Toras Corona: Halachik Dilemmas of the Covid Epidemic Part 3 - Priorities of Hatzalas Nefashos

this Tower class is brought to you by torahanytime.com okay good evening everyone welcome everyone thank you for joining um I want to continue in this series of uh interesting questions that arose during this uh epidemic the covet epidemic and I especially thank those who are joining tonight who heard this this morning but um I want to speak about a few and young I'm basically three Indiana two of them that are just um very basic to the epidemic that we we just went through and one of them very much connected to this week's parasha the first one if you have the Mario Makai Mouse it's on page four oh he's dalid we're reading from ravasha Weiss's countries on uh which is known as the minhasa chironment of Corona in his second edition which is approximately 175 pages and this question interestingly was um posed to him by Professor RAV avram Steinberg who is a prominent pediatric neurologist a medical ethicist the director of medical ethics and Sharita Hospital which I believe Revolution is the poisek there and it's a very difficult question and as ravasha Weiss presents it basically their worst fears have come true where many medical centers throughout the world are concerned that if the corona spreads as fast as uh they predict it may there may be a very severe shortage of ventilators and respirators to go around and they're going to have to make the all-important call of me yes is there any way to give priority in terms of life you know there's actually someone in our shul who uh had gone into the ventilator business and I think he was doing okay but um this this really gave him a lot of because the next thing he knows he's being contacted by New York State and they want to order thousands of ventilators so it's really it's remarkable you know when you see 600 000 people six hundred thousand years okay Mr A.T was watching on Torah anytime thank you so you make the brother what does that bracha refer to that you have to realize that God knows about all the secrets and all the what's going on in everybody's life it's an amazing thing there could be 600 000 people each one has their own set of circumstances and predicaments and revenge some is aware of everybody's uh massive but what's really amazing is a machines changes the seasons and the times and how everyone is affected differently depending on your line of work you know someone in the ventilator business they had they had a boon somebody who is um selling something out of a store out of a retail store there's no business people have to who have certain type of work they uh they were very matelyak and other people had terrible challenges in parnosa and the revolution calculates to the pinpoint Precision exactly when he brings this makla how it's going to affect now as mentioned because the the of the possibility of a shortage then they're gonna have to make the all-important call yamos and the question is are there any principles are there any general guidelines and rules when determining how to divvy health care and medical equipment who has first dibs who has first cracks and Revolution wise basically establishes two general principles and that is we have to evaluate the goidol hassakana we have to evaluate the gravity of the danger and number two vigoidal hasikoi and how hopeful are we that with medical intervention we will be successful so regarding the first guideline if unfortunately two people present themselves and both of them are um very ill so that the is we give it to the one who is more in danger the one whose life is engraver a Graver danger the one whose life is in more Jeopardy he has precedence in terms of health care and medical equipment so in other words two people show up the one who's in worse shape one of them is deathly ill and the other one is still hanging in there we're going to allocate the uh we're going to allocate the equipment to the one who um to the one who is in Graver danger and number two says Russia Weiss when two people present themselves we're going to give the equipment to somebody who there's a better shot that they're going to survive in other words you have two people one of them it's unlikely the ventilators can help them their mamish in a terrible amounts of let's say 20 survival chance of survival on the other hand somebody else is in basically decent shape and he has a really good shot so the person whose life who has a better chance of surviving will have have precedence in terms of the medical equipment and the medical care what about age says or Russia Weiss is age a factor you know let's say two people present themselves one guy is 30 years old and he expects you know has at least another 90 years old and someone who is 80 only has 40 years left so maybe uh so should we give it to the uh 30 year old the younger person sort of says in we do not find anywhere that age makes a difference that age is a factor that age plays any role whatsoever in determining the the quality of one's life the value ones of one's life there in no way do we say that a younger person is more valuable his life is more valuable than an older person and therefore halachically age is a meaningless factor cesra of Usher why is a very important principle all of these laws of Kadima are only regarding if we have two people in front of us which one are we going to hook up to the machine but once we've hooked somebody up to the machine Mr Deutsch you're still in Australia right but um but once we've hooked somebody else once we've hooked somebody up to the machine so then the hawaka is we cannot pull him off even to give somebody who has a better chance of surviving even to give somebody who more likely um who's in Graver danger in other words is once somebody's hooked up it belongs to him you can't take him off you can't remove him even if you have somebody who you think you could save their life is in Graver danger and is a better chance of surviving now the question is as follows says ravasha Weiss let's say the situation