Triage and the Sanctity of Life in our Ancient Texts (text sheet based on Rabbi Nevins and Rabbi Dorff's Teshuvot)

"Jewish ethics begins with theological beliefs in divine creation, the fashioning of humans in the divine image, the Torah’s record of commandments designed to sanctify the people Israel, and the efforts of rabbis in the past two millennia to apply these beliefs and practices to contemporary life"
Rabbi Nevins

Are there any texts that speak to saving one life over a different life?

What would the criteria be?

משנה הוריות ג׳:ז׳-ח׳

(ז) הָאִישׁ קוֹדֵם לָאִשָּׁה לְהַחֲיוֹת וּלְהָשִׁיב אֲבֵדָה. וְהָאִשָּׁה קוֹדֶמֶת לָאִישׁ לִכְסוּת, וּלְהוֹצִיאָהּ מִבֵּית הַשֶּׁבִי. בִּזְמַן שֶׁשְּׁנֵיהֶם עוֹמְדִים לְקַלְקָלָה, הָאִישׁ קוֹדֵם לָאִשָּׁה:

(ח) כֹּהֵן קוֹדֵם לְלֵוִי, לֵוִי לְיִשְׂרָאֵל, יִשְׂרָאֵל לְמַמְזֵר, וּמַמְזֵר לְנָתִין, וְנָתִין לְגֵר, וְגֵר לְעֶבֶד מְשֻׁחְרָר. אֵימָתַי, בִּזְמַן שֶׁכֻּלָּן שָׁוִין. אֲבָל אִם הָיָה מַמְזֵר תַּלְמִיד חָכָם וְכֹהֵן גָּדוֹל עַם הָאָרֶץ, מַמְזֵר תַּלְמִיד חָכָם קוֹדֵם לְכֹהֵן גָּדוֹל עַם הָאָרֶץ:

Mishnah Horayot 3:7-8

(7) A man takes precedence over a woman in matters concerning the saving of life and the restoration of lost property, and a woman takes precedence over a man in respect of clothing and ransom from captivity. When both are exposed to degradation in their captivity the man takes precedence over the woman.

(8) A priest takes precedence over a levite, a levite over an israelite, an israelite over a mamzer, a mamzer over a natin, a natin over a convert, and a convert over a freed slave. When is this so? When all these were in other respects equal. However, if the mamzer was a scholar and the high priest an ignoramus, the scholar mamzer takes precedence over the ignorant high priest.

What does the above text articulate about the value of life?

How do you feel about this message?

Can one life be traded for another?

שמואל ב כ׳:א׳

(א) וְשָׁ֨ם נִקְרָ֜א אִ֣ישׁ בְּלִיַּ֗עַל וּשְׁמ֛וֹ שֶׁ֥בַע בֶּן־בִּכְרִ֖י אִ֣ישׁ יְמִינִ֑י וַיִּתְקַ֣ע בַּשֹּׁפָ֗ר וַ֠יֹּאמֶר אֵֽין־לָ֨נוּ חֵ֜לֶק בְּדָוִ֗ד וְלֹ֤א נַֽחֲלָה־לָ֙נוּ֙ בְּבֶן־יִשַׁ֔י אִ֥ישׁ לְאֹהָלָ֖יו יִשְׂרָאֵֽל׃

II Samuel 20:1

(1) A scoundrel named Sheba son of Bichri, a Benjaminite, happened to be there. He sounded the horn and proclaimed: “We have no portion in David, No share in Jesse’s son! Every man to his tent, O Israel!”

