Conjoined twins

Responsa Tzitz Eliezer, 12:43

Question 1:
Baby A and Baby B were joined from the shoulder to the pelvic area, sharing one liver and one six-chambered heart. The wall between the four essentially normal chambers belonging to Baby B and the stunted two-chamber heart belonging to Baby A was too thin to be divided; the twins, therefore, could not each be given a heart. Even if it were possible, a two-chambered heart could not have supported Baby A for long. In addition, Baby A had a circulatory defect that would eventually kill her. The doctors could only help Baby B, by giving her the entire six-chambered heart. This procedure would end the life of Baby A.

סנהדרין ע״ד א:כ׳

רוצח גופיה מנא לן סברא הוא דההוא דאתא לקמיה דרבה ואמר ליה אמר לי מרי דוראי זיל קטליה לפלניא ואי לא קטלינא לך אמר ליה לקטלוך ולא תיקטול מי יימר דדמא דידך סומק טפי דילמא דמא דהוא גברא סומק טפי

Sanhedrin 74a:20

The Gemara asks: From where do we derive this halakha with regard to a murderer himself, that one must allow himself to be killed rather than commit murder? The Gemara answers: It is based on logical reasoning that one life is not preferable to another, and therefore there is no need for a verse to teach this halakha. The Gemara relates an incident to demonstrate this: As when a certain person came before Rabba and said to him: The lord of my place, a local official, said to me: Go kill so-and-so, and if not I will kill you, what shall I do? Rabba said to him: It is preferable that he should kill you and you should not kill. Who is to say that your blood is redder than his, that your life is worth more than the one he wants you to kill? Perhaps that man’s blood is redder. This logical reasoning is the basis for the halakha that one may not save his own life by killing another.

ויקרא י״ט:ט״ז

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

Leviticus 19:16

(16) Do not deal basely with your countrymen. Do not profit by the blood of your fellow: I am the LORD.

משנה תורה, הלכות רוצח ושמירת נפש א׳:ז׳-ח׳

(ז) כֵּיצַד. אִם הִזְהִירוּהוּ וַהֲרֵי הוּא רוֹדֵף אַחֲרָיו אַף עַל פִּי שֶׁלֹּא קִבֵּל עָלָיו הַתְרָאָה כֵּיוָן שֶׁעֲדַיִן הוּא רוֹדֵף הֲרֵי זֶה נֶהֱרָג. וְאִם יְכוֹלִים לְהַצִּילוֹ בְּאֵיבָר מֵאֵיבְרֵי הָרוֹדֵף כְּגוֹן שֶׁיַּכּוּ אוֹתוֹ בְּחֵץ אוֹ בְּאֶבֶן אוֹ בְּסַיִף וְיִקְטְעוּ אֶת יָדוֹ אוֹ יִשְׁבְּרוּ אֶת רַגְלוֹ אוֹ יְסַמּוּ אֶת עֵינוֹ עוֹשִׂין. וְאִם [אֵינָן] יְכוֹלִין לְכַוֵּן וּלְהַצִּילוֹ אֶלָּא אִם כֵּן הֲרָגוּהוּ לַרוֹדֵף הֲרֵי אֵלּוּ הוֹרְגִין אוֹתוֹ אַף עַל פִּי שֶׁעֲדַיִן לֹא הָרַג שֶׁנֶּאֱמַר (דברים כה יב) "וְקַצֹּתָה אֶת כַּפָּהּ לֹא תָחוֹס עֵינֶךָ":

(ח) אֶחָד בִּמְבוּשָׁיו וְאֶחָד כָּל דָּבָר שֶׁיֵּשׁ בּוֹ סַכָּנַת נְפָשׁוֹת. אֶחָד הָאִישׁ אוֹ הָאִשָּׁה. עִנְיַן הַכָּתוּב שֶׁכָּל הַחוֹשֵׁב לְהַכּוֹת חֲבֵרוֹ הַכָּאָה הַמְּמִיתָה אוֹתוֹ מַצִּילִין אֶת הַנִּרְדָּף בְּכַפּוֹ שֶׁל רוֹדֵף. וְאִם אֵינָן יְכוֹלִין מַצִּילִין אוֹתוֹ אַף בְּנַפְשׁוֹ שֶׁנֶּאֱמַר (דברים כה יב) "לֹא תָחוֹס עֵינְךָ":

Mishneh Torah, Murderer and the Preservation of Life 1:7-8

(7) What is implied? If the rodef was warned and continues to pursue his intended victim, even though he did not acknowledge the warning, since he continues his pursuit he should be killed.