has been reduced to where you have very limited equipment and somebody is in the hospital and let's say they're unlikely to be helped in other words if you hook them up very far chance that you're going to be able to help them furthermore let's say they're in not such grave danger and the other hand you have somebody else who the situation is as follows right now there's no one else in the hospital but it was on one of those days maybe six weeks ago when you could ask the hatsala every few minutes they're getting calls every few minutes people were rolling into the emergency room and so the question is right now you have a bifanecha who needs the ventilator but it's very unlikely by hooking them up you'll be able to save their life on the other hand in 10 minutes and 15 minutes in an hour somebody will be brought into this emergency room and they will have a much greater chance of saving their life it will be much more likely impossible to help them so in other words if you have two people in front of you certainly you give it to the one who's in Graver danger certainly you give it to the one who you could help more but right now you only have one person in front of you and the other person doesn't exist is not the faneja so then can you delay and refrain from treating someone who's in the emergency room to spare and save the ventilator to use on somebody else who you'll have a better chance of of helping cesare of weissade I tremble I shudder to think about such a question because this is however it says revise a revolutionary psac that halachly there is no advantage of having the the in front of you there's no difference whether he's in front of you or you know he's coming the fact that you know he's coming that's tantamount to be funny says that there's no not Kamina ifaneja um only if it's common or not in other words if it's likely that somebody who's really going to need it and someone who you could really help is going to be on his way then you need to refrain and save it for that person says revise just imagine the following case you have someone in the emergency room who unlikely you could save their life with a ventilator and you get a call on the phone someone's being brought in the ambulance and very likely if you hook them up you'll save their life so what you're going to say oh this person's in front of me I should just give it to them even though I know someone's on the way no that would not be my stabber if you know someone's on the way so likewise if it's a massive of people are constantly coming in and it's only a matter of a short amount of time the next person will be brought in you are authorized to sort of hold on to the uh to the equipment to be able to save it for the next person now perhaps we could bring the following Raya and support to this idea that if you know someone's coming that's like they're in front of you is and during years of famine he once gave sadaka to anama RS and he was very nastier he was very pained because he could have given it to Adam so when he found out that the guy I remember somebody once asked of a Victor Miller what's a town someone who knows so Robbie gave it to anama arrest and he was upset he could have given it to Tamara foreign otherwise had there not been a possibility that he could give it to it you do need to support anama furthermore if someone comes in front of you and they're dying of hunger you have to feed them even though maybe maybe will come in an hour and we'll need it ah says that means furthermore if Agape sadaka has to feed an amarets but if by doing so it's going to come at the cost of giving money to atama you can't give it to the Yama Earth even though the time is not in front of you he's coming so we see that in order for someone um we see that if someone is on the way that is considered as if they're in front of you so again this is all talking about in amata when the danger was very acute and people were you know being brought in Non-Stop by the way it would come out from uh I'm gonna I'm gonna mention it in one moment also if you knew for sure was next you would not be allowed to feed the Yama RS so we see cesarevasha wise a very interesting that even though the other person's not in front of you the fact that you're positive that they will eventually come within a short amount of time now what a short amount of time is that's uh that's unclear it's hard to know what a short amount of time is but if you know for sure that they're coming then you uh could save the medical equipment for them even though you could technically make a hillock that maybe there's a difference between saving medical equipment to someone's life and giving funding but at the end of the day says eyes we see the svara that the person does not have to be mamish in front of you for you to be able to refrain and treat and hold on to equipment for later now why say Russia wise this is not similar to when you have various midsos that are weighing on you and you want to know which Mitzvah to perform first so you you fulfill the Mitzvah that is incumbent upon you now before a myth so that is incumbent upon you later but that's when various mitzvos are incumbent upon you however in this situation where you have uh we're not dealing with us performance of midsize we're dealing with human beings and you want to know who do you give the equipment to you would be entitled to wait and give it to someone who who would be more would benefit greater from this equipment now in his opinion he disagrees with those godelum who want to say that first come first serve you get to the hospital first in the ventilator what kind of is this this is some kind of money monetary acquisition there's some kind of Kenyan we're dealing with hot sauce nafachos there's no monetary right here says I've seen then I saw in the chuva subraman Orbach and says do not give medical equipment to someone who is unlikely you'll be able to save if you have a shortage of medical equipment however some asaman says once you start treating patient a then you're sort of subject to patient