LEV212 Desta is a 38-year-old new patient for me, asking for help getting pregnant. … The workup and testing I do show Asherman’s syndrome: the front and back walls of the uterus have scarred together… Desta’s risk of death in pregnancy is somewhere between 10 and 50 percent because her heart disease is now severe. .... Desta is very clear that she is willing to die to get a child far enough along in gestation to survive, even if it means that the child will face serious challenges due to prematurity and/or losing his or her mother. I look at my hands. It is not unreasonable to surgically correct her Asherman's. I have the know-how, training, and setting to do it relatively safely. Desta cannot do it for herself. As a member of the medical community, do I have an obligation to restore Desta’s uterus to a relatively normal state? I know I am obligated to return “lost property,” (Deuteronomy 22:2); I see myself as morally obligated to heal people. These are expressions of tikkun olam, the way to be God's partner in the ongoing act of creation. But the sole purpose of the surgery in her mind is to get her pregnant, a much more life-threatening condition for her than it normally is for most women. What would God want me to do? Who am I to judge what is right for her? I believe she clearly understands the risks of pregnancy to herself and her potential child. In general, I like to think of myself as a guide to the complex medical world for my patients. For me, “Love your neighbor as yourself” means respecting an individual's desires, hopes, and dreams, even if they differ from my own. In the end, a patient gets to decide for herself if she wants a treatment or therapy. A patient can choose surgery and chemotherapy or just let the cancer take its course.... If she gets pregnant and dies, I will feel my surgical actions aided and abetted her death. Although it would be with her permission and blessing--even fulfilling her greatest hope--I will know I hastened her death. In medical ethics the rule is nonmaleficence, “first do no harm.” Even though harm is far from guaranteed in this case, the risk is high enough that I believe by refusing to do the surgery I am protecting her life. Judaism clearly mandates the protection of life over nearly all other commandments, based on the Rabbis’ interpretation of Leviticus 18:5. I tell Desta I will not do the surgery. … Rabbi Akiva’s classic scenario with the water and two men in the desert does not fit from whether either one of us stand. I see her life versus a life that does not yet exist and hence cannot be snuffed out. Of course she gets the water. But she can already see her not-yet-conceived son or daughter and, like any mother, will of course give the water to her child. ... Nearly ten years have passed since this encounter.... I stole possibility, hope, and dreams by saying no. Those too are a part of being made in God's image, hence a part of what I am charged with caretaking. I still wonder if I did the right thing. (By Judith Levitan)

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LEV218 Rabbi Eliezer said, “If circumcision, which pertains to only one of the two-hundred-and-forty-eight limbs of the body, takes precedence over the prohibitions of Shabbat, all the more so the saving of the entire body should take precedence over the prohibitions of Shabbat.” (After the Talmud offers a number of proofs for this, this statement is offered:) Said Rabbi Yehuda in the name of Rabbi Shmuel, “If I had been there, I would have offered an even finer proof text, specifically, “He shall live by them” (Leviticus 18:5) [that is to say, one should live by the commandments] and not die by them. Babylonian Talmud Yoma 85b.

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LEV226 The Rabbis took (this verse) and interpreted it to mean that in cases of physical survival and observance of the Law, physical survival took precedence. "He shall live by them," the Rabbis interpreted to mean that no one should die as a result of observing the Law of God. Yoma 85b, Sanhedrin 74a. This rather open-ended leniency apparently was restricted in the case of idolatry, incest, and murder. Sanhedrin 74a. [However] ... The Rabbis opinions went from apparently favoring physical life over Law under all conditions, to limiting this preference of life over Law to only when one is forced into committing any breach of God's Law by unusual circumstance. If one lives in a time where the law of the regime forces Jews to breach all God's Law they should be martyred before allowing the regime to succeed in this endeavor. Other Rabbis took this further and said that even under unusual circumstances (not a regular rule of the regime) one should not allow any breach God's Law if it is to be practiced in public. Ibid, 74a-b.

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LEV225 The ninth level (of The Stringency of Mitzvos and Classification of Punishment) is the severity of sins that require one to forfeit his life rather than transgress them. Our Sages, z"l, said (Sanhedrin 74a), "If one is told regarding any transgression in the Torah, 'Sin, and then you will not be killed,' he must sin and not submit himself to death, as the pasuk says [this verse], '… which a person shall do, that he may live by them' -- that he may live by them and not die through them." [This, however, is] to the exclusion of idolatry, illicit relations, and murder: if regarding any one of these three he is told, 'Sin, and then you will not be killed,' he must submit himself to death rather than sin – – even if he is told to sin in private. [Even] regarding any one of the mitzvos of the Torah, if he is told to sin in public, then he must submit himself to death rather than sin, as the pasuk says (Yayikra 22:32), "I shall be sanctified among the Children of Yisrael"; and in times of religious persecution, even [when forced to sin] in private, one must submit himself to death rather than sin.