If it is possible to save the pursued by damaging one of the limbs of the rodef, one should. Thus, if one can strike him with an arrow, a stone or a sword, and cut off his hand, break his leg, blind him or in another way prevent him from achieving his objective, one should do so.

If there is no way to be precise in one's aim and save the person being pursued without killing the rodef, one should kill him, even though he has not yet killed his victim. This is implied by Deuteronomy 25:11-12, which states: "If a man is fighting with his brother, and the wife of one... grabs the attacker by his private parts, you must cut off her hand; you may not show pity."

(8) There is no difference whether she grabs "his private parts" or any other organ that imperils his life. Similarly, the rodef may be a man or a woman. The intent of the verse is that whenever a person intends to strike a colleague with a blow that could kill him, the pursued should be saved by "cutting off the hand" of the rodef. If this cannot be done, the victim should be saved by taking the rodef's life, as the verse continues: "you may not show pity."

משנה תורה, הלכות רוצח ושמירת נפש א׳:י״ג-י״ד

(יג) כָּל הַיָּכוֹל לְהַצִּיל בְּאֵיבָר מֵאֵיבָרָיו וְלֹא טָרַח בְּכָךְ אֶלָּא הִצִּיל בְּנַפְשׁוֹ שֶׁל רוֹדֵף וַהֲרָגוֹ הֲרֵי זֶה שׁוֹפֵךְ דָּמִים וְחַיָּב מִיתָה אֲבָל אֵין בֵּית דִּין מְמִיתִין אוֹתוֹ:

(יד) כָּל הַיָּכוֹל לְהַצִּיל וְלֹא הִצִּיל עוֹבֵר עַל (ויקרא יט טז) "לֹא תַעֲמֹד עַל דַּם רֵעֶךָ". וְכֵן הָרוֹאֶה אֶת חֲבֵרוֹ טוֹבֵעַ בַּיָּם. אוֹ לִסְטִים בָּאִים עָלָיו. אוֹ חַיָּה רָעָה בָּאָה עָלָיו. וְיָכוֹל לְהַצִּילוֹ הוּא בְּעַצְמוֹ. אוֹ שֶׁיִּשְׂכֹּר אֲחֵרִים לְהַצִּילוֹ וְלֹא הִצִּיל. אוֹ שֶׁשָּׁמַע עוֹבְדֵי כּוֹכָבִים אוֹ מוֹסְרִים מְחַשְּׁבִים עָלָיו רָעָה אוֹ טוֹמְנִין לוֹ פַּח וְלֹא גִּלָּה אֹזֶן חֲבֵרוֹ וְהוֹדִיעוֹ. אוֹ שֶׁיָּדַע בְּעַכּוּ''ם אוֹ בְּאוֹנֵס שֶׁהוּא בָּא עַל חֲבֵרוֹ וְיָכוֹל לְפַיְּסוֹ בִּגְלַל חֲבֵרוֹ לְהָסִיר מַה שֶּׁבְּלִבּוֹ וְלֹא פִּיְּסוֹ. וְכָל כַּיּוֹצֵא בִּדְבָרִים אֵלּוּ. הָעוֹשֶׂה אוֹתָם עוֹבֵר עַל לֹא תַעֲמֹד עַל דַּם רֵעֶךָ:

Mishneh Torah, Murderer and the Preservation of Life 1:13-14

(13) Whosoever can save [a pursued victim] by [injuring one] of the limbs [of the pursuer] and he did not bother with [limiting himself to only doing] that [measure], rather he saved [the victim] with the life of the pursuer [i.e.] he killed [the pursuer], this [vigilante] is a spiller of blood [i.e. a murderer] and is liable to death, though a [human] court does not execute him [for this crime].

(14)

Whenever a person can save another person's life, but he fails to do so, he transgresses a negative commandment, as Leviticus 19:16 states: "Do not stand idly by while your brother's blood is at stake."

