Title: Touro University: Medical Halachah Annual Volume 1 – The Pandemic and Its Implications
Touro University, New York Medical College
The inaugural issue of Medical Halachah Annual, published by Touro University/New York Medical College, is simply a triumph. The editors have gathered groundbreaking and thorough articles on eternal and contemporary issues from significant talmidei chachamim, including some who have not previously published extensively in this field. The articles are lively and informative without being superficial. The volume can be read for pleasure and information and should then be kept as an essential reference.
The opening article, Rabbi Meir Twersky’s “Risk Assessment in Halachah,” features the author’s characteristically brilliant analysis and deep commitment to seeing halachah as a system of metaphysically grounded concepts. He takes statements about the odds of danger or death being greater than, less than, or equal to one in one thousand as literal rather than hyperbolic, because one thousand equals ten to the third, and ten and three are Jewishly significant numbers in relevant ways. Thus, when Maggid Mishneh says that we violate Shabbat only in an unusual way for a birthing mother “because not one in a thousand dies,” he means that an exactly one in a thousand chance of death justifies violating Shabbat in a usual way. Similarly, Rav Akiva Eiger’s statement that odds of one in a thousand of danger-to-life may be halachically ignored means that odds of nine hundred ninety-nine to one may not be ignored. Rabbi Twersky urges great methodological rigor in assessing these odds, for example that risk must be calculated using data for the specific populations to which a patient belongs rather than for generic humans.
By contrast, Rabbi Ahron Lopiansky writes in “The Roles of Medical Expertise and Rabbanim in the Pandemic” that “The expression ‘one in a thousand’ does not seem to be a specific figure but rather a turn of phrase,” and that “The Chazon Ish seems to maintain that it is the evaluation of the posek at hand, rather than any objective standard per se, that determines whether something is pikuach nefesh.” It is in the nature of periodicals that this and other sharp differences of opinion, reflecting fundamentally different orientations to the raw materials of halachah, are left for the reader to discover.
For those focused on contemporary issues, Rabbi Mordechai Willig’s “Confronting the Pandemic in the Community: A Rabbi’s Memoir” offers unprecedented insight into the way halachic decisions were made for our community during COVID. Dr. Yonah Rubin and Rabbi Dr. Jason Weiner’s “Adult ECMO and Mechanical Circulatory Support: Framing the Halachic and Ethical Issues” is ideal for fans of the genre of “hard medical halachah,” which builds extensive clear explanations of cutting-edge technology into its discussion of legal issues. Note that the distinction between medical halachah and Jewish medical ethics is assumed by some authors and implicitly rejected by others.
A minor caveat is that the footnotes were not consistently edited to the same high standard as the articles. For example, Rabbi Zvi Loewy writes in “Clinical Trials for COVID-19 Vaccines” that since the gemara derives the obligation to save lives from the obligation to return lost property, “just as the rightful owner may decide to forego his property and not seek its return, a patient may also avoid treatment and avoid restoration of health in specific situations.” The footnote for the paragraph cites only the original gemara (Sanhedrin 73a) and provides no source for the extension. Another example: Rabbi Akiva Tatz writes in “Allocation of Scarce Resources” that “All else being equal, one would have to bypass a stranger to treat one’s own close relative.” The footnote astonishingly states only that “The halachic derivation of this point is beyond the scope of his essay (the student of halachah will find it an instructive exercise).” One last example: Rabbi Dr. Aharon Steinberg writes in “Management of Profound Multi-Organ Failure” that “It seems reasonable to assume that this medical stage represents the halachic state of goseis, although it does not fulfill all criteria cited by the poskim.” No source or argument is provided.
Medical Halachah Annual deserves wide and deep readership, and the editors deserve our community’s gratitude and appreciation. I look forward eagerly to reading future volumes of the same scope and quality.