Editor’s note: Some readers requested expansion upon Rav Hershel Schachter’s ruling that one is obligated to get the Covid vaccine (in the July 9 issue). So we asked one of Rav Schachter’s leading students, Rabbi Daniel Z. Feldman, to expand upon it.
Thank you to The Jewish Press, as always, for publishing the rulings of Rav Schachter, shilta, especially on the crucially important topic of vaccination at this most perilous time. While I cannot speak on behalf of Rav Schachter, there are many points he has made in the past that, together with other classic sources of halacha and hashkafah, expand upon the published position and may serve to further emphasize its message. (Any mistaken interpretations or extrapolations are my fault).
It should be stressed at the outset that, as Rav Schachter noted, individuals may have specific medical advice that is particularized for their circumstances, and they should consult medical professionals familiar with their personal situation. Regarding the general population, however, it is appropriate to speak more broadly.
The obligation to protect one’s health is defined by the current state of medical knowledge. While there are always points of disagreement, as in all areas, there is a process within the field for weighing and assessing the various views and opinions and emerging with a dominant direction. In the case of the Covid-19 vaccines, the overwhelming conclusion has been that the vaccines are safe and greatly effective, and that Covid is horrendously dangerous.
This certainly exceeds the standard established in the Shulchan Aruch (O.C. 328:10), that one doctor should be followed when advocating for a patient to eat on Yom Kippur, out of abundance of caution in the preservation of life.
Some have pointed to this source as a reason not to take the vaccine, arguing that even a minority opinion among doctors fearing the vaccine is sufficient basis to avoid it. However, this application is difficult to sustain. In the context of Yom Kippur, the two choices are to factor in a minor health risk, or not to. The conclusion is that the mandate of preservation of life is so central that even the less-likely possibility is acknowledged.
On the other hand, in the context of the vaccine, the decision to validate a minority opinion does not result in greater sensitivity to the sanctity of life; it results in the disregarding of a clear majority view and a consequential risk to human life – of the individual deciding as well as of others.
Similarly, some have argued that it is better to decline the vaccine even at the risk of contracting Covid, based on the halachic principle of “shev v’al ta’aseh adif” – i.e. it is preferable to avoid a deliberate action that may be harmful, even if the passive alternative is also connected to a possible negative outcome. Here too, this is a difficult application; failure to adhere to medical direction in a situation of such serious risk would certainly be considered willful negligence. This is in no way analogous to acting passively in the face of a difficult choice.
It is noteworthy that the Torah mandates healing the sick in the language of permission: “V’rapo yerape” (Shemos 21:19) – that there is permission granted to the doctor to heal (Bava Kama 85a). Commentaries offer various explanations as to the need to grant “permission” for an action which is actually obligatory (see Devarim 22:2 and Sanhedrin 73a). Among the suggestions is the recognition that every medical intervention carries some aspect of risk; accordingly, one might think that the healing act should carry a prohibition or liability (see Ramban, Vayikra 26:11). The message, then, would be to validate the active measure – one that has been endorsed by responsible and knowledgeable professionals – over any preference for passivity as policy.
This last caveat regarding the qualifications of the practitioner is emphasized in the codification of the Shulchan Aruch (YD 336:1), which assigns both guilt and liability to one who “practices without a license.” This is presumably applicable also (at least in spirit) to one who advises against the recommendations of medical consensus, particularly in areas of great danger to life.
One might suggest that from a religious perspective, the question is even more straightforward. If one perceives that, rather than seeing his own decisions as determinative of his fate, Divine providence is guiding the result, then considering that there’s a halachic mandate to follow professional medical advice (see Taz, YD 336), the conclusion is most clearly in line with the dominant medical consensus. In other words, Hashem decides what will happen, and our responsibility is to adhere to the process dictated by halacha and by medical instruction.
The language of “chiyuv” is somewhat subject to context. At times it conveys a literal application of a defined mitzvah; at other times, the circumstances are more complex and require a more subjective assessment of a situation, as well as the incorporation of broader values. Nonetheless, the great ethicists (see for example, R. Alexander Ziskind of Horodna, Yesod ViShoresh HaAvodah, sha’ar 1, ch. 9) emphasize that the service of G-d guides all behavior in terms of obligation and prohibition, and requires the path that responsible analysis indicates.
