IS OLD AGE A DISEASE?

Following Rabbi Feinstein, we might hold that the principle of equality of persons controls this question. If so, we might con­clude that, as we are not entitled to determine that any one person is more deserving of life than another(the question of“whose blood is redder”), we are similarly forbidden to offer a greater share of society’s medical resources to any one person than to any other. On the other hand, should we conclude that this question is best defined according to the principle of medical efficacy, we would resolve to invest our monies and efforts in such a way as to ensure the creation of the most effective health-care system: that is, the kind of system that would allow us to fulfill the mitzvah of piku’ah nefesh in its best sense by saving the greatest possible number of lives.?* To take this position would in turn justify a number of policy choices. We often hear calls, for example, to appropriate a larger share of society’s available budgets to such objectives as prenatal care, nutritional education, mass vaccination, or basic research and to reduce expenditures on expensive and experimental technologies and therapies, on the grounds that the former allow us to save more lives, to cure more illness, and to safeguard the health of more persons than do the latter. The principle of medical efficacy would argue that we as a society adopt such priorities as the basis upon which we make our budgetary decisions with respect to medical care, and liberal halakhists might well see this principle and its resulting policy decisions as reflecting the best understanding of the Jewish legal tradition.

There is, meanwhile, another option to explore: the principle of qualitative evaluation, derived from B. Horayot 13a. Although Rabbi Feinstein mentions this principle, however briefly, as part of his system, we liberals would tend to reject it out of hand. We quite properly reject any suggestion that we make life and death decisions

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