IS OLD AGE A DISEASE?

treatment, even if the decision to admit him into the emergency room was made in error(that is, we intended to admit the second patient but admitted the first one by mistake), that treatment may not be discontinued before it has been completed, even to save the life of the second patient.

In the second teshuvah, Rabbi Feinstein clarifies some of the terminology used in the above decision.* He explains that the patient with a“normal lifespan” is one whose illness can be successfully treated to the point that, according to medical prognosis, he will live for at least one year. The patient whom doctors believe they cannot“cure” is one who is expected to die from his disease or injury within one year. The latter patient is in the legal category of tereifah, to whom the halakhic sources refer as gavra ketila, an already-dead person, one who has lost his essential hold on life.’ Although we are certainly not permitted to kill the tereifah, we are justified in allowing others to take precedence over him when the question involves the saving of life. If, however, the physicians believe that the second, terminal patient will live for longer than one year, he or she is no longer a tereifah; both patients now have an equal claim to our medical attention. Whom then do we treat first, when we cannot treat both simultaneously? Rabbi Feinstein writes that the doctor must first treat

the patient who called first, or the one who is closest to the doctor’s home. If they are equal in this regard, the doctor must observe the priorities set forth in the mishnah in Horayot 13a. And if this cannot be established, then lots(goral) must be drawn to establish the order of treatment.

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