Jewish Medical Ethics

R. Chanina b. Teradyon died a martyr's death at the hands of the Romans during the Hadrianic persecutions of the second century C.E.65 According to the story, the Romans burned R. Chanina at the stake, wrapped in the parchment of a sefer Torah, and they place wet woolen rags around him in order to retard the flames and to prolong his agony. He nonetheless refuses to open his mouth and let the fire enter, in order to hasten his death; "it is better that the One who gives life take it away than for a person to bring harm upon himself." Yet when a Roman guard asks: "Rabbi, if I increase the flame and remove the rags, will you guarantee me life in the world to come?", R. Chanina answers "yes," and the guard did so.
- Talmud Bavli, Avodah Zara 18a

We do not cry out for a moribund person at the moment of the departing of the soul, lest his soul return and he will then suffer affliction. “There is a time to die” (Eccl. 3:2).What is the meaning of this? It is to teach that when a person is moribund and his soul is departing, we do not pray that his soul return to him because he would in any event be able to live only a few more days, and those days would be in pain.
- Sefer Hasidim, section 234. New York, NY: Pardes Publishing, 1953:78.
We do not act to postpone a person’s death. For example, if a person was moribund and a woodchopper was near that house and the soul could not depart (because of the sound of the chopping of the wood), we remove the woodchopper from that area. We [also] do not place salt on a patient’s tongue to prevent him from dying. [However,] if he is moribund and says: “I cannot die until I am moved to another location,” he is not to be moved.
- Sefer Hasidim, section 723. New York, NY: Pardes Publishing, 1953:173

Though generally one should take care of one’s self before assisting others, this should not come at any cost, especially at the potential cost of someone else’s health. The Talmud addresses this dilemma in a well-known story about two people who were walking in the desert: Two people were walking along a deserted path, and in the hand of one of them was a jug of water. If both of them drink, they will both die [before reaching another source of water]. If one drinks, he will reach an inhabited place [and survive]. Ben Petora explained: “It is best that both drink and both die, so that one will not see the death of his friend. But then Rabbi Akiva taught: “Let him live by your side” (Lev. 25:36) – your life comes before the life of your companion.42 Though Rabbi Akiva thinks that an individual should put her life first, most commentaries assume that he ruled like this because the jug of water was clearly owned by one of the two individuals. If it had been a shared jug of water, then it is possible that Rabbi Akiva would have ruled differently. It is important to note that no one suggests that the person who did not bring the jug of water should take his friend’s jug. That would be stealing, and perhaps, since it would lead to his friend’s death, even a more severe offense. Even though the friend’s life is in danger, this is not a case where he would be justified in taking the other person’s jug of water. We must take care of ourselves first, but not at the potential cost of other’s health and wellbeing.
- Rabbinical Assembly: Vaccination and Ethical Questions Posed by COVID-19 Vaccines

P’sak Din: Halakhic Conclusion
In the throes of a pandemic or other health emergency in which clinicians must choose among patients (or have a triage officer choose for them) to receive intensive medical treatment, utilitarian analysis is not the only ethical option. Jewish law provides several criteria for the prioritization of care based on the sacred obligation to heal those who are ill. Patients who have the most urgent need should be the first to receive treatment, unless they are unlikely to survive, in which case patients who are expected to survive with intensive therapy should receive priority. After that, the first patient to request the resource has priority.
If a patient who is currently being sustained through artificial ventilation decides (themselves, through advanced directive, or through proxy) to discontinue this therapy due to their experience of futile suffering, then they may be extubated, and the ventilator reallocated to another patient based on the above criteria. Likewise, if a ventilator dependent patient is deemed terminal, the scarce resource may be reallocated to a viable patient. However, it is forbidden to remove a patient from a ventilator, causing their death, based only on the utilitarian assessment that another patient has a better prognosis, or meets some other socially valued criterion. Even physicians who advocate such actions concede that they would cause clinicians “moral distress” (White and Lo) or be “extremely psychologically traumatic for clinicians” (Emanuel, et al.). Clinicians and ethics committees should refuse such orders and focus instead on healing and saving all viable patients equally with all available resources.
Rabbi Daniel Nevins - Rabbinical Assembly: Triage and the Sanctity of Life