שמואל ב כ׳:י״ט-כ״ב

(יט) אָנֹכִ֕י שְׁלֻמֵ֖י אֱמוּנֵ֣י יִשְׂרָאֵ֑ל אַתָּ֣ה מְבַקֵּ֗שׁ לְהָמִ֨ית עִ֤יר וְאֵם֙ בְּיִשְׂרָאֵ֔ל לָ֥מָּה תְבַלַּ֖ע נַחֲלַ֥ת יְהוָֽה׃ (פ) (כ) וַיַּ֥עַן יוֹאָ֖ב וַיֹּאמַ֑ר חָלִ֤ילָה חָלִ֙ילָה֙ לִ֔י אִם־אֲבַלַּ֖ע וְאִם־אַשְׁחִֽית׃ (כא) לֹא־כֵ֣ן הַדָּבָ֗ר כִּ֡י אִישׁ֩ מֵהַ֨ר אֶפְרַ֜יִם שֶׁ֧בַע בֶּן־בִּכְרִ֣י שְׁמ֗וֹ נָשָׂ֤א יָדוֹ֙ בַּמֶּ֣לֶךְ בְּדָוִ֔ד תְּנֽוּ־אֹת֣וֹ לְבַדּ֔וֹ וְאֵלְכָ֖ה מֵעַ֣ל הָעִ֑יר וַתֹּ֤אמֶר הָֽאִשָּׁה֙ אֶל־יוֹאָ֔ב הִנֵּ֥ה רֹאשׁ֛וֹ מֻשְׁלָ֥ךְ אֵלֶ֖יךָ בְּעַ֥ד הַחוֹמָֽה׃ (כב) וַתָּבוֹא֩ הָאִשָּׁ֨ה אֶל־כָּל־הָעָ֜ם בְּחָכְמָתָ֗הּ וַֽיִּכְרְת֞וּ אֶת־רֹ֨אשׁ שֶׁ֤בַע בֶּן־בִּכְרִי֙ וַיַּשְׁלִ֣כוּ אֶל־יוֹאָ֔ב וַיִּתְקַע֙ בַּשּׁוֹפָ֔ר וַיָּפֻ֥צוּ מֵֽעַל־הָעִ֖יר אִ֣ישׁ לְאֹהָלָ֑יו וְיוֹאָ֛ב שָׁ֥ב יְרוּשָׁלִַ֖ם אֶל־הַמֶּֽלֶךְ׃ (ס)

II Samuel 20:19-22

(19) I am one of those who seek the welfare of the faithful in Israel. But you seek to bring death upon a mother city in Israel! Why should you destroy the LORD’s possession?” (20) Joab replied, “Far be it, far be it from me to destroy or to ruin! (21) Not at all! But a certain man from the hill country of Ephraim, named Sheba son of Bichri, has rebelled against King David. Just hand him alone over to us, and I will withdraw from the city.” The woman assured Joab, “His head shall be thrown over the wall to you.” (22) The woman came to all the people with her clever plan; and they cut off the head of Sheba son of Bichri and threw it down to Joab. He then sounded the horn; all the men dispersed to their homes, and Joab returned to the king in Jerusalem.

What does this text say about sacrificing one live to save the many?

Rabbi Jehiel Jacob Weinberg, who survived the Shoah and understood the terrible moral calculus forced on communal leaders in crisis, writes in his responsa:
"Rather the interpretation [of the Sheva b. Bikhri story] is that [saving] life is the highest value, and it is not given to quantification or assessment [of value], even if many lives can be saved only by the killing of one person. Murder is absolutely forbidden with no limit or condition."

"only if the one person was already sentenced to death, or actively dying, or specified by the attackers, or certain to die with the rest of the group, and only in the context of a war, could one be sacrificed to save the many."
Rabbi Nevins

Rabbi Dorff offers the story of Sheva b. Bikhri in its rabbinic retellings as a basis for instituting a policy in the extreme situation of a pandemic in which one viable patient could be denied scarce medical resources or even removed from them in order to treat one or more other patients.

Which view do you find more compelling based on the story?

משנה תורה, הלכות יסודי התורה ה׳:ה׳

(ה) נָשִׁים שֶׁאָמְרוּ לָהֶם עוֹבְדֵי כּוֹכָבִים תְּנוּ לָנוּ אַחַת מִכֶּן וּנְטַמֵּא אוֹתָהּ וְאִם לָאו נְטַמֵּא אֶת כֻּלְּכֶן יִטָּמְאוּ כֻּלָּן וְאַל יִמְסְרוּ לָהֶם נֶפֶשׁ אַחַת מִיִּשְׂרָאֵל. וְכֵן אִם אָמְרוּ לָהֶם עוֹבְדֵי כּוֹכָבִים תְּנוּ לָנוּ אֶחָד מִכֶּם וְנַהַרְגֶּנּוּ וְאִם לָאו נַהֲרֹג כֻּלְּכֶם. יֵהָרְגוּ כֻּלָּם וְאַל יִמְסְרוּ לָהֶם נֶפֶשׁ אַחַת מִיִּשְׂרָאֵל. וְאִם יִחֲדוּהוּ לָהֶם וְאָמְרוּ תְּנוּ לָנוּ פְּלוֹנִי אוֹ נַהֲרֹג אֶת כֻּלְּכֶם. אִם הָיָה מְחֻיָּב מִיתָה כְּשֶׁבַע בֶּן בִּכְרִי יִתְּנוּ אוֹתוֹ לָהֶם. וְאֵין מוֹרִין לָהֶם כֵּן לְכַתְּחִלָּה. וְאִם אֵינוֹ חַיָּב מִיתָה יֵהָרְגוּ כֻּלָּן וְאַל יִמְסְרוּ לָהֶם נֶפֶשׁ אַחַת מִיִּשְׂרָאֵל:

