IS OLD AGE A DISEASE?

of discussion and analysis, we must attempt to locate the halakhic justification for this“clear and simple” statement of the law. This, to be sure, is not an excessively difficult task. Feinstein holds the principle of equality of persons to be central to decisions of patient selection, and this ruling coheres quite well with that principle: if no one person can be favored over another, then the elderly, as persons, must surely enjoy an equal right to treatment.

We might well agree with him that this principle corresponds to the best and most convincing understanding of the halakhic tradition available to us; if so, we might well adopt his ruling as our own position. Yet, as we have seen, it is not the only available understanding of the tradition, and it is not necessarily better than the others. Some halakhists, contra Feinstein, do declare that in matters of life saving“the young person precedes the old one, and the healthy old person precedes the old person who is sick.” And, again, it is not too difficult to imagine why this is so. If we were to begin our thinking about resource allocation from the criterion of medical efficacy, we would recognize that since physicians always take the age of a patient into account when planning a course of treatment, the age of the patient or patients before us is not an irrelevant detail.

Given that our duty is to create the best and most efficient health-care system possible, and given that the time, money, and effort we might allot to the care of one elderly patient might other­wise be invested in securing substantial health benefits for numerous others, we would be morally obliged to consider all these costs before making our fateful choices. On a societal level, we would be obliged to recognize the fact that medical expenditures for the elderly far outweigh those invested in any other segment of the

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