Similarly, this commandment applies when a person sees a colleague drowning at sea or being attacked by robbers or a wild animal, and he can save him himself or can hire others to save him. Similarly, it applies when he hears gentiles or mosrim conspiring to harm a colleague or planning a snare for him, and he does not inform him and notify him of the danger.

And it applies when a person knows of a gentile or a man of force who has a complaint against a colleague, and he can appease the aggressor on behalf of his colleague, but he fails to do so. And similarly, in all analogous instances, a person who fails to act transgresses the commandment: "Do not stand idly by while your brother's blood is at stake."

בבא מציעא ס״ב א:ב׳

ורבי יוחנן האי וחי אחיך עמך מאי עביד ליה מבעי ליה לכדתניא שנים שהיו מהלכין בדרך וביד אחד מהן קיתון של מים אם שותין שניהם מתים ואם שותה אחד מהן מגיע לישוב דרש בן פטורא מוטב שישתו שניהם וימותו ואל יראה אחד מהם במיתתו של חבירו עד שבא ר' עקיבא ולימד וחי אחיך עמך חייך קודמים לחיי חבירך

Bava Metzia 62a:2

The Gemara asks: And Rabbi Yoḥanan, what does he do with this verse: “And your brother shall live with you”? The Gemara answers: He requires the verse for that which is taught in a baraita: If two people were walking on a desolate path and there was a jug [kiton] of water in the possession of one of them, and the situation was such that if both drink from the jug, both will die, as there is not enough water, but if only one of them drinks, he will reach a settled area, there is a dispute as to the halakha. Ben Petora taught: It is preferable that both of them drink and die, and let neither one of them see the death of the other. This was the accepted opinion until Rabbi Akiva came and taught that the verse states: “And your brother shall live with you,” indicating that your life takes precedence over the life of the other.

סנהדרין ע״ב ב:י״ד

איתיביה רב חסדא לרב הונא יצא ראשו אין נוגעין בו לפי שאין דוחין נפש מפני נפש ואמאי רודף הוא שאני התם דמשמיא קא רדפי לה

Sanhedrin 72b:14

Rav Ḥisda raised an objection to Rav Huna from a baraita: If a woman was giving birth and her life was being endangered by the fetus, the life of the fetus may be sacrificed in order to save the mother. But once his head has emerged during the birthing process, he may not be harmed in order to save the mother, because one life may not be pushed aside to save another life. If one is permitted to save the pursued party by killing the minor who is pursuing him, why is this so? The fetus is a pursuer who is endangering his mother’s life. The Gemara answers: This is not difficult, as it is different there, with regard to the woman giving birth, since she is being pursued by Heaven. Since the fetus is not acting of his own volition and endangering his mother of his own will, his life may not be taken in order to save his mother.

“But then the verse continues, comparing a Jewish woman to a pearl – yet even that is not as precious as she is. But why a pearl? There are many precious jewels. Why not the diamond or ruby (as the word is often mistakenly translated). Unlike these other gems, the process of the creation and formation of the pearl most brilliantly describes the development of a Jewish woman. Just as one must seek to find the woman of valor, so too must one seek to find the pearl. The pearl 18 is hidden within an oyster and rests at the bottom of the ocean. The external of the oyster however is ugly, hiding the beauty within. And yet the name in Hebrew for the pearl, pnimim, relates to the word for both panim, meaning “face” as well as “pnimiyut” which means “internal.” While the pearl has a harsh and rough external casing but is beautiful within, the Jewish woman’s true beauty lies within but shines and can be seen through the outside as well. Just as our face is the portal to our internal selves, our faces represent the beauty of our souls and should reflect what lies within, not hide it. The Jewish woman of valor is not one who has it all, but one who works and betters all that she has. The pearl is the result of a process, and not an easy one at that. The pearl is formed inside the shell of certain mollusks as a defense mechanism against a potentially threatening irritant such as a parasite inside its shell, or an attack from outside that could injure the mantle tissue. The mollusk therefore creates a pearl sac to seal off the irritation. What this means is that our beauty, our strength, our accomplishments, take work, often very hard work. We might have a lot of barriers in our way, but with the right mentality, and keeping focused on our goal, we will become stronger and better because of the adversity. If anything, those tests and 19 challenges will allow our true beauty to shine forth and will show us and those around us the strength we have within that otherwise may not have been revealed.” – Sara Esther Crispe