that you can then and go dedicate that equipment to Patient be even though you haven't hooked up patient day yet it's almost like oh you say um however says Rivers probably with shamizama never offered a definitive sock he's just saying it because never in our history did any of these questions ever were they ever La Mesa did the ever realistically come up that would have given a definitive shot I would ask that why don't we why don't we uh utilize the the following rule now you want to know what if it's a matter of Gentile and Jew Mr Dutch wants to know in Australia so umra look um there's even a question is one allowed to treat an akum is one allowed to save their life so basically we do it but certainly there's no question that priority would be given to uh Bene Briseno um over let's say um Salama like him in other words there's no question even though the mission says in harios in ish Isha so these are all interesting uh factors now I would ask the following question why can't why don't we say that why don't we say the following principle why don't we say foreign comes into the hospital you have a ventilator good the chances of saving over 20 and maybe in an hour you'll have the chance of eighty percent of saving the next guy but isn't there a rule we have a sheer an old shear and parishes by yakell a famous Shiloh somebody's in jail and they're gonna they're willing to let them out of jail one day a year what day should you pick should you pick some say pick tomorrow you never know if you're going to make it past tomorrow some say no wait till Yom Kippur but we basically but we basically maintain that you do it as soon as possible because you never know you never know if you're gonna make it you never know if uh you never know if you're going to survive and so forth so why don't we say that save the first patient I mean who knows what's going to be in an hour maybe mashiach will come maybe they'll invent the vaccine maybe who knows what could happen in an hour why don't we utilize that Sarah of mitsaha okay that's the first Shyla for tonight um let's see one more moment beautiful okay how's everybody doing so far everyone's happy everyone's in good mood Okay the reason why I'm speaking about this now to speak about this you know like uh four weeks ago people were having such anxiety this year would just you know people would have to go on medication or something from a share like this but now people are calming down a little bit I even saw two people smile already on the show today I haven't seen Smiles in a very long time you know who's that I mean don't tell me but how's he doing foreign thank God you should have her before she Lima case what's the chance of survival this is a proof that the dots themselves had no idea what to do with I second that there there's a great very great degree of uh uncertainty and the unknown and that's an understatement next Shyla we go to isvav and that is this is an interesting Shyla that again because of the fear of the shortage slimy how you doing because of the shear of the the fear of shortage of ventilators there was a possibility of hooking two people up to the same ventilator in other words let's say you have one guy a patient day hooked up to the ventilator one patient B is brought in so there was a notion maybe we'll hook up patient B to the same event now this is talking about where the person's really in a deep coma and the breathing is completely monitored by a machine and this can only be done under these kinds of circumstances but but the problem is that there is a slight possibility by hooking up patient B to the same ventilator patient a is on it could be very painful um very dangerous to Patient a patient a may lose his life it's not likely but it's possible that by sharing a ventilator and saving the life a patient B in May there is a chance a small chance but a chance a patient a will lose his life and the question is again can we try to save the life of patient B risking patient A's life so revasha wife says again this is a very difficult Shayla this is a Shyla of life and death and God-fearing doctors have asked and presented this question you know what do we do under these circumstances well it says about since we have no alternative we have to make every effort to save another life and we're allowed to do it and even though there is a possibility it may cause patient a a his life that's not considered like the doctor's murdering patient a that is not his kavana and he is allowed to sort of ignore that possibility says because look the reality is whenever a doctor gives more attention to a particular patient that patient has a better shot at surviving so what do you do when a doctor needs to leave a room and visit another patient and see another patient how could he go to the other patient by minimizing the care of the patient he's currently seeing it may cause uh damage it may actually co-cost that person his life but the answer is the doctor is sort of that's not his intention his intention is to help as many people as possible and the fact that it may indirectly result in the harm of the first patient well that's a risk you're allowed to take for example especially patients in the ICU well once the doctor walks out of the room well that patient's uh hope and a chance has just been minimized and mitigated nevertheless the doctor has no alternative he can't be with one patient the entire day says when a division of the hospital and a part of the hospital is full of I'm not saying the ICU they're packed and another acutely ill patient is now brought into the into that word what they'll do is they'll take out the guy who's in the best shape and they'll put him elsewhere even though it might be harmful to him because what are you going to do that that's uh we have to make estimated guesses and choices what's best for the overall status of everybody well says Revolution a fantastic Shyla foreign somebody shot an arrow or someone is forced to shoot an arrow and that Arrow could either be shot into a crowded area where it would perhaps