risk. Again, the thrill of the wind in your hair and exhaust in your face is not enough to justify the risk of driving a Formula 1 car at 200 mph.

On the other hand (yes, to be a practicing Orthodox Jew, you need lots of hands), if someone shoots someone who is falling from a 100 story building onto a concrete sidewalk, he is not considered a murderer. The faller's death is a certainty and so the shooter is considered to have killed a dead guy. The shooter, by they way, is certainly guilty of a crime; it's just not the crime of murder. What's considered "certain to die" and in what time frame is a matter of some discussion. A disease that will kill them within the year is very likely in that category. ("Old age" is not a disease, and shorting someone's life by even a moment is considered an act of murder.) On the other hand (I already warned you about the hands), as long as the person is breathing we are obligated to do anything to save his life -- even if it entails many people violating the Sabbath.

So we have the risk arguing against the surgery and the benefit arguing for it. One of the proofs that R' Chaim Ozer adduced was from a gemara that discusses a group of four lepers (who where dying) who risked entering a city known for wantonly killing lepers. These "strange" cases the gemara brings often have startlingly direct practical applications. R' Chaim Ozer came out that the person was obligated to have the surgery, but it was better to have a Jewish doctor; all things being equal. The question was again addressed more recently by the Tzitz Eliezer, who concurred that the surgery was required, but argued that it didn't matter whether the doctor was Jewish or not; even though all other things are equal.

This shiur, was very personal to me. My father faced precisely the same choice nearly 40 years later. By that time, the surgery was very low risk and one of the most commonly performed around the world. One cannot change the past, of course. But we can and should use our past to make these questions more personal. The more we can make our learning personal, the more we can magnify its impact on our daily living.

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