CUR aa GS i adie| Sis ER ERE i oR

SELECTED REFORM RESPONSA

life may be set aside in favor of the other’s." All are of equal status in relation to life or death.

There is. however, some other standard of choice before the physician, one which is precisely relevant. There is a discussion in the Talmud (Avoda Zarah 27b) which is developed in the legal literature into a principle. It can be stated as follows:[When there is a chance for a cure] we do not put too much value upon the last hours of a dying man (Ein mashgihim lechayei sha-ah). In other words, these last few hours are not so valuable that we may not risk them if we want to try out some new and hitherto untried remedy. These last hours are fading anyhow. So Jacob Reischer . Rabbi of Metz(died 1733), in his responsa(Shevut Yaakov 111,#75) concludes that we may risk the few hours of a dying man and try an untried remedy, if there is a fair prospect that he can be cured enough to have, say, a year of life. He says at first that even the hayei shaah(the remaining hours of life) are important and we must guard them(i.e., we never hasten death); nevertheless, if there is a remedy by use of which it is possible to cure him, then in that case we may risk it. The same decision was arrived at in a responsum published this past year by Mordecai Jacob Breisch(Helkat Yaakov 111,#141). From this we conclude that the physician must endeavor to decide not on the basis of personality reasons, but on medical grounds. He must select the patient- rich or poor, good or bad- who has the better prospect of survival and of getting more of a relatively healthy life. As for the others, no direct action should be taken by him against them. Their sickness will run its course.

This same conclusion, i.e., that the one who will benefit most should receive the remedy, was arrived at over a hundred and fifty years ago by Joseph Teomim (1727-1793). Of course, he could not have had any knowledge of modern transplants, nor of the special problems involved in them. He came to his conclusion purely on the basis of the

Spirit of the law. His statement is in his commentary Peri Megadim to Shulhan Arukh, Orah Hayim 328(commenting on the Magen David ). The Shulhan Arukh at that point deals with the question of which patients

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