kill and hurt many many people or he could direct it to a place where it will only uh hurt a few people not only is he recommended to divert it to where less people will be heard it's a great Mitzvah to do so actually says the precise case was a talmud of the Nish once reported basically there was a driver who lost control of his in Hebrew you know that language of that foreign language Bill I'm of what are billum of what are the uh what are the the translation of bilamav like the breaks basically you have a driver imagine you know he loses he loses control of his brakes and he's you know he's driving he's crazy he's Galloping out of control so basically and he's headed to a crowded area maybe there's a store and there are a hundred people eating outside of the store and meanwhile the car is is out of control the brakes are failing and he's headed to this crowded area and now he could Veer off the only thing is if he veers off he's gonna hit and kill one person do we say okay look it's not my fault that the the brakes are failing right now it's headed in that direction those people there's a death sentence on them and the guy walking innocently on the other direction Hashem wants him to live I don't have a right I don't have a right to now go kill um you know the the that guy who's walking innocently down the street I'm not heading in that direction in other words uh the question is can I now take into my hands and make a decision to kill somebody in order to save more lives in the khazonish says you need to do it and if you do it you don't need to do chuva that's not called killing someone then they're called killing someone that's cool to have solace in the First Choice you're not intending to kill anyone you're intending to save the lives of perhaps dozens of people so too over here by putting this uh new patient sharing the ventilator you're not trying to hurt the first patient that's the last thing on your agenda you want to help as many people as possible it's unlikely you're going to be hurting the first patient and therefore ravasha y says that is the way to go and that is the correct procedure okay I want to conclude this evening with a very interesting Shayla a that's very relevant to the Corona and uh tomorrow next week will be our grand finale Bezos Hashem is Barack this is the last sheer that is only going to be on Zoom so for all you out there who will not be in the show next week for example I I don't think the Mr Deutsch in Australia will be able to be at this year although you're certainly uh invited next Wednesday we're gonna what I can't even get out of the country to go there to stop my thoughts into Tampa Bay I don't know maybe we could get a special dispensation for this year or something I don't know but um but this time we'll be able to move into the into the show um next Wednesday officially we could fill up a quarter capacity we're taking it slow we're going to have about 25 people in the main sanctuary this week and uh and the ladies section another menu downstairs but uh bezel Hashem of the following Shabbos will be able to expand further the the next Shiloh is um when I had my case which was in a certain way extremely mild because when I when I had an active case of Corona um I had very little fever barely over a hundred but I did lose taste and smell but just for a short amount of time I know some people people in the show were calling me for days they still can't taste they still can't taste they still can't taste I said you know be happy you um you could breathe you know I'll trade with you the breathing for the tasting you know so when my uh when my taste got came back I had a problem with the breathing it's uh it's on the mend but um taste and smell are the telltale signs of the corona and with the fascinating Shyla and this this occurred over pesach and I want to tell you something if you can't taste food eating is just not the same you know forgive the pun but eating has no time you know what I mean so you eat food it all it tastes like dust you like the nachash it's like the curse of the nachash so the question is somebody who can't taste what do you do with the Mitzvah matzah and Mara this week's parachutes yeah so it's like our Shear where we're revisiting pesach what do you do if you can taste the matzah and you can taste the mara can you make a bracha on it is that considered eating is is chewing food you know taking your teeth and just crunching it and and ingesting it without any flavor without any taste I mean that's not eating is that eating can you make a bracha can you make a burger and the question is twofold number one can you make a breakfast and number two can you make a burger can I make a shahako can I make a hamoti I'm not enjoying it what kind of enjoyment is it so without your wise first establishes that inshas in general we find four different categories of unusual types of eating for example number one achilagasa Sonu eats the discussion in Yuma and in yavamus we learn from here um and you're not you'd say the Mitzvah of Iraq however toast is over there brings it down says there's two kinds of when like you know after a Shabbos meal you have no appetite anymore somebody comes after a Shabbos meal oh here you want a bowl of challenge I mean uh I'm I'm finished I'm good I don't I don't want a bowl of talent on the other hand sometimes a person has such a big meal that not only do they have no appetite they're disgusted by food food is is Despicable to them when a person is that full then the eating is not considered eating so in other words when you're full and you're not hungry then if you eat matzah that's not mitso but your yard say the Mitzvah and the Mr Brewer brings us down that someone who eats uh the afikoi men and they're not really in the mood of eating it's not but if someone is so stuffed and they ate so much that they the thought of food is Despicable to them that's not considered Akila that's one category of eating would anybody say that someone who has lost the taste of the sense of taste is not considered eating Donny