Changing Views of Health Care Delivery 105

may be damaged, destroyed, or hastened toward death in any way (Shab 151b; A.Z. 18a). Saving a single life, therefore has been understood as akin to saving the entire world(B.B. 10a). This primary obligation is listed among the positive commandments assembled in the Talmud and later writings.

As such supreme value has been placed on human life, the physician’s work of healing has always been understood as a mitzvah and as assistance to God ’s initial act. It has never been seen as interference with God ’s intentions(B.K. 85a; Bet Yosef to Tur Yore Deah 336). No ritual obligation was permitted to stand in the way of the healing process, not the holiness of the Sabbath or anything else.

Parallel to this is the view that life be lived fully; life and love were celebrated in the biblical Song of Songs . Life should be thoroughly enjoyed. The broad implications were clearly stated in biblical times through the regulations governing military service stipulated in Deuteronomy . As such service always endangered life, individuals were excused from military service if they had not yet fully enjoyed some of the basics of human life, including a new wife, a new house, and even a new vineyard. Any of these eliminated the obligation of military service with its inherent danger of death or injury(Deut 20:5 ff. and commentaries; Tur and Shulhan Arukh) Maimonides further elaborated on these conditions and broadened their application(Hillkhot Melakhim 5:1 ff).!

Discussions in post-biblical Judaism indicate that the command to save human life is understood in a very broad context; every human life was included, no matter what the cost or the difficulty. This applied to all human beings irrespective of religion, race, or any other consideration. Saving a human life overrides virtually all other commandments. This became clearest