R. Walter Wurzberger, Ethics of Responsibility, Pg. 91
As in life boat ethics some rational system of priorities should be devised rather than resorting to random selections of patients. As painful as it may be to play God and determine who shall live as a result of our intervention and who shall die as the consequence of our nonintervention, we cannot abdicate this responsibility. Random choice can hardly qualify as a more humane method to resolve our dilemmas.
מתני׳ האיש קודם לאשה להחיות ולהשב אבדה והאשה קודמת לאיש לכסות ולהוציא מבית השבי בזמן ששניהם עומדים בקלקלה האיש קודם לאשה:
MISHNA: The man precedes the woman when there is uncertainty with regard to which of them to rescue or to return a lost item to first. And the woman precedes the man with regard to which of them to provide with a garment first, because her humiliation is great, or to release from captivity first, due to the concern that she will be raped. When they are both subject to degradation, i.e., there is also concern that the man will be raped in captivity, the release of the man precedes the release of the woman.
מתני׳ כהן קודם ללוי לוי לישראל ישראל לממזר וממזר לנתין ונתין לגר וגר לעבד משוחרר אימתי בזמן שכולם שוים אבל אם היה ממזר תלמיד חכם וכהן גדול עם הארץ ממזר תלמיד חכם קודם לכהן גדול עם הארץ:
MISHNA: A priest precedes a Levite. A Levite precedes an Israelite. An Israelite precedes a son born from an incestuous or adulterous relationship [mamzer], and a mamzer precedes a Gibeonite, and a Gibeonite precedes a convert, and a convert precedes an emancipated slave. When do these halakhot of precedence take effect? In circumstances when they are all equal in terms of wisdom. But if there were a mamzer who is a Torah scholar and a High Priest who is an ignoramus, a mamzer who is a Torah scholar precedes a High Priest who is an ignoramus, as Torah wisdom surpasses all else.
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
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
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.
Responsa Tzitz Eliezer 10, 25:7:12
One is allowed to donate for a scholar even an organ that life depends on and by doing so one will die and it is considered a mitzva even though one is not required to do so. And one should carefully consider if in practice one should allow this, and it is easier to allow it if the recipient is a renowned scholar who is needed by many...
Dr. Alan Jotkowitz, Tradition 47:1
In the eighteenth century, R. Yaakov Emden also discussed the issue of prioritization from an halakhic perspective. In a lengthy responsum he makes the following points:
-He is not sure if the traditional preference given to kohanim is applicable because of the uncertainty surrounding the genealogy of all kohanim.
-The young person takes precedence over the old person.
-The healthy take precedence over the sick.
-A person who is in danger takes precedence over the tereifa (a person with less than a year to live)
-A woman who is God-fearing takes precedence over one who is not.
שו"ת ציץ אליעזר חלק ט סימן כח
אלא הענין דאם ישתו שניהם על כל פנים יחיו יום או יומים גם שניהם, שלא יגיעו לישוב, ואולי עד כה יזדמן להם מים, מה שאין כן אם לא יתן לחבירו הרי ימות בודאי בצמא עיין שם, ואם כן הוא הדין נאמר כן בהיכא שהרפואה שלנו דלא שנו דברי רבי עקיבא דחייך קודמין ואזלינן בזה בתר דעתיה דבן פטורא, דמחויב לתתה ולחלקה בין שניהם.
Responsa Tzitz Eliezer 9:28
Rather, the point is that if both drink, they will each live at least another day or two, which is not the case if he does not give to a friend, who will certainly die in famine, see there. And if so, the same is true in the case of medication, where we do not follow the words of Rabbi Akiva that one life precedes another, and me must distribute equally between them.
Paul Ramsey, The Patient as a Person, 1970, pg. 256
When the ultimate of life is the value at stake, and when not all lives can be saved, it can reasonably be argued that men should stand aside as far as possible from the choice of who shall live and who shall die… random selection is preferable not simply because life is a value incommensurate with all other, and so not negotiable by bartering one man’s worth against another’s. It is sustained also because we have no way of knowing how really and truly to estimate a man’s social worth.
Igrot Moshe, Hoshen Mishpat, Part 2 #73
The life of someone who can be saved and live a normal life gets precedence over someone who is dying and the physician is unable to cure, but the dying patient does not have an obligation to save someone else with his life, and if he was treated first he does not have to give up his place.
שו"ת ציץ אליעזר חלק יח סימן א
קטע זה של"האיש קודם לאשה" שבמשנה, השמיטו הרמב"ם בהלכותיו בספרו משנה תורה... גם לרבות הטור ביו"ד סימן רנ"א השמיט ג"כ קטע זה מהלכותיו...
Responsa Tzitz Eliezer 18:1
This section of "the man precedes the woman" in the Mishnah is omitted by Maimonides in his rulings in Mishneh Torah... moreover, the Tur in Yoreh Deah 251 also omits this section in his rulings...
Haim Sabbato, In Quest of Your Presence: Conversations with Rabbi Aharon Lichtenstein [in Hebrew] (Tel Aviv: Yedioth Aharonot Books, 2011), 79
Rabbi Shabtai Rappaport said in a public lecture, not in private, that R. Feinstein, the grandfather of his wife, ruled that in our present circumstances we do not follow these criteria [of the mishna in Horayot]. R. Shabtai explained that the reason for the ruling was that nowadays it is impossible to rule according to these criteria when we are confronted by the question...
I ask myself this point which brings me to question the criteria of the mishna in Horayot, where does it come from? Does it come from values that I gained at home [the world of Torah] or do they come from foreign influences? Practically, I am stringent upon myself and ask myself in these situations maybe my thoughts come from the fact that I love to read Shakespeare or Milton and maybe they influenced my worldview. And then in the midst of this examination, I say to myself, wait a minute, the mishna supports me. The mishna itself. Because what does the mishna say at the end of Horayot: talmid hakham mamzer and a kohen gadol am haarets, the mamzer talmid hakham takes precedence. What does this sentence say? What it says is that everything the mishna says at the beginning on the priorities due to genealogy is erased with the last sentence in that it establishes that the accomplishments of a person is more important than his genealogy.