Rosenthal what would you say you think that's considered eating is that eating somebody who doesn't have taste and smell not my book what do you say not eating stop it's not eating but look you know there's some people they're they're very disciplined they only eat to keep themselves alive so they get the nutrition either way regardless of whether there's food or not there should be uh there should be maybe perhaps considered eating I think there's a difference between a gilagasa where you can't even get it down and someone who he's gonna eat to keep himself going he needs nourishment he just doesn't taste anything then there's a concept of if you wrap up matzah or marar in an inedible object like a fiber so is that's not considered eating because that's what is that analogous to someone who can't taste not really because someone who can't taste he's getting the sensation of chewing he's mixing the food naturally there's nothing interposing between his mouth and the food it's just that it's just that he doesn't get the sensation of taste uh then there's something called that sits on eats with a feeding tube so that's if you eat that on let's say IV IV on Yom Kippur that's uh that one is Potter and some say the concept of is only by Mahala sasurus not by Mitzvahs and then there's another category of eating something that's harmful for you for example if somebody eats vinegar you don't make a bracha because it hurts you would that be analogous to somebody who eats food and can't taste no because someone who can't taste it's not harmful to them it's just they don't have the enjoyment now the mission Brewer says that if the vinegar is not that potent you do have to make a bracha and the charityon even says that if you eat vinegar on your Kippur even though you would technically have to make a bracha on it because if the vinegar is not that strong and potent but you would not be higher for eating on Yom Kippur because Yom Kippur has a higher level requirement of Hana on Yom Kippur it's only not considered fasting if it's yusuva daita in other words someone who eats a Keziah sonium Kipper is still fasting you have to eat a much larger amount of hagasa the bottom line is ravashowai says this is probably most analogous too somebody who eats cooked matzah we know that if you eat matsum evushalas you're not say because you don't get a taste of that matzah ah so we see you have to get a taste says no it's not analogous cooked matzo it's not possible to get a taste it is matzah which is inherently tasteless but what if the matzah is inherently matzah it's just you par your particular set of circumstances doesn't allow you to enjoy it perhaps you would be I'd say in fact says you know what this would be analogous to what if somebody swallows matzah you have a guy he's tasting really good you know um I spoke to a lot of guys they got their taste back how prednisone they took the steroid and in five days 40 milligrams ignore all my medical advice please but five days 40 milligrams a day that does the trick all the senses are sharpened people went from 60 percent taste to 95 percent taste I heard everybody is a chef but let's say a guy who tastes perfectly and swallows matzah what do we see from there you don't have to actually get taste from the matzah what you have to do is you have to it has to be math so that could be tasted that has taste Cesar of ice we learn from the case of Bala matsayatsa that you don't have to be markish the time and therefore if you lose your taste you can make a brachan matzah we know the gemara says that if you swallow Morrow you're not you'd say and the rashbam explains because you need to have a bitter taste in your mouth so says if swallowing Maro you're not say which means you have to be able to taste the bitterness if somebody doesn't have taste you're not your Cinema so he says but you could be michalik because the guy who swallowed the moral did not eat it in a way that taste could be gotten but if someone eats it normally he just happens not to have taste maybe you could make a brother says Russia wise it's a glottasvara it's a good hillock other we cannot definitively say that you're allowed to make a bracha based on asvara in other words the gemara of balam seems to indicate you have to be able to get flavor you have to be able to get taste and even though it could be mahalik maybe that's only because you have to be able to eat it in a way that you could get taste and therefore the bottom line is that when it comes to matzo if you don't have taste you could make when it comes tomorrow if you if you don't have taste you cannot make and what about so that's a major discussion what is the Hana of eating is it the flavor on your taste buds is it the sensation of chewing is it the feeling of satiety in your stomach the bottom line is ravasha wise concludes that if somebody does not taste food is you still make a bracha because the icker enjoyment and benefit of food is the nutritional value provided that it's eaten in a normal way which this person is eating he's chewing it he's salivating his tongue is mixing it and the whole process of ingestion and digestion is is occurring in the normal way he just happens not to be getting an element of the Hana but he would still make a bracha okay so we're going to hold it over here next week will be uh hopefully the grand finale of this subject next week's topic is Hillcrest Zoom the halachic ramifications of this new invention called Zoom you know there was this comic going around you know who's behind uh who's behind Corona is it China is it Italy or is it some mad scientist somewhere so they had a guy pull off the mask of this ghost Corona and who's underneath Zoom the zoom company anyway I both said that would be next week's sure wishing everyone great night let's go what I miss it why um yeah we actually figured out a way to live stream and zoom simultaneously so we could be in the show we could be on all of the different venues there's our sashem you've just experienced another Torah class brought to you by torahanytime.com