For the past 16 years I have served as the rabbi of Cedars-Sinai Medical Center in Los Angeles. Being the rabbi of a Jewish hospital is meaningful and thrilling, though it can be challenging and lonely. Although in the past there were more than 120 Jewish hospitals in America, today there are fewer than 10, so I don’t often get to talk to colleagues who are serving in similar roles. In Israel, however, almost every hospital is a Jewish hospital – some are even Orthodox Jewish hospitals, and they all have rabbis. I therefore make a point of visiting these hospitals as frequently as possible in order to get to know their rabbis.
Last month, I had an especially meaningful trip to Israel during which I visited Shaare Zedek in Jerusalem, Sheba/Tel Hashomer in Tel Aviv, and Maayanei Hayeshua in Bnai Brak. The rabbis in these hospitals have very central roles in patient care. Not only do they comfort patients and provide religious services, such as overseeing kashrut and minyanim, but they also are truly on the front lines of applying halacha to modern medicine all day long.
My first visit was to Shaare Zedek, to speak with their outgoing rabbi, Rav Moshe Flegg. He explained to me their system for ensuring that any procedure that might involve any halachic question – from fertility treatments to abortion to end-of-life issues such as terminal extubation or posthumous organ retrieval – must be brought to him for permission before they can be carried out. It was incredible to see the truly central and pivotal role this rabbi has at such a large modern medical center.
I then spent an entire afternoon with Rav Yosef Hoffner, the rav of Maayanei Hayeshua in Bnai Brak. This is a 350-bed hospital that was designed to be a chareidi institution. Their rav is one of the most central figures in the entire hospital, with dozens of daily halachic questions requiring his input and all hospital policies going through his office. The entire building is designed to prevent kohanim from having any issues in entering the building, and they developed their own unique hydraulic nurse-call button system for Shabbat.
Rav Hoffner was kind enough to share his approach to various halachic dilemmas with me. Among his other accomplishments, he has instituted halachically-based practices and procedures for the doctors and nurses. What I found fascinating was that many of these rulings are based on the application of classical Jewish sources in ways I had never seen published in any works of Jewish law but which he has brought to life with fascinating relevance. Additionally, Rav Hoffner showed me their new state-of-the-art mental health facility, complete with a beit midrash, rabbis on staff, and gender-specific wards, to ensure religiously sensitive care for chareidi patients.
My next visit was to Sheba/Tel Hashomer Hospital in Tel Aviv. Unlike Maayanei Hayeshua and Shaare Zedek, Tel Hashomer is not under Orthodox auspices. But as the largest hospital in the entire Middle East, it has many religiously observant patients, and their rav, Rabbi Yoav Waknin, fields halachic questions from patients all day long. One of the most fascinating things he showed me was their new men’s mikveh, the only one in the world in a hospital. Why did a hospital build a men’s mikveh? He explained that the hospitals in Israel are reimbursed for most patients from the kupat cholim, from which they end up losing money on most admissions. However, childbirth is reimbursed by social security, which they make money on, so they are trying to attract more chareidim from nearby Bnai Brak, whose high birth rate will result in more profit for the hospital. So even though they are not officially an Orthodox hospital, economics ensures their religiously sensitive care.
My final meeting was with my rebbe, Rav Asher Weiss, who is the posek for Shaare Zedek. Two of my daughters were with me for this trip, and when I told them I was going to meet with Rav Weiss, they begged to join me. Not only did Rav Weiss welcome them, but each time I asked him a halachic question, he first turned to them and asked each of them by name, “What do you think?”
My final question for him, inspired by requests from researchers at my home institution, was for general Jewish guidance on how fast medical technology should advance. On the one hand, these innovations can save lives, and any delays may result in deaths. On the other hand, if these innovations are advanced too quickly, they could lead to significant dangers to individuals, completely undermining their life-saving goals. Rav Weiss’s answer was brilliant and insightful. He told me that when the goal is saving life, we should seek to encourage new technologies to progress as quickly as possible, but with some basic precautions. He analogized this to driving an ambulance to save a life. The ambulance should be driven as speedily as possible to reach the patient in need quickly. However, it would be irresponsible to drive recklessly, since that would jeopardize the crew’s likelihood of saving the life in need.
The wisdom coming from our great rabbinic leaders in Israel is staggering. They are forced to apply Torah to real life dilemmas on the front lines of life and death, demonstrating how our Torah is truly alive, a Torat Chaim in the deepest sense of the word.