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Student-Run Medical Ethics Conference Explores Interplay of Halacha and Medicine in Israel

As Americans across the country debated the ethical, legal and practical ramifications of Obamacare, Yeshiva University’s Student Medical Ethics Society (MES), a student club mentored by YU’s  Center for the Jewish Futue (CJF), looked to the Israeli medical system as the framework for a very different kind of conversation: What does universal health care look likein a country bound by Jewish law?

That question was at the heart of MES’ eighth annual Fuld Family Conference, titled “Prescribing for a Nation: Examining the Interplay of Jewish Law and Israeli Health Care.” The October 20 event explored the ways in which Israeli medical institutions utilize Jewish law to form national policy as well as important ethical and halachik [Jewish legal] questions that emerge from practicing medicine in Israel.

“It’s vital that we remember our connection to Israel and look to it as an example, especially in the complicated realm of medicine, of how halacha and science must work together,” said Chani Herzig, co-president of MES. “As Jews we need to make sure we’re making the right decisions inline with Torah values, and Israel is the perfect model for how to approach that challenge.”

Dr. Jonathan Halevy, director general of Shaare Zedek Medical Center and a key figurein the formation of Israel’s national medical policy, delivered the keynote address, “Jewish Values in the Israeli Health Care System.” His remarks focused on the singular nature of Israel as a Jewish democratic state and public debate about whether these seemingly incongruous identities can coexist, with particularly close analysis of several recently-enacted laws—such as The Dying Patient Law, The Good Samaritan Law and The Brain/Respiration Death Law—based on Jewish values and halacha, which play an important role in the day-to-day practice of Israeli hospitals and itshealth care system.

“I see laws such as The Dying Patient Law as a victory of multiculturalism in Israel,” said Halevy of the 2005 legislation, which allows patients to ask not to be placed on life support if they suffer from an incurable disease and are estimated to have no more than six months to live by two senior physicians. “This law is a magnificent combination of respect for the secular world’s emphasis on the autonomy of the patient with respect for the importance of the sanctity of life to the religious world, while also reflecting the right of the patient not to suffer—and halachik authorities have also confirmed that you are not committed to bring a patient back to a life of endless suffering if it is from an incurable disease.”

Halevy’s talk was followed by a discussion between himself, Rabbi Mordechai Willig, RabbiDr. Sol Roth Professor of Talmud and Contemporary Halacha at YU-affiliated Rabbi Isaac Elchanan Theological Seminary; and Rabbi Kenneth Brander, YU vice president of university and community life and David Mitzner Dean of the CJF, about the unique medical questions that arise in treating a very high concentration of the world’s Jewish population. Rabbi Willig highlighted some of the more challenging issues that arise in a primarily Jewish country but are equally relevant across the Atlantic Ocean, such as beginning of life and fertility concerns as well as transplants, while Halevy spoke about a few ways those issues are handled in Israel.

Another plenary session on Israeli methods of responding to medical crises and terror attacks featured Dr. Mitchel Schwaber, director of the National Center for Infection Control at the Israel Ministry of Health and a staff physician of Israel’s renowned mobile trauma hospital in Haiti; Yitzchak Shalita, member of the Israel Defense Force Search and Rescue Team and a longtime Magen Dovid Adom and ZAKA volunteer; and Rabbi Yosef Blau, seniormashgiach ruchani [spiritual advisor] at YU. The panel was moderated by Dr. Michel Frogel, president-elect of American Physicians and Friends for Medicinein Israel, and detailed the ethical issues encountered in natural disasters and terror strikes, as well as Israeli strategies and measures for dealing with these situations and the religious imperative of Jewish outreach.

“We all need to be proud of what Israel has done in the area of disaster preparedness. Israel doesn’t just absorb disasters, it has become the world leader in preparing for them,” said Frogel, highlighting recent Israeli tactics such as buildingunderground facilities in hospitals, endless drills for a plethora of possible situations, and policies that emphasize moving injured victims to hospitals as quickly as possible rather than treating them at the scene, which is more common in the United States. He also touched upon Israel’s efforts to share these strategies with other countries, including the U.S., where Israeli training inBoston two yearsprior to the BostonMarathon bombing helped streamline local response to the attack and save lives.

However, listing events that included everything from the nuclear leaks in Japan to Hurricane Sandy, Frogel added, “There’s no lack of disasters around the world or need to be prepared for them.”

Rabbi Blau focused on the halachik and hashkafik question of to what extent the Jewish nation owes support and aid to the rest of the world, especially when the need is great at home. Quoting Rabbi Joseph B. Soloveitchik, he said, “We’re part of this broader world and have responsibilities to the welfare of the world, and we also have a unique, distinct identity that we’re not prepared to sacrifice just to be part of the world. But we have to find a way to do both at the same time.” Ultimately, however, Blau said, “If you have compassion, if you care and understand and recognize the needs of others, thatwill be expressed in many different ways. If you live in a world where you’re only caught up in your own identity and your own needs, you won’t have time for anybody, no matter what.”

Recounting his experience in Haiti after the 2002 tsunami, Schwaber spoke about the heartbreaking decisions medical professionals must make on the field when there are not enough personnel, supplies or time to treat everyone requiring care. “We were told to save as many lives as possible,” he said. “But that has a very different meaning in a disaster setting or a field hospital than it does in civilian life. Those who have the most urgent needs are often those who require the greatest expenditures of resources.”

In the afternoon, breakout sessions featuring an assortment of speakers and topics took place. Talks included “Special Ops and Giving Faith a Chance: Understanding the Secret Life of ZAKA International and the Legal Ethics Behind Jewish End-of-Life Rescue,” led by Rabbi Zvi Gluck, chief executive officer of Zaka, and Mark J. Kursmann, a principle at Kurzman Law Offices, P.C.; “Building a Modern Hospital According to Halacha,” led by Halevy; “Solutions for the Future: Solving Infertility and Genetic Challenges in Israel,” led by Rabbi Dovid Fuld; and a continuation of “Responding to Disaster” discussion broken into two parts, one focusing on “The APF: American Physicians; Strengthening Israeli Medical Infrastructure from Across an Ocean,” led by Frogel, and the other focusing on “Haiti: The Extended Story,” led by Schwaber.

“The unique thing about a program like this is that not only does it bring together experts on topics of such critical importance, but it’s all student-run,” said Rabbi Brander. “To have students give of themselves so completely to provide this kind of forum for our community is truly a leadership incubator for our society.”

The annual conference is sponsored through the generous support of Rabbi Dovid and Mrs. Anita Fuld. “It’s a privilege for us to have our small cheilek [share] in the Medical Ethics Society of YU,” said Rabbi Fuld. “The students here are privileged to grow in a medium of chachma [wisdom] and kedushah [holiness] together. This place is a star and has been so for awhile.”

“It was wonderful to watch the participants engage in these issues which are often in the foreground of our homeland but take a backseat herein America,” said Kalman Laufer, co-president of MES. “Today we examine halachaas it pertains to the medical issues Israel faces in a very real way.”

“I’m so impressed by everything the students run here and the topics are so fantastic,” said Debbie Ross, a nurse currently working in clinical informatics at Holy Name Medical Center in Teaneck, NJ. Recalling how the hospital had consulted with Shaare Tzedek before buildingits new emergency room, Ross said that she found the Medical Ethics conferences especially helpful because she was often asked to explain halachik issues regarding Jewish patients at work. “I’m here to see what else I can learn,” she said.

All conference sessions are available online at YUTorah.org.