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The question was also posed regarding someone who is in a low-risk group, and whether they should get the vaccine in order to prevent the spread to others, who may be more vulnerable, as well as to contribute to the broader battle against the virus.
It is hard to fully grant the premise of this question, as the virus has tragically killed individuals from all demographics and health categories, and caused devastating long-term consequences for many others, even if in actuarial terms there are distinctions among groups.
Nonetheless, even granting this premise, it would seem clear that vaccination is called for, in order to prevent or minimize the spreading of the disease to those more vulnerable, and to contribute to the possibility of herd immunity and then end of the pandemic.
However, the question presumes also that there is a risk inherent in taking the vaccine, and thus the question is whether one is obligated to undertake that risk to accomplish the positive goal.
Here again, that premise is difficult to validate, as per the above. Still, to address the issue in theory, we can briefly consider the critical question of whether one is obligated or even permitted to risk one’s life in order to protect the life of another who is already at risk.
As one might imagine, the topic is highly complex and controversial. The implication of the Talmud Yerushalmi is that one is indeed obligated to take on a possible risk to protect another from a more definite harm.
R. Yosef Karo notes this in his commentaries to the Rambam and the Tur, but does not explicitly state this is the case when he codifies the obligation of life-saving in his Shulchan Aruch (C.M. 426:1). This has led many of the commentaries to assume that the position of the Shulchan Aruch is that the mitzvah of life-saving does not require, or perhaps even permit, risking one’s own life, as that is the general standard for mitzvos. (See Sm’a; and Pischei Teshuvah, who cites Agudas Ezov, and who understands this to be the position of the Talmud Bavli.)
However, even if this is the normative halacha, it would still be necessary to note several qualifications. As this exemption is not mentioned explicitly by the Shulchan Aruch, it would presumably not be the case that no one is ever expected to take on any risk to save others; rather, a significant risk, enough to exempt one from general mitzvos, would seemingly have to be present. Similarly, the Radbaz (III, 627), who does assume there is no obligation to take on risk, emphasizes that one should not be overly eager to exempt one’s self with insufficient basis; doing so, as the Talmud indicates (Bava Metzia 33a, and Rashi there), is morally wrong and invites Divine retribution. (See also Aruch HaShulchan, as well as the comments of Tiferes Yisrael, Yoma 8:3, regarding the smallpox inoculation.)
As such, even the self-preservation exemption, when it comes to saving others, is considered by poskim to be very dependent on the specific statistics and realities. For example, as medical advances made kidney donations progressively less risky for the donors and more likely beneficial to the recipients, poskim adjusted their assessments accordingly, seeing donation as somewhere between highly encouraged and obligatory, depending on the circumstances. Again, per the above, medical consensus would certainly see receiving the vaccine as less dangerous than donating a kidney.
Rav Schachter’s father in law, R. Aharon Yeshaya Shapiro, was instrumental in preparing the publication of R. Shimon Shkop’s classic work, Sha’arei Yosher. In the often-quoted introduction to that volume, R. Shkop considers the meaning of the statement of Hillel in the mishnah in Pirkei Avos: “Im ein ani li, mi li; u’kesh’ani l’atzmi, mah ani?” This is often translated as reflecting a conflict in values: “I must take care of myself” pitted against “but if I am only for myself, that’s not good either.”
R. Shkop understood the two phrases as one continuous message. Human beings must take care of themselves first; no one else will. Nonetheless, the word “ani” in the mishnah does not have to be translated minimally, as “I” the individual. It is the prerogative of each person to define, through his attitude, the word ani more expansively: I and my family; and my extended family; and my community; and the Jewish people; and the entire world. One’s greatness is displayed by how broadly they define their personal “ani”; conversely, ’kesh’ani l’atzmi, mah ani: if I define “ani” as “atzmi,” the lone individual, then what am I, really?
Covid -19 has wrought horrific devastation on the entire world. Through the suffering, some lessons have emerged. One is the inescapable reminder that none of us are lone individuals, disconnected from others, free to make decisions that consider only our own circumstances. What we choose to do impacts those around us, whether we want that or not. Realizing that, and living and acting with that knowledge, is what leads us to greatness.