Mishneh Torah, Foundations of the Torah 5:5

(5) If idolaters will demand one of a group of women, saying: "Yield us one of among you and we will defile her, if not we will defile you all", let all be defiled, rather than surrender to them one soul in Israel.⁴Terumot, 8.12. C. G. Likewise, if idolaters will say to a group of men: "Yield us one of you and we will kill him, if not we will kill you all", let all of them be killed rather than surrender to them one soul in Israel. If, however, they single out the one, saying: "Give us that man, if not we will kill you all", if he be guilty of a capital crime, as, for example, Sheba son of Bichri⁵See Second Samuel; 20. 1. G., they may surrender him to them, but it is not commendable to advise them to do so; if he be not guilty of a capital crime, they all must submit rather than surrender them one soul in Israel. (RAMBAM)

What is RAMBAM's criteria for turning over one person to save the many?

Tosefta Terumot 7:20
If a caravan of [Jewish] people were attacked by gentiles who demanded, “Give us one person to kill, or else we will kill you all,” then they should all die before giving up one Jewish life. But if [the attackers] singled out one [victim], as in the case of Sheva ben Bikhri, they should hand him over, and not all die. Rabbi Yehudah said, in what case did they say [not to hand over the victim]? Only when the victim was inside [the barricade] and the attackers were outside, but if they were already inside and prepared to kill everyone, then they may hand him over and not all be killed.

Jerusalem Talmud, Terumot 46b
It was taught about caravans of [Jewish] people who were on the road, and were attacked by gentiles who said, “Give us one of you to kill, or else we will kill you all.” Even if they would all die, they should not hand over one Jewish life [But if] they specified one person, like Sheva ben Bikhri, they may hand him over rather than be killed. Rabbi Shimon b. Lakish said, but only if he had been sentenced to death [by a Jewish court] like Sheva b. Bikhri. But Rabbi Yohanan says, even if he hadn’t been sentenced to death like Sheva b. Bikhri [but...?].

What qualifications are being added to whether or not a person can be handed over?

נדרים פ׳ ב:ז׳

ורמי דרבי יוסי אדר' יוסי מעיין של בני העיר חייהן וחיי אחרים חייהן קודמין לחיי אחרים בהמתם [ובהמת אחרים בהמתם] קודמת לבהמת אחרים כביסתן וכביסת אחרים כביסתן קודמת לכביסת אחרים חיי אחרים וכביסתן חיי אחרים קודמין לכביסתן

Nedarim 80b:7

§ The Gemara raises a contradiction between this statement of Rabbi Yosei and another statement of Rabbi Yosei. It was taught in a baraita: In the case of a spring belonging to the residents of a city, if the water was needed for their own lives, i.e., the city’s residents required the spring for drinking water, and it was also needed for the lives of others, their own lives take precedence over the lives of others. Likewise, if the water was needed for their own animals and also for the animals of others, their own animals take precedence over the animals of others. And if the water was needed for their own laundry and also for the laundry of others, their own laundry takes precedence over the laundry of others. However, if the spring water was needed for the lives of others and their own laundry, the lives of others take precedence over their own laundry.

What statement is this Gemara making about taking care of oneself and taking care of others?

ויקרא י״ט:ט״ז

(טז) לֹא־תֵלֵ֤ךְ רָכִיל֙ בְּעַמֶּ֔יךָ לֹ֥א תַעֲמֹ֖ד עַל־דַּ֣ם רֵעֶ֑ךָ אֲנִ֖י יְהוָֽה׃

Leviticus 19:16

“Do not stand [idly] over the [endangered] blood of your companion”

How is this text from Leviticus a proof text for the text in Nedarim?

Rabbi Yosef b. Meir Teomim (1727–1792)
Pri Megadim, OH, Mish. Zahav, # 328:1.
Nevertheless, if there is one [patient] who is in certain danger according to the physicians and others, and another who is only in possible danger, and there is not enough medication for both, the [person in] certain danger supersedes the doubtful danger.