“Whoever saves one life, it is as if he has saved the whole world” (Babylonian Talmud Sanhedrin 4:5).
Who cannot fail to feel a sense of duty when confronted by stories of overflowing emergency wards in European hospitals and people being refused life saving equipment due to lack of resources? And who would refuse to spend every penny of their income to save the life of a loved one? The morality of saving another life seems cut and dry. We should spend every penny we have to do so.
But it’s not so clear cut in the Mishnah.
“Do not ransom hostages for more than their financial worth because of Tikun Olam” (Babylonian Talmud Gittin 4:6)
This may seem astonishing, especially considering that a hostage at the time of the Talmud was in fear of his life, a true case of pikuach nefesh. And the Rabbis (Babylonian Talmud Gittin 45a) debate what “Tikun Olam” means in this context. The first opinion is because it places too great a financial burden on the community funds (“duchta detzibura”) but the second opinion is because it would encourage more hostages to be taken. The Talmud does not resolve the debate, leaving both options as possibilities.
The first option, that of placing too great a burden on the community is, in fact, a key source for the Jewish ethical approach to triage, the allocation of limited medical resources. If it were not for this permission, a Jewish community might have to spend all its financial resources on healthcare, preserving life, and would not be able to operate yeshivot or chesed organisations.
So now comes the key question. If there is infinite value to a human life, how can there also be a finite limit to how much we must spend to save it?
I would like to suggest an answer. The Mishnah in Sanhedrin that commands us to save a human life, no matter what the cost, is speaking to us as individuals. The Mishnah in Gittin that limits the expenditure on saving a life is speaking to us as a community.
An individual is free to spend his money as he wishes and should certainly be encouraged to use his funds to save lives, even at great expense. Community funds, however, come with a responsibility to provide a wide range of community services – healthcare, security, welfare, education and so on.
In our Corona hit world, the question of what is a reasonable expenditure by a government on preventing death is a political hot potato. Many leaders, including Netanyahu, have sworn that they will reduce the mortality of this plague to the minimum.
Is this the most Jewishly moral response?
If we look at the mortality data from Corona, it appears that a worst case scenario would result in 0.1% of a population dying from this disease (the rate is mostly under 0.05% in most worst hit countries at this date). If the disease were to, God forbid, mutate, the outcome could be as bad as 0.5%, but few experts are predicting more.
At the same time, the cost of a lockdown can be 15% (and possibly a lot more) of a country’s annual budget to prevent just some of this mortality. Unemployment has rocketed to unheard of levels (20% or more in many Western countries that have instituted lockdowns) and the tourism and aviation industries are on their knees.
When the Rabbis debated the cost of saving a hostage’s life, did they ever imagine that one day there would be countries spending over 15% of their funds to save 0.1% of the population? What if, God forbid, the mortality rate was 10% and not 0.1% – would we be prepared to spend 100% of the budget or more on saving those lives? What would happen to the other 90% without food, healthcare provision or education for decades?
From a public health perspective, there are cheaper, and more effective, alternatives to lockdowns. If the elderly (including those in old age homes), and most at risk, could be effectively shielded, this would, most likely, save more lives and certainly would keep far fewer families from being thrown into an indefinite period of poverty. The younger generation could continue to learn, the working generation could continue to work. As has been clear from the start of this pandemic, this disease puts the young and healthy at a very low risk of mortality (not dissimilar to flu). It is not crazy to believe that the more young people gain immunity through exposure, the safer the elderly will be as a result. As a kid I remember attending a Chickenpox party that was thrown by a friend in order to make sure that I became infected at a young age when it would be far less harmful to me than as an adult. The old rules of epidemiology apply, despite the scaremongering that the world’s media would have us believe.
Saving a life is a core Torah, and human, value. But saving a life at the expense of many others is not. Individuals must continue to act as individuals, helping those at risk to minimise their exposure as many wonderful volunteers and professional healthcare workers are doing today. However, politicians must act responsibly as administrators of the community purse and that means making some tough decisions. If they do not want to make those decisions, perhaps they are not cut out for public service.
The writer is the emeritus Rabbi of Radlett United Synagogue with a Masters degree in Public Health from Hebrew University and a lifelong career in finance.