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LEV219 Rashi there comments that "one is expected to perform the commandments only when he is sure he shall live by them, and not when in the performance of them he risks the possibility of losing his life. Therefore we may violate the Sabbath in cases of safek [uncertainty]." Maimonides' statement is the most instructive. "It is forbidden to delay violating the Sabbath for a sick person whose life is in danger, for it says, 'which if a man do them he shall live by them' and not die by them. We are thus taught that the commandments of the Torah are not intended to inflict punishment upon mankind but to bestow mercy, loving-kindness, and peace. As for the apikorsim, who say that this is a violation of the Sabbath and is forbidden, in regard to them Scripture says, 'I have given them laws which are not good, and commandments by which they cannot live'" (Ezekiel 20:25). Hilkhot Shabbat, Ch. 2, Para. 3.

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LEV223 The leitmotiv of our ethical system is the command of God: "Ye shall therefore keep My statutes and Mine ordinances, which if a man do, he shall live by them; I am the Lord." [this verse]. Man must eat to live, not live to eat. He has the duty to look after his physical and mental welfare as he has the responsibility to be solicitous for the well-being of others. Interesting in this connection is the shrewd remark of a Hasidic Rabbi, to whom one complained that "So-and-so" desecrated the Sabbath and ate all kinds of forbidden foods. "You have been given two eyes. one with which to see your own faults, the other with which to behold the virtues of another." Glancing at the physical robustness of the complainant, the Rabbi added this: "My friend, I would advise you to look after your own soul and the body of another, rather than make yourself censorious of another man's soul whilst feeding carefully your own body." The duties man owes to his fellow-being could not have been more masterfully stated.

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LEV224 The main purpose of the intricate network of the Halachah was to keep the nation alive through all its vicissitudes. The word Halachah (derived from the root ch-l-h "to go") suggests "Progress" and is meant to serve as a guide in daily life. The world has not yet progressed to those sublime standards of holy living and action patterned in our codes. The Jew, who faithfully adheres to the standards blazoned forth before his trail in the Codes, Biblical and post-Biblical, will be armed with a moral strength that will overpower those that rise up against Him. He will echo the words of R. Yehudah Halevi: "Men revile me; but they know not that the shame endured for thy sake, O God, is naught but honour." To study our ethical codes is to possess ourselves with a further source for strength and pride in our Judaism.

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LEV213 Drawing a parallel from the commandment against the kidnapping and subsequent sale of a person into involuntary servitude [Exodus 21:16; Deuteronomy 24:7 - AJL], Rabbi Unterman (No'am, VI, 4f; Shevet me-Yehudah, I, 9f) cites the opinion of Rashi, Sanhedrin 85d, who maintains that this prohibition encompasses the sale of an unborn child as well. Although the fetus may not be considered a fully developed person, his kidnapper is culpable because he has stolen an animate creature whose status is conditioned by its potential development into a viable human being. Rabbi Unterman further notes that the unborn fetus lacks human status. Consequently, it is excluded from the injunction, "and he [man] shall live by them" [this verse], which justifies violation of other precepts in order to preserve human life. Numerous authorities nevertheless permit violation of the Sabbath in order to preserve fetal life. Rabbi Unterman views such permission as being predicated upon a similar rationale. Anticipation of potential development and subsequent attainment of human status creates certain privileges and obligations with regard to the undeveloped fetus. Consideration of future potential is clearly evidenced in the Talmudic declaration: "Better to violate a single Sabbath in order to observe many Sabbaths" (Shabbat 151b). Rabbi Unterman concludes that reasoning in these terms precludes any distinction which might otherwise be drawn with regard to the various stages of fetal development.

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LEV214 Human life is sacrosanct, and of supreme and infinite worth. Life is of itself the summum bonum of human existence. The Divine law was ordained only "that man shall live by it" [this verse]. Hence any precept, whether religious or ethical, is automatically suspended if it conflicts with the interest of human life (Yoma 85b), the exceptions being only adultery, murder and immorality (adultery and incest)--the three cardinal crimes against God, one's neighbor and oneself--as expressly stipulated in the Bible itself (Pesachim 25a and b; Yoreh De'ah, 195:3; 157:1; based on Deut. 6:5 and 22:26). The value of human life is infinite and beyond measure, so that any part of life--even if only an hour or a second-- is of precisely the same worth as seventy years of it, just as any fraction of infinity, being indivisible, remains infinite. Accordingly, to kill a decrepit patient approaching death constitutes exactly the same crime of murder as to kill a young, healthy person who may still have many decades to live (footnote five). For the same reason, one life is worth as much as a thousand or a million lives (Footnote six) – – infinity is not increased by multiplying it. This explains the unconditional Jewish opposition to deliberate euthanasia as well as to the surrender of one hostage in order to save the others if the whole group is otherwise threatened with death (footnote seven).

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LEV222 See [[LEV903]] Leviticus 22:32 name ROSNER-BLEICH 327

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