Q&A: I Would Appreciate Your Help
I Would Appreciate Your Help
Question
Hello and blessings,
My name is N., I finished medical school about a month ago, and I live in Lod.
I am currently studying the topic of life-saving necessity on the Sabbath, and in particular I am dealing right now with the issue of possible life-saving necessity.
Since I heard a lecture of yours in the past that touched on this area, I would like to present you with a question that is bothering me, and I would be happy if you could refer me to relevant sources if possible:
How can one integrate the halakhic way of thinking about life-saving necessity, which is characterized by the binary of 0 and 1—that is, either there is or there is not life-saving necessity—with medical thinking today, which speaks in percentages—the statistics show that a certain situation involves X% danger / mortality, etc. After all, even the simplest situations carry some percentage of dangerous complications.
Is it possible to describe a boundary line such that only beyond a certain percentage would something be called possible life-saving necessity?
Thank you very much,
Have a wonderful evening
Answer
Hello N.,
It seems to me that your question mixes together two different planes. The difference is not between medicine and Jewish law, but between reality and the normative ruling that relates to it.
Everyone understands that dangers are not measured in binary logic (1 or 0) but in continuous logic (probability). Medical science deals, among other things, with dangers, so it is no surprise that it measures them in the language of chances. But a normative system like Jewish law or civil law has to end with a bottom line: permitted or forbidden. Therefore there is no escaping drawing a line on the continuum of probabilities and risks, beyond which the situation will be defined as life-saving necessity, and below which it will not. On this matter, you can read my article here:
https://mikyab.net/%D7%9B%D7%AA%D7%91%D7%99%D7%9D/%D7%9E%D7%90%D7%9E%D7%A8%D7%99%D7%9D/%D7%94%D7%9C%D7%9B%D7%94-%D7%95%D7%9E%D7%A6%D7%99%D7%90%D7%95%D7%AA-%D7%9E%D7%94%D7%99-%D7%9E%D7%95%D7%9E%D7%97%D7%99%D7%95%D7%AA-%D7%94%D7%9C%D7%9B%D7%AA%D7%99%D7%AA/
Therefore Jewish law is not binary in the way it views reality. It is binary in its normative instructions with respect to reality. Its view of reality is exactly like the medical one, since it does not deal with reality—just as medicine does not deal with norms.
If you are looking for a line in the sense of a number (for example: dangerous means starting at a 70% risk level), you will not find such a line in any normative system—not in Jewish law and not in jurisprudence. The language used there is that of reasonable risk, high risk, and low risk. The judge / halakhic decisor on the ground has to decide, under the given circumstances, into which of these categories the case before him falls. Thus, for example, in Jewish law there are statements like “The Lord protects the simple,” which mean that if this is a risk that reasonable people take, then halakhically it is not considered a dangerous situation (for example smoking, traffic accidents, and more), regardless of the objective probability of loss of life.
In summary, there is no basis for comparing Jewish law to medicine, since one deals with norms and the other with facts. Admittedly, there are rabbis, doctors, and many other people who confuse the fields and arrive at foolish statements because they do not understand this distinction. For example, I have encountered doctors who think that on a pregnancy termination committee the decision should be made by a physician (and who protest, for example, against rabbinic presence on the committee), and there is no greater nonsense than that (see my article above). Similarly, psychiatrists think that defining illness is a medical-clinical question, and there is no greater mistake than that (see my article above, and in the links that will immediately follow).
You can see an example of this in a debate I had with Prof. Yoram Yovel in columns 25 and 26 on my site (and originally in Makor Rishon). You can see it here:
https://mikyab.net/%D7%A2%D7%9C-%D7%A1%D7%98%D7%99%D7%99%D7%94-%D7%9E%D7%95%D7%9E%D7%97%D7%99%D7%95%D7%AA-%D7%95%D7%A2%D7%A8%D7%9B%D7%99%D7%9D-%D7%AA%D7%92%D7%95%D7%91%D7%94-%D7%9C%D7%9E%D7%90%D7%9E%D7%A8%D7%95/
and the continuation here:
https://mikyab.net/%D7%A2%D7%9C-%D7%A1%D7%98%D7%99%D7%99%D7%94-%D7%9E%D7%95%D7%9E%D7%97%D7%99%D7%95%D7%AA-%D7%95%D7%A2%D7%A8%D7%9B%D7%99%D7%9D-%D7%AA%D7%92%D7%95%D7%91%D7%94-%D7%9C%D7%9E%D7%90%D7%9E%D7%A8%D7%95-2/