MARK WASHOFSKY

with this treatment it is unlikely that he will recover. At best, this patient’s life will be lengthened by a relatively short span, but he will die of the disease or injury that has brought him here. The second patient, by contrast, does not appear to require immediate attention, but the doctors are confident that if he does receive that treatment he will recover from his disease or injury. There is but one bed in the emergency room. Which person is to be treated first? Rabbi Feinstein answers that if neither patient has yet been taken into the emergency room, we offer treatment first to the second patient, the one whom the physicians believe they can cure. If, however, the first patient has for some reason already begun to receive care, that treatment may not be discontinued. The reason for these priorities, says Rabbi Feinstein, is pashut, obvious:

Clearly, one who we believe will live a normal life­span takes precedence over those whom we cannot cure. But this principle applies only to the commu­nity at large. The patient himself has no obligation to save another at the cost of his own life, and once he has been offered medical treatment he has acquired a legal title to that treatment. Whether he pays for it or is accepted as a charity patient, he enjoys a lien (shi’abudim) over the hospital, its doctors, and its medical services. He is not required—and may even be forbidden—to sacrifice this legal title, through which he can live for whatever short time is left to him, even for the sake of one who can live a normal lifespan.

This is the case even if the second patient does require immediate intensive care. As long as the terminal patient has begun to receive

47